David P. Newman, Adam T. Soto
Sacroiliac joint dysfunction is a common cause of low back pain. A set of provocation tests that together have high sensitivity and specificity can help differentiate sacroiliac joint dysfunction from other causes of back and lower extremity pain. Manipulation combined with...
Brian Ford, Sebastian Lara, James Park
The lifetime incidence of murmurs in children is high. The presence of a murmur can indicate conditions ranging from no discernable pathology to acquired or congenital heart disease. All infants, with or without a murmur, should have pulse oximetry screening to detect...
Stephen D. Cagle, Jr., Brett L. Hutcherson, Anna T. Wiley
Health care–associated infections are a significant cause of morbidity and mortality in the United States; common examples include catheter-associated urinary tract infections, central line–associated bloodstream infections, ventilator-associated pneumonia, surgical site...
Drew C. Baird, Stuart H. Batten, Steven K. Sparks
This rapid evidence review details screening, diagnostic testing, and treatment options for alpha- and beta-thalassemia, including indications for transfusion therapy, iron chelation therapy, and hematopoietic stem cell transplantation. Common complications from thalassemia...
Rashmi S. Mullur, Joseph S. Hsiao, Khristina Mueller
Telemedicine can be useful for the management of diabetes mellitus. Remote monitoring of glucose levels improves A1C levels in people with poor glucose control. When multiple daily injections of insulin are required, continuous glucose monitoring improves glycemic control and...
Jarrett Sell, Sarah Ramirez, Michael Partin
Parathyroid disorders are usually identified incidentally by abnormalities in serum calcium levels. They can be primary or secondary and treated with surgery or medical management. Initial laboratory testing can be used to identify potential etiologies of parathyroid...
Sam Longfellow, Jason Zhang
A three-year-old boy presented with hair loss that started as a small patch on the back of his head and worsened over the last two months.
Clota Snow, Sara Heard, Jonathan Karnes, Gabrielle Harpell
An infant presented with a rash that first appeared on her chin and then spread to the diaper area, limbs, and chest.
Pamela G. Rockwell
The 2022 adult and child/adolescent immunization schedules have been approved by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. These schedules now combine links to COVID-19 vaccination information, Vaccination Information...
Caitlyn de Kanter, Sukhamani Dhaliwal, Matthew Hawks
The American College of Gastroenterology released updated guidelines for CRC screening.
Eliminating the use of low-value care (interventions for which harms typically exceed benefits) in children is crucial.
Incidental findings on imaging studies and laboratory can lead to office visits, invasive tests, hospitalizations, and new diagnoses. These cascades of care will become even more common as imaging tests gain sensitivity.
Jacob M. Appel
Many patients have personal preferences regarding their choice of physicians. These may include personal factors such as the physician’s race, ethnicity, religion, gender, sexual orientation, or age. These patient preferences, and requests to accommodate them, occur on a...
Keri Sewell, Afi M. Semenya
Plenity, in combination with moderate calorie restriction, may be an effective option for adults wishing to lose weight, at least in the short term. However, as a medical device, Plenity has not been held to the same standard of testing as would be expected with medications.
Jedda Rupert, Anne Mounsey
Mobile phone–based interventions improve adherence to cardiovascular medication regimens and may improve blood pressure control, but there is no patient-oriented evidence that these interventions are beneficial.
Azithromycin (Zithromax) is the most consistently studied antibiotic for use in treating patients infected with the SARS-CoV-2 virus; it does not improve mortality after 28 days or affect the clinical course for hospitalized adults with COVID-19. In outpatient adults with...
Matthew Schefft, Elizabeth R. Wolf, Ricardo Quinonez, Helen Haskell, John James
A collaboration between AFP and the Lown Institute promotes a vision of delivering health care that is based on the evidence, balanced in its approach, and focused on the patient.
Jason W. Deck, Lamont Cavanagh, Christopher Crane, Franklin T. Perkins, III, Christopher Jarrett, Toni Hoberecht
The type of cast used does not appear to impact outcomes. A short arm cast allows the patient to have better function and mobility during immobilization without compromising the healing process. Thumb spica casts are no better than casts that do not include the thumb in...
Henry C. Barry
This study suggests that listening to music, especially sedative music, can improve sleep quality in older adults, but the underlying data are limited and of mixed quality.
Allen F. Shaughnessy
There is considerable uncertainty, which is reflected in the disparate guidelines, about whether screening for depression is helpful to patients (rather than a way to label them as being depressed or not). Most of the positive scores on the Patient Health Questionnaire-9 tool...
Allen F. Shaughnessy
Using a cutoff of 3% risk (from The National Institute for Health and Care Excellence), dysphagia or changes in bowel habits in men and rectal bleeding in women should trigger referral for further workup to exclude cancer or inflammatory bowel disease (IBD). Symptoms such as...
Mark H. Ebell
For older adults who have a history or are at risk of stroke, the use of a salt substitute safely reduces their risk of death or stroke.
UCH-L1 and GFAP are serum markers that may be used to reduce the need for head CT after mild TBI. However, there are no studies on the incorporation of these markers into existing head CT clinical decision rules or that describe the optimal use of the i-STAT TBI Plasma test...
The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride and apply fluoride varnish to the primary teeth of all infants and children starting at the age of...
Brit Long, Michael Gottlieb
Learn more about azithromycin for treatment of COVID-19.
Sheena Harris, Wigdan Farah, Christopher Snitchler
Case study: Hispanic parents who are new to your practice bring in their two children, two years of age and four months of age, for routine wellness visits. Neither child has any known chronic medical conditions, and both are current on routine immunizations. The four-month...
Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.
Stephen M. Young, Aaron Saguil
Is it possible to predict the likelihood of bacterial meningitis in children with clinically suspected meningitis?
Sacroiliac (sa-krow-i-lee-ak) joint dysfunction is a type of low back pain. Pain is felt along the buttocks (see Photo 1) on one side or both sides, but not in the center. The pain can be felt (see Photo 2) up along the back muscles (red arrow), down along the back of the...
A heart murmur is a noise that comes from the blood flowing through the heart. The doctor can hear it with a stethoscope. Most of the time, a murmur is just the sound of normal blood flow and it will go away over time. Once in a while, murmurs come from problems inside the...
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