American family physician
-
Lung cancer is the second most common cancer in men and women in the United States; however, it remains the leading cause of cancer-related death in the United States and worldwide. The most common but nonspecific symptom of lung cancer is cough. Associated symptoms, including hemoptysis or shortness of breath, or systemic symptoms, including anorexia or weight loss, greatly increase the likelihood of having lung cancer. ⋯ As of 2021, the U. S. Preventive Services Task Force recommends annual lung cancer screening using low-dose computed tomography starting at 50 years of age in patients with a 20 pack-year history.
-
American family physician · May 2022
Constipation in Children and Adolescents: Evaluation and Treatment.
Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. ⋯ Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers' specific challenges and the negative effects of constipation on the child's quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.
-
Seizures are transient signs and symptoms of abnormal, excessive, or synchronous neuronal activity in the brain. Up to 10% of adults have a seizure during their lifetime, with increasing incidence in people older than 55 years. One-third of people have a recurrent seizure within one year of an initial unprovoked seizure. ⋯ Recurrence rates between three and five years are similar between patients who start anti-seizure medication immediately after the first seizure and those who do not. Restoration of driving privileges varies by state. After a seizure, safety concerns should be addressed, such as the need for a safety companion when bathing or swimming and the risks of ladders and other hazards.