High Blood Pressure in Children and Adolescents

Margaret Riley, Anita K. Hernandez, Angela L. Kuznia

Despite the increasing prevalence and potential risks of hypertension in children, the diagnosis is often overlooked. Blood pressure should be measured annually beginning at three years of age, or at every visit if risk factors are present. A thorough history and physical...

Urinary Retention in Adults: Evaluation and Initial Management

David C. Serlin, Joel J. Heidelbaugh, John T. Stoffel

Urinary retention is the inability to voluntarily pass an adequate amount of urine. The condition can be acute or chronic, and it primarily affects men. Causes of retention are obstructive (most common), infectious, inflammatory, iatrogenic, and neurologic in nature. Initial...

Depression: Screening and Diagnosis

Douglas M. Maurer, Tyler J. Raymond, Bethany N. Davis

Screening for depression is the cornerstone of early recognition, diagnosis, and management, although many patients are not being screened in the primary care setting. All adults should be screened regardless of risk factors, as well as children and adolescents 12 years and...

Cerumen Impaction: Diagnosis and Management

Charlie Michaudet, John Malaty

Cerumen production is a normal and protective process for the ear canal. However, cerumen should be removed when it causes symptoms or prevents assessment of the external auditory canal, tympanic membrane, or audiovestibular system. It should also be removed when it limits...

AAFP News: AFP Edition

AAFP Supports ACT for Better Diagnosis | U.S. Patients Pay Higher Prescription Costs, Get Fewer Days of Therapy | AAFP Introduces Telemedicine Platform for Family Physicians | Aggressively Reducing SBP in Older Persons Can Increase Risk of Falls, Syncope

Counseling Patients About Prostate Cancer Screening

James J. Stevermer, Kenneth S. Fink

The AAFP finds that the net benefit of population screening for prostate cancer is small at best, and it does not recommend routinely discussing PSA-based screening if the patient does not request it.

Morning vs. Evening Administration of Levothyroxine

Linda Contillo Garufi, Katarzyna Jabbour, Susan E. Hansen, Brian Stello, Kristine A. Petre

The effectiveness of levothyroxine for reducing TSH levels is most dependent on the timing of meals in relation to drug administration. There is conflicting evidence. In two studies, levothyroxine taken at least two hours after eating in the evening maintained or improved TSH...

Newborn with a Hyperextended Knee

Brian Ford, Brian Burke, Trent Ainsworth

The initial examination of an infant was notable for passive hyperextension at right knee but otherwise full range of motion.

Screening for Prostate Cancer

Tracy Wolff, Yuri J. Jadotte

A.E., a 57-year-old black man, comes to your office for an annual visit. He has a history of diabetes mellitus, has never smoked, and has no family history of prostate cancer. He is current with preventive services, including screening for colorectal cancer and counseling for...

Recombinant Zoster Vaccine (Shingrix) for the Prevention of Shingles

Leena Deshpande

Recombinant zoster vaccine is a relatively new shingles vaccine that has been shown to have greater effectiveness and protection than the existing live vaccine. Local and systemic adverse effects may occur after administration, but have been shown to resolve within one to...

Influenza Vaccination Recommendations for 2018–2019: Updates from ACIP

Carrie Armstrong

Key Points for Practice

Screening for Prostate Cancer: Recommendation Statement

For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)–based screening for prostate cancer should be an individual one. Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of...

Long-Acting Muscarinic Antagonists Plus Inhaled Steroids Are Equivalent to Long-Acting Beta Agonists Plus Inhaled Steroids

David Slawson

Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not Helpful for Nonneuropathic Pain

Mark H. Ebell

This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose,...

Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated UTI

David Slawson

A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.

Ambulatory Blood Pressure Important for Decision-Making About Treatment

Mark H. Ebell

This study supports the guidelines recommending that treatment decisions be based on ambulatory blood pressure measurements rather than in-office blood pressure results. The difference between the two measurements in this cohort was 19/11 mm Hg, which is enough to change the...

The Presence of Bull's Eye Lesion Is Not Required to Diagnose Lyme Disease

Genetic Factors Should Be Considered When Caring for Colorectal Cancer Survivors