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Abnormal Uterine Bleeding in Premenopausal Women - American Family Physician

Apr 1, 2019 - Abnormal uterine bleeding is a common symptom in women. The acronym PALM-COEIN facilitates classification, with PALM referring to structural etiologies (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia), and COEIN referring to nonstructural etiologies (coagulopathy, ovulatory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p435.html

Acne Vulgaris: Diagnosis and Treatment - American Family Physician

Oct 15, 2019 - Acne vulgaris is the most prevalent chronic skin disease in the United States, affecting nearly 50 million people per year, mostly adolescents and young adults. Potential sequelae of acne, such as scarring, dyspigmentation, and low self-esteem, may result in significant morbidity. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1015/p475.html

Acupuncture for Pain - American Family Physician

Jul 15, 2019 - Acupuncture has been increasingly used as an integrative or complementary therapy for pain. It is well-tolerated with little risk of serious adverse effects. Traditional acupuncture and nontraditional techniques, such as electroacupuncture and dry needling, often result in reported pain...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p89.html

Acute Hand Infections - American Family Physician

Feb 15, 2019 - Acute hand infections are often caused by puncture wounds and are generally classified into superficial or deep infections. Superficial infections occur in the skin and subcutaneous tissues, whereas deep infections can involve the tendon sheaths, adjacent anatomic compartments, deep ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p228.html

Acute Kidney Injury: Diagnosis and Management - American Family Physician Restricted content. Login required.

Dec 1, 2019 - Acute kidney injury is a clinical syndrome characterized by a rapid decline in glomerular filtration rate and resultant accumulation of metabolic waste products. Acute kidney injury is associated with an increased risk of mortality, cardiovascular events, and progression to chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p687.html

Acute Lower Gastrointestinal Bleeding: Evaluation and Management - American Family ... Restricted content. Login required.

Feb 15, 2020 - Evaluation and management of acute lower gastrointestinal bleeding focus on etiologies originating distally to the ligament of Treitz. Diverticular disease is the most common source, accounting for 40% of cases. Hemorrhoids, angiodysplasia, infectious colitis, and inflammatory bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p206.html

Acute Pyelonephritis in Adults: Rapid Evidence Review - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Acute pyelonephritis is a bacterial infection of the kidney and renal pelvis and should be suspected in patients with flank pain and laboratory evidence of urinary tract infection. Urine culture with antimicrobial susceptibility testing should be performed in all patients and used to ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p173.html

Acute Respiratory Distress Syndrome: Diagnosis and Management - American Family Physician

Jun 15, 2020 - Acute respiratory distress syndrome (ARDS) is noncardiogenic pulmonary edema that manifests as rapidly progressive dyspnea, tachypnea, and hypoxemia. Diagnostic criteria include onset within one week of a known insult or new or worsening respiratory symptoms, profound hypoxemia, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p730.html

ADHD in Children: Common Questions and Answers - American Family Physician Restricted content. Login required.

Nov 15, 2020 - Attention-deficit/hyperactivity disorder (ADHD) is a multidimensional chronic neurodevelopmental condition that affects 8.4% of U.S. children between two and 17 years of age and may pose long-term morbidity if untreated. The evaluation for ADHD begins when parents or caregivers present ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1115/p592.html

Adhesive Capsulitis: Diagnosis and Management - American Family Physician

Mar 1, 2019 - Adhesive capsulitis, also known as frozen shoulder, is a common shoulder condition characterized by pain and decreased range of motion, especially in external rotation. Adhesive capsulitis is predominantly an idiopathic condition and has an increased prevalence in patients with diabetes...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p297.html

Adolescent Idiopathic Scoliosis: Common Questions and Answers - American Family Physician Restricted content. Login required.

Jan 1, 2020 - Adolescent idiopathic scoliosis affects 1% to 3% of U.S. adolescents. It is defined by a lateral curvature of the spine (Cobb angle) of at least 10 degrees in the absence of underlying congenital or neuromuscular abnormalities. Adolescent idiopathic scoliosis may be detected via the ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p19.html

Adolescent Substance Use and Misuse: Recognition and Management - American Family ...

