Constipation in Children and Adolescents: Evaluation and Treatment

Elie Mulhem, Faiza Khondoker, Sanjiv Kandiah

The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Functional constipation is the most common type in children and can usually be diagnosed with a comprehensive history and physical examination, which should exclude red...

Tendinopathies of the Foot and Ankle

Rajwinder S. Deu, Alexis M. Coslick, Geoffrey Dreher

This article reviews the diagnosis and treatment of posterior tibial, peroneal, and tibialis anterior tendinopathies.

Lung Cancer: Diagnosis, Treatment Principles, and Screening

Jeffrey Kim, Hobart Lee, Brian W. Huang

Lung cancer is the second most common cancer in men and women in the United States, and it remains the leading cause of cancer-related death in the United States and worldwide. The most common but nonspecific symptom of lung cancer is a cough.

Evaluation After a First Seizure in Adults

Kate Rowland, Carl Earl Lambert, Jr.

The evaluation of a patient with a first seizure should focus on identifying underlying provoking factors such as brain injury, metabolic derangement, or certain medications. The decision to start anti-seizure medication is based on assessment of the patient's risk of seizure...

Sexually Transmitted Infections: Updates From the 2021 CDC Guidelines

Jessica Dalby, Bradley P. Stoner

The 2021 Centers for Disease Control and Prevention (CDC) sexually transmitted infection (STI) guidelines provide updated recommendations. Family physicians can reduce STIs by taking a thorough sexual history, ordering screening tests and treatment based on the CDC guidelines...

Child Abuse: Approach and Management

Elizabeth A. Suniega, Lauren Krenek, Gabriel Stewart

Child abuse and maltreatment can include neglect and emotional, physical, and sexual abuse. Physicians should be aware of risk factors and signs of potential abuse and mindful of providing trauma-informed care. A comprehensive list of resources is provided in an online table.

The Case for Supervised Injection Sites in the United States

Jorge Finke, Jie Chan

As the opioid epidemic continues, a movement advocating for medically supervised injection sites in U.S. cities is growing. Family physicians should be knowledgeable about their potential impacts.

Credentialing Family Physicians Who Provide Maternity Care

Michael Loeven

Without national standards of credentialing based on competency, family physicians who provide obstetric care may struggle to obtain hospital privileges.

Diabetes, Vocal Cord Dysfunction, Periodontal Disease, Light Therapy, Septic Arthritis, Dental Cleanings, Pneumonia in Children

What is the preferred medication for diabetes mellitus management in patients with end-stage renal disease? | What tests are performed in the diagnostic workup for vocal cord dysfunction? | Does periodontal disease contribute to the development of other diseases? | Does light...

Reduced Dietary Salt for Patients With Chronic Kidney Disease

Madhavi Singh, Kiyomi Goto, Jeffery Wisinski

In patients with chronic kidney disease (CKD), reducing dietary salt intake by approximately 4.2 g per day lowers mean systolic blood pressure by 6.9 mm Hg and diastolic blood pressure by 3.9 mm Hg compared with patients on a higher salt diet. In patients with CKD who do not...

Kinesiology Taping for Rotator Cuff Disease

Jeffrey C. Leggit, Alan L. Williams

Kinesiology taping for adults with rotator cuff disease has little to no benefit compared with sham taping or conservative (i.e., nonsurgical) therapy.

Physical Activity and the Health of Wheelchair Users

Ruben Salinas, Jr., Aaron Saguil

What are the benefits of physical activity in patients with multiple sclerosis (MS), cerebral palsy, and spinal cord injury who use or are at risk of using wheelchairs?

Does Performing Dating Ultrasonography Before a First-Trimester Uterine Evacuation Improve Outcomes or Safety?

Emily Rose Bainwol, Brianna Grinnell, Anh-Chi Do, Jon O. Neher, Sarah Safranek

Routine use of ultrasonography before a first-trimester abortion is not necessary. In patients seeking medical or surgical abortion in the first trimester, date of the last menstrual period (LMP) alone can appropriately determine gestational age for treatment (before 63 to 90...

MyProstateScore for Predicting High-Grade Prostate Cancer

Sarah M. Balloga, Jennifer G. Chang

MyProstateScore (MPS; also referred to as Michigan Prostate Score) is a promising tool for the detection of clinically significant prostate cancer and has been validated for determining the necessity of a prostate biopsy in select individuals. It has not been studied as a...

Vaccination Disagreement Between Parents

James Giordano

In addressing this case, it is important to note that the dissenting parent (the mother) has not informed the family physician that she adamantly opposes giving the vaccine; this opposition would provide explicit proscription. Importantly, in a legal context, a parent (the...

A Diffuse Nodular Eruption

Joy Shen-Wagner, Amanda Alldredge, Kian Lari

A 40-year-old man presented with erythematous, raised, painful nodules across his trunk, back, arms, and legs and unintended weight loss.

Jammed Finger in High School Football Player

Daniel Warden, Nicholas Moore, Kyle Samyn

A 16-year-old football player presented after a game with pain and deformity of his left ring finger.

Sexually Transmitted Infections: Updated Guideline From the CDC

David A. Klein, Christina R. Valerio, Zari N. Cofield

The Centers for Disease Control and Prevention released updated recommendations for management of sexually transmitted infections.

Psoriasis: Update on Topical Therapy From the American Academy of Dermatology

Alex M. Shreiber, Eileen Friery

The American Academy of Dermatology and National Psoriasis Foundation updated their recommendations on topical therapies for patients with mild to moderate psoriasis.

Nirmatrelvir/Ritonavir Reduces Risk of Hospitalization in At-Risk Outpatients

Mark H. Ebell

Nirmatrelvir/ritonavir significantly reduces the likelihood of hospitalization or death in unvaccinated adults with confirmed COVID-19 who are at risk of a more severe course of disease.

Ibuprofen, Ketorolac, and Diclofenac Are Equivalent for the Treatment of Acute, Nonradicular Low Back Pain

David C. Slawson

This study found no differences among ibuprofen, ketorolac, and diclofenac in the primary outcome of overall clinical improvement at five days in adults presenting to the emergency department with acute, nonradicular low back pain. Some of the secondary outcomes favored...

Dual Antiplatelet Therapy With Aspirin Plus Clopidogrel for 30 Days Is the Best Option After Minor Stroke or TIA

Mark H. Ebell

For patients with minor stroke or transient ischemic attack, dual antiplatelet therapy with aspirin plus clopidogrel for up to 30 days reduces the likelihood of subsequent stroke more than aspirin monotherapy, with a small increase in the risk of major hemorrhage. A longer...

Amoxicillin for Children With CAP: Low-Dose for Three Days Is Noninferior to High-Dose for Seven Days

David C. Slawson

In children with community-acquired pneumonia who are discharged from an emergency department or inpatient setting within 48 hours, a lower dose of oral amoxicillin is noninferior to a higher dose, and three days of treatment is noninferior to seven days in reducing the need...

Upright Walkers as Mobility Assistive Devices for Older Adults

USPSTF Recommendations for the Management of Dyslipidemia for Cardiovascular Risk Reduction

Lung Cancer

Lung cancer is a tumor on your lung. It can make you cough, be short of breath, have chest pain, and cough up blood. As the cancer gets worse or spreads, you may not want to eat as much as normal, and you may lose weight, lose your energy, and become weak.

Seizures in Adults: What You Should Know

A seizure (SEE-zhure) is typically a sudden, unexpected disruption of your normal brain activity. It can make your body jerk or shake. You might repeat movements like smacking your lips or grinding your teeth. Sometimes people pass out or stare into space during a seizure....