{"title":"Cannabis Use in Pregnancy Is Associated With an Increased Incidence of Low Birth Weight and Small-for-Gestational-Age Infants.","authors":"Linda Speer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"644"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case Report: Small Bowel Obstruction After Starting Tirzepatide (Mounjaro).","authors":"Leandra Morgenthaler, Regina DePietro","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"562"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nolan E Lee, Arielle Ilano, Ha Kirsten Do, Maylynn Tam
{"title":"Painless Black Toe.","authors":"Nolan E Lee, Arielle Ilano, Ha Kirsten Do, Maylynn Tam","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"635-636"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Weight Loss in Patients With Overweight or Obesity and Knee Osteoarthritis.","authors":"Thomas Troy, Hanh Ngo, Lauren Pham","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"641-642"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute abdominal pain in children is a common presentation in the clinic and emergency department settings and accounts for up to 10% of childhood emergency department visits. Determining the appropriate disposition of abdominal pain in children can be challenging. The differential diagnosis of acute abdominal pain, including gastroenteritis, constipation, urinary tract infection, acute appendicitis, tubo-ovarian abscess, testicular torsion, and volvulus, and the diagnostic approach vary by age. Most causes of acute abdominal pain in children are self-limited. Symptoms and signs that indicate referral for surgery include pain that is severe, localized, and increases in intensity; pain preceding vomiting; bilious vomiting; hematochezia; guarding; and rigidity. Physical examination findings suggestive of acute appendicitis in children include decreased or absent bowel sounds, psoas sign, obturator sign, Rovsing sign, and right lower quadrant rebound tenderness. Initial laboratory evaluation may include urinalysis; complete blood cell count; human chorionic gonadotropin, lactate, and C-reactive protein levels; and a comprehensive metabolic profile. Ultrasonography, including point-of-care ultrasonography, for the evaluation of acute abdominal pain in children is the preferred initial imaging modality due to its low cost, ease of use, and lack of ionizing radiation. In addition to laboratory evaluation and imaging, children with red-flag or high-risk symptoms should be referred for urgent surgical consultation. Validated scoring systems, such as the Pediatric Appendicitis Score, can be used to help determine the patient's risk of appendicitis.
{"title":"Acute Abdominal Pain in Children: Evaluation and Management.","authors":"Katie L Buel, James Wilcox, Paul T Mingo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute abdominal pain in children is a common presentation in the clinic and emergency department settings and accounts for up to 10% of childhood emergency department visits. Determining the appropriate disposition of abdominal pain in children can be challenging. The differential diagnosis of acute abdominal pain, including gastroenteritis, constipation, urinary tract infection, acute appendicitis, tubo-ovarian abscess, testicular torsion, and volvulus, and the diagnostic approach vary by age. Most causes of acute abdominal pain in children are self-limited. Symptoms and signs that indicate referral for surgery include pain that is severe, localized, and increases in intensity; pain preceding vomiting; bilious vomiting; hematochezia; guarding; and rigidity. Physical examination findings suggestive of acute appendicitis in children include decreased or absent bowel sounds, psoas sign, obturator sign, Rovsing sign, and right lower quadrant rebound tenderness. Initial laboratory evaluation may include urinalysis; complete blood cell count; human chorionic gonadotropin, lactate, and C-reactive protein levels; and a comprehensive metabolic profile. Ultrasonography, including point-of-care ultrasonography, for the evaluation of acute abdominal pain in children is the preferred initial imaging modality due to its low cost, ease of use, and lack of ionizing radiation. In addition to laboratory evaluation and imaging, children with red-flag or high-risk symptoms should be referred for urgent surgical consultation. Validated scoring systems, such as the Pediatric Appendicitis Score, can be used to help determine the patient's risk of appendicitis.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"621-631"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"562"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremy D Schroeder, Steven D Trigg, Gerardo E Capo Dosal
Bone stress injuries (BSIs) are a spectrum of overuse injuries caused by an accumulation of microdamage, from high physical demands on normal bone or normal physiologic loads on structurally compromised bone. They typically result from overuse in younger patients but are also caused by pathologic bone conditions, including relative energy deficiency in sport, which features decreased bone mineral density. Stress fractures, representing 20% of BSIs, are the most severe type and feature discernable sclerosis or fracture lines on imaging. Without treatment, they can progress to complete fractures. BSIs present as localized pain and loss of function, most often in the setting of sudden load volume changes. Palpatory bony tenderness is the most significant examination finding. Prevention focuses on recognition and optimization of modifiable risk factors, which include nutritional, lifestyle, and physical activity habits. Despite low sensitivity, radiography should be the initial imaging modality for suspected BSI. Magnetic resonance imaging is the preferred definitive study. Point-of-care ultrasonography is gaining popularity, but training and availability are barriers in primary care. Once a BSI is diagnosed, early intervention is imperative to reduce pain and promote healing. Severity of BSI (grade) and location (low- vs high-risk of complications) guide the management approach. Injuries in low-risk sites are treated conservatively, whereas fractures in high-risk sites warrant consultation with sports medicine or orthopedics. Femoral neck BSIs, especially when tension-sided, require urgent surgical consultation.
{"title":"Bone Stress Injuries: Diagnosis and Management.","authors":"Jeremy D Schroeder, Steven D Trigg, Gerardo E Capo Dosal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bone stress injuries (BSIs) are a spectrum of overuse injuries caused by an accumulation of microdamage, from high physical demands on normal bone or normal physiologic loads on structurally compromised bone. They typically result from overuse in younger patients but are also caused by pathologic bone conditions, including relative energy deficiency in sport, which features decreased bone mineral density. Stress fractures, representing 20% of BSIs, are the most severe type and feature discernable sclerosis or fracture lines on imaging. Without treatment, they can progress to complete fractures. BSIs present as localized pain and loss of function, most often in the setting of sudden load volume changes. Palpatory bony tenderness is the most significant examination finding. Prevention focuses on recognition and optimization of modifiable risk factors, which include nutritional, lifestyle, and physical activity habits. Despite low sensitivity, radiography should be the initial imaging modality for suspected BSI. Magnetic resonance imaging is the preferred definitive study. Point-of-care ultrasonography is gaining popularity, but training and availability are barriers in primary care. Once a BSI is diagnosed, early intervention is imperative to reduce pain and promote healing. Severity of BSI (grade) and location (low- vs high-risk of complications) guide the management approach. Injuries in low-risk sites are treated conservatively, whereas fractures in high-risk sites warrant consultation with sports medicine or orthopedics. Femoral neck BSIs, especially when tension-sided, require urgent surgical consultation.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"592-600"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"SGLT-2 Inhibitors for Individuals With Diabetes and Chronic Kidney Disease.","authors":"Michael D North, Alexei O DeCastro","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"online"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Over 13.6 Years, Children With Hypertension Are Twice As Likely to Have Major Adverse Cardiovascular Events.","authors":"Henry C Barry","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 6","pages":"645-646"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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