Jun 1, 2019 - Adolescent use of illicit substances imposes an enormous burden on individuals, families, and communities. The types of illicit substances adolescents are using have changed drastically over the past decade with decreases in alcohol use (including binge alcohol use) offset by increases ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p689.html

Amblyopia: Detection and Treatment - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Amblyopia is the leading cause of monocular vision loss in children. Early recognition and treatment are important to prevent vision loss. The U.S. Preventive Services Task Force recommends vision screening for all children at least once between three and five years of age to detect the...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p745.html

Amenorrhea: A Systematic Approach to Diagnosis and Management - American Family Physician

Jul 1, 2019 - Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p39.html

Anaphylaxis: Recognition and Management - American Family Physician Restricted content. Login required.

Sep 15, 2020 - Anaphylaxis is a life-threatening systemic reaction, normally occurring within one to two hours of exposure to an allergen. The incidence of anaphylaxis in the United States is 2.1 per 1,000 person-years. Most anaphylactic reactions occur outside the hospital setting. Urticaria, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0915/p355.html

Anticoagulation: Updated Guidelines for Outpatient Management - American Family Physician

Oct 1, 2019 - Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p426.html

Apophysitis and Osteochondrosis: Common Causes of Pain in Growing Bones - American ...

May 15, 2019 - Apophysitis and osteochondrosis are common causes of pain in growing bones but have differing etiologies and required management. Apophysitis results from a traction injury to the cartilage and bony attachment of tendons in children and adolescents. Most often it is an overuse injury in...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p610.html

Asymptomatic Bacteriuria - American Family Physician Restricted content. Login required.

Jul 15, 2020 - Asymptomatic bacteriuria, defined as the presence of bacteria in the urine in the absence of urinary symptoms, is a common clinical finding that often warrants a decision about whether to initiate antimicrobial therapy. There are few indications to treat asymptomatic bacteriuria, and ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0715/p99.html

Atopic Dermatitis: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

May 15, 2020 - Atopic dermatitis (atopic eczema) is a chronic relapsing and remitting inflammatory skin disease affecting one in 10 people in their lifetime. Atopic dermatitis is caused by a complex interaction of immune dysregulation, epidermal gene mutations, and environmental factors that disrupts ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0515/p590.html

Back Pain in Children and Adolescents - American Family Physician Restricted content. Login required.

Jul 1, 2020 - Back pain is a relatively common presenting symptom in children and adolescents. Typical causes include muscle strain or spasm, spinal deformities (e.g., Scheuermann kyphosis, adolescent idiopathic scoliosis), spondylolysis, bulging or herniated intervertebral disks, apophysitis of the ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p19.html

Bartholin Duct Cyst and Gland Abscess: Office Management - American Family Physician

Jun 15, 2019 - The Bartholin glands, located in the base of the labia minora, have a role in vaginal lubrication. Because of the presence of other glands, removal of a Bartholin gland does not affect lubrication. Ductal blockage of these typically pea-sized structures can result in enlargement of the ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p760.html

Basal Cell and Cutaneous Squamous Cell Carcinomas: Diagnosis and Treatment - American ... Restricted content. Login required.

Sep 15, 2020 - Keratinocyte carcinoma, traditionally referred to as nonmelanoma skin cancer, includes basal cell and cutaneous squamous cell carcinoma and is the most common skin cancer malignancy found in humans. The U.S. Preventive Services Task Force recommends counseling about minimizing exposure ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0915/p339.html

Benign Anorectal Conditions: Evaluation and Management - American Family Physician Restricted content. Login required.

Jan 1, 2020 - Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p24.html

Blood Product Transfusion in Adults: Indications, Adverse Reactions, and Modifications ... Restricted content. Login required.

Jul 1, 2020 - Millions of units of blood products are transfused annually to patients in the United States. Red blood cells are transfused to improve oxygen-carrying capacity in patients with or at high risk of developing symptomatic anemia. Restrictive transfusion thresholds with lower hemoglobin ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p30.html

Care of the Military Veteran: Selected Health Issues - American Family Physician

Nov 1, 2019 - According to the U.S. Census Bureau, 18.2 million veterans were living in the United States in 2017, of whom 1.6 million were female. Less than one-half of all veterans receive care at a Veterans Health Administration or military treatment facility, leaving most to receive services from...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p544.html

Caregiver Care - American Family Physician

Jun 1, 2019 - Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p699.html

Caring for Transgender and Gender-Diverse Persons: What Clinicians Should Know - ...

