{"title":"Neutropenia.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"online"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965060","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":"Acupuncture for Procedural Pain in Newborns.","authors":"A Savannah Campbell, Sean Haley","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"677-678"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965047","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":"Intensive Glucose Control in Older Patients With Diabetes.","authors":"Andy Lazris, Alan Roth, Helen Haskell, John James","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"668-670"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965083","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}
Neutropenia is defined as an absolute neutrophil count of less than 1,500 per μL in adults and children older than 1 year, and less than 1,000 per μL in infants. Neutropenia can be acquired or inherited. It is classified as mild (1,000-1,500 per μL), moderate (500-999 per μL), or severe (less than 500 per μL). Patient presentation can range from asymptomatic to severe illness requiring hospitalization. Acquired neutropenias and their causes include autoimmune neutropenia, chronic idiopathic neutropenia, chemotherapy-induced neutropenia, febrile neutropenia, hematologic malignancy, idiosyncratic drug-induced neutropenia, infection-related neutropenia, and nutritional deficiency (ie, vitamin B12, folate, and copper). Inherited neutropenias and their causes include bone marrow failure, cyclic neutropenia, and severe congenital neutropenia. Genetic testing may be required for diagnosis. Acquired neutropenias are treated by addressing the underlying etiologies. Some patients experiencing recurrent severe infections may benefit from granulocyte colony-stimulating factor. Most inherited neutropenias are treated with granulocyte colony-stimulating factor. Febrile neutropenia is an oncologic emergency. It is defined as a single oral temperature of 101°F or greater or a temperature of 100.4°F or greater sustained for 1 hour with an absolute neutrophil count of less than 500 per μL. Febrile neutropenia warrants emergent evaluation, but low-risk patients with a malignancy who meet strict criteria can be treated as outpatients.
{"title":"Neutropenia: Evaluation and Management in the Primary Care Setting.","authors":"Michael J Kim, Chloe Forlini, Kaleb Kremsreiter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neutropenia is defined as an absolute neutrophil count of less than 1,500 per μL in adults and children older than 1 year, and less than 1,000 per μL in infants. Neutropenia can be acquired or inherited. It is classified as mild (1,000-1,500 per μL), moderate (500-999 per μL), or severe (less than 500 per μL). Patient presentation can range from asymptomatic to severe illness requiring hospitalization. Acquired neutropenias and their causes include autoimmune neutropenia, chronic idiopathic neutropenia, chemotherapy-induced neutropenia, febrile neutropenia, hematologic malignancy, idiosyncratic drug-induced neutropenia, infection-related neutropenia, and nutritional deficiency (ie, vitamin B12, folate, and copper). Inherited neutropenias and their causes include bone marrow failure, cyclic neutropenia, and severe congenital neutropenia. Genetic testing may be required for diagnosis. Acquired neutropenias are treated by addressing the underlying etiologies. Some patients experiencing recurrent severe infections may benefit from granulocyte colony-stimulating factor. Most inherited neutropenias are treated with granulocyte colony-stimulating factor. Febrile neutropenia is an oncologic emergency. It is defined as a single oral temperature of 101°F or greater or a temperature of 100.4°F or greater sustained for 1 hour with an absolute neutrophil count of less than 500 per μL. Febrile neutropenia warrants emergent evaluation, but low-risk patients with a malignancy who meet strict criteria can be treated as outpatients.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"618-628"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965115","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":"More Options to Treat Migraine.","authors":"Robert Bonakdar, Michael Ready, Dawn C Buse","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"594-595"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965067","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}
Late pregnancy bleeding, any vaginal bleeding that occurs after 20 weeks' gestation, can be due to obstetric emergencies or benign etiologies. The amount of blood loss does not always correlate with seriousness of the etiology, and the source of bleeding is often not immediately obvious. Even small amounts of blood loss should be evaluated carefully because this may be the initial symptom of emergent bleeding. Emergent obstetric etiologies include placental abruption, placenta previa, vasa previa, and uterine rupture. Placental abruption rarely presents with the classic triad of vaginal bleeding, pain, and uterine hypertonicity; vaginal bleeding with abnormal fetal heart rate is more common. Placenta previa is usually diagnosed on ultrasonography but can present with intermittent painless vaginal bleeding. A digital cervical examination should be avoided in patients with placenta previa, but a sterile speculum examination and transvaginal ultrasonography are safe regardless of placental location. Vasa previa, the presence of unprotected vessels outside the placenta running through membranes over or near the cervix, can cause rapidly emergent fetal bleeding. Uterine rupture is an immediate threat to the fetus that requires urgent cesarean delivery. Causes of bleeding that are not emergent include bloody show from labor, bleeding ectropion, cervical polyp, cervicitis, and vaginal infections. Performing ultrasonography to locate the placenta is key in making a diagnosis in patients with late pregnancy bleeding. Frequent vital signs, fetal monitoring, and serial laboratory tests will help identify those at high risk for complications.
{"title":"Late Pregnancy Bleeding.","authors":"Nicole Yonke, Francheska Sevy Gurule, Sandra Rosenfeld-O'Tool","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Late pregnancy bleeding, any vaginal bleeding that occurs after 20 weeks' gestation, can be due to obstetric emergencies or benign etiologies. The amount of blood loss does not always correlate with seriousness of the etiology, and the source of bleeding is often not immediately obvious. Even small amounts of blood loss should be evaluated carefully because this may be the initial symptom of emergent bleeding. Emergent obstetric etiologies include placental abruption, placenta previa, vasa previa, and uterine rupture. Placental abruption rarely presents with the classic triad of vaginal bleeding, pain, and uterine hypertonicity; vaginal bleeding with abnormal fetal heart rate is more common. Placenta previa is usually diagnosed on ultrasonography but can present with intermittent painless vaginal bleeding. A digital cervical examination should be avoided in patients with placenta previa, but a sterile speculum examination and transvaginal ultrasonography are safe regardless of placental location. Vasa previa, the presence of unprotected vessels outside the placenta running through membranes over or near the cervix, can cause rapidly emergent fetal bleeding. Uterine rupture is an immediate threat to the fetus that requires urgent cesarean delivery. Causes of bleeding that are not emergent include bloody show from labor, bleeding ectropion, cervical polyp, cervicitis, and vaginal infections. Performing ultrasonography to locate the placenta is key in making a diagnosis in patients with late pregnancy bleeding. Frequent vital signs, fetal monitoring, and serial laboratory tests will help identify those at high risk for complications.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"638-645"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965062","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":"Proton Pump Inhibitors to Prevent NSAID-Induced Ulcers and Dyspepsia.","authors":"Tracy Johns, Elizabeth Lawrence","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"607-608"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965042","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":"Prevention and Treatment of Heat Illness: Guidelines From the Wilderness Medical Society.","authors":"Michelle Nelson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"700-702"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965081","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":"Solitary White Papule on the Lateral Tongue.","authors":"David C Bury, Elizabeth Gross, Cecil B Rhodes","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"683-684"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965093","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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