HOLLY SALZMAN, DUSTIN LILLIE
Outpatient management is appropriate for clinically stable, uncomplicated diverticulitis. Inpatient management is necessary for patients who need intravenous fluids, or antibiotics, bowel rest, and aggressive management of symptoms.
JACOB L. BIDWELL, ROBERT W. PACHNER
True hemoptysis usually can be differentiated from pseudohemoptysis and hematemesis by a history and focused physical examination. Some patients may require fiberoptic bronchoscopy or high-resolution computed tomography.
MONICA K. CRANE, MARSHA WITTINK, DAVID J. DOUKAS
Despite widespread support for advance care planning, few Americans have living wills or other advance directives. Family physicians can help integrate medical knowledge, individual values, and cultural influences into end-of-life care.
JENNIFER E. FRANK
This enzyme deficiency is an X-linked inherited disorder that can cause a spectrum of disease but is rarely fatal. Clinical presentations include acute hemolytic anemia, chronic hemolytic anemia, and neonatal hyperbilirubinemia.
FRANCINE RAINONE
CAM Used since ancient times to treat liver and gallbladder disease, this herb has been investigated as a cytoprotectant for the treatment and prevention of cancer and as a supportive treatment for Amanita phalloides poisoning.
CRAIG P. GRIEBEL, JOHN HALVORSEN, THOMAS B. GOLEMON, ANTHONY A. DAY
Up to 20 percent of recognized pregnancies end in spontaneous abortion. Surgical evacuation of the uterus is the treatment of choice in unstable patients, but patient preferences should be considered for patients without complications.
JOYCE A. MERRIMAN
Our ability to publish the kind of journal you want and need depends on feedback from you. Your input helps us make appropriate decisions to improve the journal. The survey below was distributed at the publications booth during the recent Scientific Assembly in San Francisco....
LISA GRAHAM
New memories may erase old cravings, according to a study published in the Proceedings of the National Academy of Sciences. Researchers found they could influence people to crave strawberry ice cream less after implanting false suggestions about bad childhood experiences with...
The physician assistant (PA) and nurse practitioner (NP) workforces have realized explosive growth, but this rate of growth may be declining. Most PAs work outside primary care; however, the contributions of PAs and NPs to primary care and interdisciplinary teams should not...
JENNIFER JOYCE, JANICE KUPERSTEIN
Research suggests that “primary care physicians will refer more patients to physical therapists when they have more knowledge about physical therapy, recognize physical therapists’ capabilities to diagnose, and believe in the … effectiveness of physical therapy intervention....
JANELLE GUIRGUIS-BLAKE
In March 2005, the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to recommend for or against screening adults for glaucoma.1The recommendation and associated evidence review2 updated the 1996 recommendation on this topic, for which the USPSTF also...
JOHN O’HANDLEY
Fatigue is a nonspecific symptom but a common complaint of many patients. Deidre knew something was not right, yet she wasn’t one to seek medical attention lightly. Ten months postpartum, she had lost 70 lb of her pregnancy weight and was hoping to lose more, having gained...
STEVEN E. ROSKOS
An injection of the knee joint with a corticosteroid may improve the patient’s symptoms for up to three weeks after the injection (number needed to treat [NNT]= 3 to 4). There is no evidence that this intervention improves function, and there is little evidence of the...
CLARISSA KRIPKE
Does a Low Glycemic Index Diet Reduce CHD?
CLARISSA KRIPKE
Although no difference in effectiveness has been demonstrated in existing trials, too few patients have been studied to detect small but clinically important differences in pregnancy rates. Low-dose estrogen pills have higher rates of discontinuation and bleeding disturbances.
RAYMOND T. KUWAHARA, MICHAEL SWANN, CARLOS GARCIA
A 15-year-old adolescent presented with concerns about the appearance of his scalp (see accompanying figure). The patient wished to know what was causing the skinfolds because schoolmates were teasing him, calling him “Klingon Head.” The skinfolds first appeared in late...
RICHARD A. GUTHMANN, JANE BANG, JOAN NASHELSKY
There is currently no evidence of harm; however, few patients have been studied and existing studies have many limitations. Therefore, it is not possible to definitively answer this question at this time. The existing low-quality evidence suggests that combined oral...
ROBERT PRENTKY
Before addressing the particulars of this scenario, it may be helpful to review the current status of notification laws, which have evolved in the last decade. It is important to keep in mind that the presumptive purpose of community notification through registration is...
LIZ SMITH
The American Heart Association (AHA) has published a new set of recommendations for the measurement of blood pressure to increase accuracy of clinic readings, and in recognition of major changes over the past 10 years (including the prohibition of mercury in many countries).
LAURA COUGHLIN
The American Academy of Pediatrics (AAP) recently published a clinical report on the state of adolescent pregnancy in the United States. The average age at first intercourse is 16 years for males and 17 years for females.
LAURA COUGHLIN
The Committee on Pediatric Emergency Medicine of the American Academy of Pediatrics (AAP) has released a policy statement that provides recommendations to guide the care of young patients in emergency situations and the timely transfer from urgent care facilities to the...
LAURA COUGHLIN
A clinical report reviewing the risk factors and screening guidelines for diabetic retinopathy in children has been released by the American Academy of Pediatrics (AAP), in conjunction with the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).
Diverticular (say: die-ver-TICK-yoo-ler) disease affects the bowel. It is caused by pouches called diverticula (say: die-ver-TICK-yoo-luh) that can form in the wall of the large intestine (see drawing).
An advance directive is a plan for how you would make health care choices if you became very sick. If you became too sick to make decisions, your doctor would look at your advance directive to know what you would want. There are two types of advance directives. One is called...
Sleepwalking happens when a child partly wakes up during the night. If your child sleepwalks, he or she may walk or do other things and not remember them the next day. Your child may sit up in bed and rub his or her eyes or fumble with clothes. The child may get out of bed...
People who have insomnia (say: “in-SOM-nee-uh”) may not be able to fall asleep. They may wake up at night and not be able to fall back asleep, or they may wake up too early in the morning.
Most adults need about eight hours of sleep to feel fully alert when they’re awake. This usually is true for people 65 years or older. But as you get older, you might have more trouble sleeping. Many things can get in the way of sleeping well or sleeping long enough to be...
People with sleep apnea (say: AP-nee-uh) stop breathing for 10 to 30 seconds at a time while they are sleeping. This can happen hundreds of times every night. If you have sleep apnea, you may wake up from deep sleep. Sleep apnea keeps you from getting enough rest and can...
Nightmares are scary dreams. Most children have them from time to time. One out of every four children has nightmares more than once a week. Most nightmares happen between 4 a.m. and 6 a.m. Your child may wake up and come to you for comfort. He or she might be able to tell...
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