Dec 1, 2018 - Persons whose experienced or expressed gender differs from their sex assigned at birth may identify as transgender. Transgender and gender-diverse persons may have gender dysphoria (i.e., distress related to this incongruence) and often face substantial health care disparities and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p645.html

Cerebral Palsy: An Overview - American Family Physician Restricted content. Login required.

Feb 15, 2020 - Cerebral palsy, which occurs in two to three out of 1,000 live births, has multiple etiologies resulting in brain injury that affects movement, posture, and balance. The movement disorders associated with cerebral palsy are categorized as spasticity, dyskinesia, ataxia, or mixed/other. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p213.html

Cervical Colposcopy: Indications and Risk Assessment - American Family Physician Restricted content. Login required.

Jul 1, 2020 - The practice of colposcopy, a diagnostic procedure to evaluate for vaginal, vulvar, and cervical dysplasia, has evolved to incorporate patient risk factors for high-grade cervical intraepithelial neoplasia (CIN) and cancer. Changes in cervical cancer screening and guidelines, human ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p39.html

Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

Apr 15, 2020 - Chronic diarrhea is defined as a predominantly loose stool lasting longer than four weeks. A patient history and physical examination with a complete blood count, C-reactive protein, anti-tissue transglutaminase immunoglobulin A (IgA), total IgA, and a basic metabolic panel are useful ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p472.html

Chronic Dyspnea: Diagnosis and Evaluation - American Family Physician Restricted content. Login required.

May 1, 2020 - Dyspnea is a symptom arising from a complex interplay of diseases and physiologic states and is commonly encountered in primary care. It is considered chronic if present for more than one month. As a symptom, dyspnea is a predictor for all-cause mortality. The likeliest causes of ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p542.html

Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments - American ... Restricted content. Login required.

Oct 15, 2020 - Chronic low back pain, neck pain, hip and knee osteoarthritis, and fibromyalgia are the most common types of chronic musculoskeletal pain. Because no individual therapy has consistent benefit, a multimodal treatment approach to chronic musculoskeletal pain is recommended. Many ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1015/p465.html

Chronic Wounds: Evaluation and Management - American Family Physician Restricted content. Login required.

Feb 1, 2020 - Chronic wounds are those that do not progress through a normal, orderly, and timely sequence of repair. They are common and are often incorrectly treated. The morbidity and associated costs of chronic wounds highlight the need to implement wound prevention and treatment guidelines. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p159.html

Cirrhosis: Diagnosis and Management - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Cirrhosis is the 12th leading cause of death in the United States. Newer research has established that liver fibrosis is a dynamic process and that early cirrhosis may be reversible. Only one in three people with cirrhosis knows they have it. Most patients with cirrhosis remain ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p759.html

Clinically Relevant Drug-Drug Interactions in Primary Care - American Family Physician

May 1, 2019 - Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p558.html

Clostridioides difficile Infection: Update on Management - American Family Physician Restricted content. Login required.

Feb 1, 2020 - Guidelines for the diagnosis and treatment of Clostridioides difficile infection have recently been updated. Risk factors include recent exposure to health care facilities or antibiotics, especially clindamycin. C. difficile infection is characterized by a wide range of symptoms, from ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p168.html

Coccidioidomycosis (Valley Fever) in Primary Care - American Family Physician Restricted content. Login required.

Feb 15, 2020 - Primary pulmonary coccidioidomycosis (valley fever) is caused by inhaling airborne spores of the fungus Coccidioides immitis or Coccidioides posadasii. Residing in or traveling to areas endemic for Coccidioides is required for the diagnosis; no person-to-person or zoonotic contagion ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p221.html

Common Benign Chronic Vulvar Disorders - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Genitourinary syndrome of menopause results from the hypoestrogenic state that leads to ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1101/p550.html

Common Breast Problems - American Family Physician

Apr 15, 2019 - Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p505.html

Counseling Patients in Primary Care: Evidence-Based Strategies - American Family Physician

Dec 15, 2018 - Family physicians spend substantial time counseling patients with psychiatric conditions, unhealthy behaviors, and medical adherence issues. Maintaining efficiency while providing counseling is a major challenge. There are several effective, structured counseling strategies developed ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p719.html

Crohn's Disease: Diagnosis and Management - American Family Physician

Dec 1, 2018 - Crohn’s disease is a chronic inflammatory condition that affects the gastrointestinal tract. It can cause lesions from mouth to anus and may result in extraintestinal complications. The prevalence of Crohn’s disease is increasing in adults and children. Genetic predispositions to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p661.html

Current Concepts in Concussion: Initial Evaluation and Management - American Family ...

Apr 1, 2019 - Mild traumatic brain injury, also known as concussion, is common in adults and youth and is a major health concern. Concussion is caused by direct or indirect external trauma to the head resulting in shear stress to brain tissue from rotational or angular forces. Concussion can affect a...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p426.html

Cutaneous Cryosurgery for Common Skin Conditions - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Cryosurgery is the application of freezing temperatures to achieve the destruction of tissue. Cutaneous cryosurgery has become a commonly performed outpatient procedure because of the combination of its safety, effectiveness, low cost, ease of use, lack of need for injectable ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p399.html

Dental Problems in Primary Care - American Family Physician

Dec 1, 2018 - Oral health directly affects overall health and quality of life. More Americans lack dental insurance than medical insurance. Patients with poor oral health are more likely to have respiratory and cardiovascular diseases, adverse pregnancy outcomes, and diabetes mellitus. Early ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p654.html

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation - American...

May 15, 2019 - Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p620.html

Depression in Children and Adolescents: Evaluation and Treatment - American Family ...

Nov 15, 2019 - The prevalence of major unipolar depression in children and adolescents is increasing in the United States. In 2016, approximately 5% of 12-year-olds and 17% of 17-year-olds reported experiencing a major depressive episode in the previous 12 months. Screening for depression in ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p609.html

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.html

Ectopic Pregnancy: Diagnosis and Management - American Family Physician Restricted content. Login required.

May 15, 2020 - Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic...

American Family Physician : Article

https://www.aafp.org/afp/2020/0515/p599.html

Electronic Cigarettes: Common Questions and Answers - American Family Physician

Aug 15, 2019 - Electronic cigarettes (e-cigarettes) are popular devices designed to heat a liquid solution, often containing nicotine, that generates an inhaled aerosol, or vapor. e-Cigarettes have been marketed as healthier alternatives to traditional cigarettes. Thus, most adult users are current or...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p227.html

Endometrial Biopsy: Tips and Pitfalls - American Family Physician Restricted content. Login required.

May 1, 2020 - Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p551.html

Erythema Multiforme: Recognition and Management - American Family Physician

Jul 15, 2019 - Erythema multiforme is an immune-mediated reaction that involves the skin and sometimes the mucosa. Classically described as target-like, the erythema multiforme lesions can be isolated, recurrent, or persistent. Most commonly, the lesions of erythema multiforme present symmetrically on...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p82.html

Esophageal Motility Disorders - American Family Physician Restricted content. Login required.

Sep 1, 2020 - Esophageal motility disorders can cause chest pain, heartburn, or dysphagia. They are diagnosed based on specific patterns seen on esophageal manometry, ranging from the complete absence of contractility in patients with achalasia to unusually forceful or disordered contractions in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0901/p291.html

Eye Emergencies - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Central retinal artery occlusions, chemical injuries, mechanical globe injuries, and retinal detachments are eye emergencies that can result in permanent vision loss if not treated urgently. Family physicians should be able to recognize the signs and symptoms of each condition and be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1101/p539.html

Febrile Seizures: Risks, Evaluation, and Prognosis - American Family Physician

Apr 1, 2019 - A febrile seizure is a seizure occurring in a child six months to five years of age that is accompanied by a fever (100.4°F or greater) without central nervous system infection. Febrile seizures are classified as simple or complex. A complex seizure lasts 15 minutes or more, is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p445.html

Fetal Aneuploidy: Screening and Diagnostic Testing - American Family Physician Restricted content. Login required.

Apr 15, 2020 - Aneuploidy is the presence of one or more extra chromosomes or the absence of one or more chromosomes. The risk of fetal aneuploidy rises with increasing maternal age. Because fetal aneuploidy can affect any pregnancy, all pregnant women should be offered screening. First-trimester ...

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https://www.aafp.org/afp/2020/0415/p481.html

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.html

Foreign Bodies in the Skin: Evaluation and Management - American Family Physician Restricted content. Login required.

Jun 15, 2020 - Foreign bodies may be introduced into the skin through lacerations and soft tissue wounds. Long-term complications of retained foreign bodies include chronic pain and neurovascular impairment. Wound exploration and initial imaging with radiography or ultrasonography should be considered...

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https://www.aafp.org/afp/2020/0615/p740.html

Frequent Headaches: Evaluation and Management - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Most frequent headaches are typically migraine or tension-type headaches and are often exacerbated by medication overuse. Repeated headaches can induce central sensitization and transformation to chronic headaches that are intractable, are difficult to treat, and cause significant ...

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https://www.aafp.org/afp/2020/0401/p419.html

Functional Dyspepsia: Evaluation and Management - American Family Physician Restricted content. Login required.

Jan 15, 2020 - Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. Symptoms of functional dyspepsia include postprandial fullness, early satiety, and epigastric pain or...

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https://www.aafp.org/afp/2020/0115/p84.html

Gas, Bloating, and Belching: Approach to Evaluation and Management - American Family ...

Mar 1, 2019 - Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. An ...

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https://www.aafp.org/afp/2019/0301/p301.html

Gastroenteritis in Children - American Family Physician

Feb 1, 2019 - Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p159.html

Genital Ulcers: Differential Diagnosis and Management - American Family Physician Restricted content. Login required.

Mar 15, 2020 - Genital ulcers may be located on the vagina, penis, and anorectal or perineal areas and may be infectious or noninfectious. Herpes simplex virus is the most common cause of genital ulcers in the United States. A diagnosis of genital herpes simplex virus infection is made through ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p355.html

Gout: Rapid Evidence Review - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Gout is caused by monosodium urate crystal deposition in joints and tissues. Risk factors include male sex; obesity; hypertension; alcohol intake; diuretic use; a diet rich in meat and seafood; chronic kidney disease; a diet heavy in fructose-rich food and beverages; being a member of ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1101/p533.html

Hand-Foot-and-Mouth Disease: Rapid Evidence Review - American Family Physician

Oct 1, 2019 - Hand-foot-and-mouth disease is caused by human enteroviruses and coxsackieviruses. Outbreaks can occur in the spring to fall and are common in North America, and most cases occur in patients younger than 10 years. Hand-foot-and-mouth disease is transmitted by fecal-oral, oral-oral, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p408.html

Health Maintenance in School-Aged Children: Part I. History, Physical Examination, ...

Aug 15, 2019 - The goals of the health maintenance visit in school-aged children (five to 12 years) are promoting health, detecting disease, and counseling to prevent injury and future health problems. During the visit, the physician should address patient and parent/caregiver concerns and ask about ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p213.html

Health Maintenance in School-Aged Children: Part II. Counseling Recommendations - ...

Aug 15, 2019 - School-aged children (five to 12 years) are establishing patterns of behavior that may last a lifetime; therefore, during health maintenance visits, it is important to counsel families on healthy lifestyle practices. Children should eat a diet high in fruits, vegetables, whole grains, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p219.html

Hearing Loss in Adults: Differential Diagnosis and Treatment - American Family Physician

Jul 15, 2019 - More than 30 million U.S. adults have hearing loss. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. Hearing loss is categorized as conductive, sensorineural, or mixed. Age-related sensorineural hearing loss (i.e., ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p98.html

Heat-Related Illnesses - American Family Physician

Apr 15, 2019 - Heat-related illnesses comprise a spectrum of syndromes resulting from disruption of thermoregulation in people exposed to high environmental heat. Symptoms range from heat edema and exercise-associated muscle cramps to exercise-associated collapse, heat exhaustion, and life-threatening...

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https://www.aafp.org/afp/2019/0415/p482.html

Henoch-Schönlein Purpura (IgA Vasculitis): Rapid Evidence Review - American Family ... Restricted content. Login required.

Aug 15, 2020 - Henoch-Schönlein purpura, now called immunoglobulin A (IgA) vasculitis, is a systemic, immune complex–mediated, small-vessel leukocytoclastic vasculitis characterized by nonthrombocytopenic palpable purpura, arthritis, and abdominal pain. It is the most common vasculitis in children but...

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https://www.aafp.org/afp/2020/0815/p229.html

Hepatitis B: Screening, Prevention, Diagnosis, and Treatment - American Family Physician

Mar 1, 2019 - Hepatitis B virus (HBV) is a partly double-stranded DNA virus that causes acute and chronic liver infection. Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Hepatitis B vaccination ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p314.html

Hidradenitis Suppurativa: Rapid Evidence Review - American Family Physician

Nov 1, 2019 - Hidradenitis suppurativa is a chronic folliculitis affecting intertriginous areas. Onset generally occurs in young adulthood to middle adulthood (18 to 39 years of age). Females and blacks are more than twice as likely to be affected. Additional risk factors include family history, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p562.html

Hirsutism in Women - American Family Physician

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.html

House Calls - American Family Physician Restricted content. Login required.

Aug 15, 2020 - The demand for house calls is increasing because of the aging U.S. population, an increase in patients who are homebound, and the acknowledgment of the value of house calls by the public and health care industry. Literature from current U.S. home-based primary care programs describes ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p211.html

Hypothermia and Cold Weather Injuries - American Family Physician Restricted content. Login required.

Dec 1, 2019 - Hypothermia, frostbite, and nonfreezing cold injuries predominantly affect older adults, homeless or intoxicated people, adventurers, and military personnel. Prevention begins with clothing that is clean, layered, and loose to promote circulation. Base layers made of moisture-wicking ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p680.html

Inborn Errors of Metabolism: From Preconception to Adulthood - American Family Physician

Jan 1, 2019 - Inborn errors of metabolism (IEM), although individually rare, occur in 1 out of every 1,500 births. The first opportunity to detect IEM occurs during preconception counseling, when pregnant women and couples considering future pregnancies can undergo carrier screening. For individuals ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p25.html

Influenza: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Influenza is an acute viral respiratory infection that causes significant morbidity and mortality worldwide. Three types of influenza cause disease in humans. Influenza A is the type most responsible for causing pandemics because of its high susceptibility to antigenic variation. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p751.html

Ingrown Toenail Management - American Family Physician

Aug 1, 2019 - Ingrown toenails account for approximately 20% of foot problems in primary care. The great toe is most often affected. Ingrown toenails occur most commonly in young men, and nail care habits and footwear are most often contributory factors. No consensus has been reached for the best ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p158.html

Inguinal Hernias: Diagnosis and Management - American Family Physician Restricted content. Login required.

Oct 15, 2020 - Groin hernias are caused by a defect of the abdominal wall in the groin area and comprise inguinal and femoral hernias. Inguinal hernias are more common in men. Although groin hernias are easily diagnosed on physical examination in men, ultrasonography is often needed in women. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1015/p487.html

Interventional Radiology: Indications and Best Practices - American Family Physician

May 1, 2019 - Interventional radiology employs image-guided techniques to perform minimally invasive procedures for diagnosis and treatment. Interventional radiology is often used to place central venous catheters and subcutaneous ports, with some evidence of benefit over surgical placement. Arterial...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p547.html

Intrapartum Fetal Monitoring - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Continuous electronic fetal monitoring was developed to screen for signs of hypoxic-ischemic encephalopathy, cerebral palsy, and impending fetal death during labor. Because these events have a low prevalence, continuous electronic fetal monitoring has a false-positive rate of 99%. The ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p158.html

Kidney Stones: Treatment and Prevention - American Family Physician

Apr 15, 2019 - Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. During an episode of renal colic, the first priority is to rule out conditions requiring immediate referral to an emergency department, then to alleviate pain, preferably with a nonsteroidal ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p490.html

Lead Poisoning in Children - American Family Physician

Jul 1, 2019 - Asymptomatic lead poisoning has become more common in children. Blood lead levels of less than 5 µg per dL are associated with impairments in neurocognitive and behavioral development that are irreversible. Risk factors for lead poisoning include age younger than five years, low ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p24.html

Lice and Scabies: Treatment Update - American Family Physician

May 15, 2019 - Pediculosis and scabies are caused by ectoparasites. Pruritus is the most common presenting symptom. Head and pubic lice infestations are diagnosed with visualization of live lice. Nits (lice eggs or egg casings) alone are not sufficient to diagnose a current infestation. A no-nit ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p635.html

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment - American Family ...

Mar 15, 2019 - Lower extremity peripheral artery disease (PAD) affects 12% to 20% of Americans 60 years and older. The most significant risk factors for PAD are hyperlipidemia, hypertension, diabetes mellitus, chronic kidney disease, and smoking; the presence of three or more factors confers a 10-fold...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p362.html

Lymphoma: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

Jan 1, 2020 - Lymphoma is a group of malignant neoplasms of lymphocytes with more than 90 subtypes. It is traditionally classified broadly as non-Hodgkin or Hodgkin lymphoma. Approximately 82,000 new U.S. patients are diagnosed with lymphoma annually. Any tobacco use and obesity are major modifiable ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p34.html

Management of Chronic Tendon Injuries - American Family Physician

Aug 1, 2019 - Chronic tendon injuries are common athletic and occupational injuries that account for many physician visits. Tendons have a complex biology that provides a unique combination of strength, flexibility, and elasticity but also predisposes them to injury. The term tendinopathy is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p147.html

Management of Fever in Infants and Young Children - American Family Physician Restricted content. Login required.

Jun 15, 2020 - Despite dramatic reductions in the rates of bacteremia and meningitis since the 1980s, febrile illness in children younger than 36 months continues to be a concern with potentially serious consequences. Factors that suggest serious infection include age younger than one month, poor ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p721.html

Management of Hypertriglyceridemia: Common Questions and Answers - American Family ... Restricted content. Login required.

Sep 15, 2020 - Hypertriglyceridemia, defined as fasting serum triglyceride levels of 150 mg per dL or higher, is associated with increased risk of cardiovascular disease. Severely elevated triglyceride levels (500 mg per dL or higher) increase the risk of pancreatitis. Common risk factors for ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0915/p347.html

Managing Hypertension Using Combination Therapy - American Family Physician Restricted content. Login required.

Mar 15, 2020 - More than 70% of adults treated for primary hypertension will eventually require at least two antihypertensive agents, either initially as combination therapy or as add-on therapy if monotherapy and lifestyle modifications do not achieve adequate blood pressure control. Four main ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p341.html

Manipulative Therapies: What Works - American Family Physician

Feb 15, 2019 - Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p248.html

Migraine Headache Prophylaxis - American Family Physician

Jan 1, 2019 - Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p17.html

Muscle Weakness in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

Jan 15, 2020 - Although the prevalence of muscle weakness in the general population is uncertain, it occurs in about 5% of U.S. adults 60 years and older. Determining the cause of muscle weakness can be challenging. True muscle weakness must first be differentiated from subjective fatigue or ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p95.html

Neck Pain: Initial Evaluation and Management - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global assessment; therefore, emphasis is typically placed on red flags that can assist in the early recognition and ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p150.html

Nerve Blocks: Part I. Upper Extremity - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Procedural anesthesia is administered by family physicians for a variety of conditions, including neuropathies, fracture reduction, foreign body removals, and complex wound management. A nerve block may be preferred because it provides effective regional anesthesia with less anesthetic....

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p654.html

Nerve Blocks: Part II. Lower Extremity - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Family physicians use anesthesia to provide diagnostic and procedural analgesia for conditions such as neuropathies, fracture reduction, foreign body removals, and complex wound management. Local infiltration of anesthetics is commonly used in this setting because of the ease of use, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p669.html

Neuropsychological Evaluations in Adults - American Family Physician

Jan 15, 2019 - Neuropsychologists provide detailed assessments of cognitive and emotional functioning that often cannot be obtained through other diagnostic means. They use standardized assessment tools and integrate the findings with other data to determine whether cognitive decline has occurred, to ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p101.html

Newborn Circumcision Techniques - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Newborn male circumcision is a common elective surgical procedure for the removal of foreskin covering the glans penis. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and the American Academy ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p680.html

Nonalcoholic Fatty Liver Disease: Common Questions and Answers on Diagnosis and ... Restricted content. Login required.

Nov 15, 2020 - Nonalcoholic fatty liver disease (NAFLD) is the most common form of liver disease in the United States, affecting up to 30% of adults. There are two forms of NAFLD: nonalcoholic fatty liver (NAFL), defined as 5% or greater hepatic steatosis without hepatocellular injury or fibrosis, and...

American Family Physician : Article

https://www.aafp.org/afp/2020/1115/p603.html

Nonspecific Low Back Pain and Return To Work - American Family Physician Restricted content. Login required.

Dec 1, 2019 - Nonspecific low back pain refers to a condition without a distinct etiology to explain its associated symptoms. This pain may become chronic and is a major cause of work loss around the world. Without a specific explanation for a patient’s symptoms, the family physician is charged with ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p697.html

Office Spirometry: Indications and Interpretation - American Family Physician Restricted content. Login required.

Mar 15, 2020 - High-quality, office-based spirometry provides diagnostic information as useful and reliable as testing performed in a pulmonary function laboratory. Spirometry may be used to monitor progression of lung disease and response to therapy. A stepwise approach to spirometry allows for ease ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p362.html

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