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Viral Respiratory Infections: Respiratory Syncytial Virus. 病毒性呼吸道感染:呼吸道合胞病毒。
FP essentials Pub Date : 2026-10-01
Aysha Azam, Heli Naik
{"title":"Viral Respiratory Infections: Respiratory Syncytial Virus.","authors":"Aysha Azam, Heli Naik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) causes bronchiolitis and other significant lower respiratory infections. It spreads mainly via droplets, direct contact, and contaminated surfaces. In most of the United States, the prevalence of RSV infection peaks during the winter. Annually, RSV causes approximately 58,000 hospitalizations and more than 2 million outpatient visits among US children younger than 5 years. It also causes up to 160,000 hospitalizations and 10,000 deaths in adults 65 years and older. Prevention comprises hygiene measures, avoidance of infected individuals, and vaccine and antibody strategies. Vaccination is recommended for adults ages 50 to 74 years with chronic health conditions or weakened immune systems or who live in long-term care facilities. Vaccination is also recommended for adults 75 years and older and pregnant women (between 32 weeks' and 36 weeks and 6 days' ges-tation). The long-acting monoclonal antibody nirsevimab is recommended for infants younger than 8 months born during or entering their first RSV season and high-risk infants and young children ages 8 to 19 months. Diagnosis of RSV infection is primarily clinical, with testing used for high-risk or hospitalized patients. Treatment is support-ive. Hospitalization is needed for patients with hypoxia, dehydration, respiratory distress, or underlying high-risk conditions. Coinfections, socioeconomic disparities, and environmental factors (eg, tobacco smoke exposure) increase the risk of severe infection.</p>","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"569 ","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Viral Respiratory Infections: Foreword. 病毒性呼吸道感染:前言。
FP essentials Pub Date : 2026-10-01
Ryan D Kauffman
{"title":"Viral Respiratory Infections: Foreword.","authors":"Ryan D Kauffman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"569 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Viral Respiratory Infections: Upper and Lower Respiratory Tract Infections. 病毒性呼吸道感染:上呼吸道和下呼吸道感染。
FP essentials Pub Date : 2026-10-01
Heli Naik
{"title":"Viral Respiratory Infections: Upper and Lower Respiratory Tract Infections.","authors":"Heli Naik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Respiratory infections are a major health concern and are divided into upper and lower respiratory tract infections. Upper respiratory tract infections are mostly viral and self-limiting; billions of cases occur globally each year. Lower respiratory tract infections such as pneumonia and bronchitis can cause significant illness, especially in children, older adults, and individuals with comorbidities or immunocompromise. In 2021, lower respiratory tract infections caused more than 2 million deaths globally, mainly in low- and middle-income countries. Preventive measures include hand hygiene, masks, ventilation, vaccination, and pharmacologic prophylaxis. Vaccines for influenza, COVID-19, and respiratory syncytial virus infection are available in the United States. Vaccines for human metapneumovirus, parainfluenza viruses, and human rhinovirus are in development. Differentiating viral from bacterial infections is challenging. Biomarkers such as procalcitonin and C-reactive protein can guide antibiotic use. Treatment of viral respiratory infections is mainly supportive, with use of intranasal decongestants and nonsteroidal anti-inflammatory drugs. Early use of zinc and vitamin C may shorten symptom duration; evidence for vitamin D, probiotics, and echinacea varies. Judicious antibiotic use prevents antimicrobial resistance, and treatment with no or delayed antibiotics is often sufficient. Most viral respiratory infections resolve in 1 to 2 weeks, although coughing may persist longer. Patient education about self-care, prevention, and antibiotic use is key to better outcomes and reduced health care burden.</p>","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"569 ","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Viral Respiratory Infections: COVID-19. 病毒性呼吸道感染:COVID-19。
FP essentials Pub Date : 2026-10-01
Heli Naik
{"title":"Viral Respiratory Infections: COVID-19.","authors":"Heli Naik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On March 11, 2020, the World Health Organization declared COVID-19 a pandemic. By late 2024, COVID-19 had become endemic, with regional surges caused by new variants and declining population immunity. Case fatality rates have decreased because of vaccination and the emergence of less virulent variants, but long COVID persists as a public health concern. Because of structural issues, including those related to employment, housing, health care access, and mistrust, minority and low-income individuals are at higher risk for COVID-19 infection and mortality. Preventive strategies include shared decision-making about vaccination for individuals 6 months and older, two vaccine doses for adults 65 and older, and vaccination for pregnant and breastfeeding individuals. COVID-19 can be distinguished from influenza and respiratory syncytial virus infection through testing. Rapid antigen tests are faster but less sensitive than polymerase chain reaction tests. Outpatient care of COVID-19 focuses on symptomatic relief and early antiviral use when indicated. Inpatient treatment involves remdesivir, corticosteroids, interleuken-6 inhibitors, anticoagulation, and respiratory support. Long-term complications of COVID-19 include cardiovascular, pulmonary, neurologic, mental health, and renal conditions. Thrombotic risk peaks during acute infection and remains elevated for up to 1 year. An effective community response to COVID-19 requires equitable vaccine access, integrated care, and rebuilding of patient trust to counter misinformation.</p>","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"569 ","pages":"28-40"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Viral Respiratory Infections: Influenza. 病毒性呼吸道感染:流感。
FP essentials Pub Date : 2026-10-01
Heli Naik
{"title":"Viral Respiratory Infections: Influenza.","authors":"Heli Naik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The influenza virus is a highly contagious respiratory pathogen that causes yearly seasonal epidemics and occasional pandemics, leading to significant health and economic consequences. It spreads through droplets, aerosols, and surfaces. Infected individuals are contagious before symptoms appear, with peak infectivity early in the illness. In the United States, the 2024-2025 influenza season was the most severe since 2017-2018, with an estimated 47 to 82 million cases, up to 1.3 million hospitalizations, and up to 130,000 deaths. The risk of adverse outcomes is higher for vulnerable groups, including older adults, infants, and individuals who are immunocompromised, those with chronic conditions, and individuals who are pregnant, long-term care facility residents, and individuals experiencing homelessness. Vaccination is the main preventive measure and is recommended for all patients 6 months and older unless contraindicated. Advances in vaccines have improved efficacy. For the 2024-2025 vaccine, efficacy ranged from 32% to 78%, depending on age group and outcome. Misinformation, limited access, mistrust, and disparities are barriers to administration. Antiviral medications including oseltamivir and zanamivir can reduce illness and complications if given early in the infection course, and new therapies are being developed for drug-resistant strains. Strategies to more effectively address influenza include improving access to vaccines, countering misinformation, performing community outreach, and advancing research on antiviral medications and universal vaccines.</p>","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"569 ","pages":"15-27"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seizure Disorders in Adults: Foreword. 成人癫痫发作障碍:前言。
FP essentials Pub Date : 2026-09-01
Karl T Rew
{"title":"Seizure Disorders in Adults: Foreword.","authors":"Karl T Rew","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"568 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seizure Disorders in Adults: Primary Care for Patients With Epilepsy. 成人癫痫发作障碍:癫痫患者的初级保健。
FP essentials Pub Date : 2026-09-01
Kiran Mullur, Gina Bertelli
{"title":"Seizure Disorders in Adults: Primary Care for Patients With Epilepsy.","authors":"Kiran Mullur, Gina Bertelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Family physicians play a central role in the longitudinal management of epilepsy that extends beyond seizure control to address medication adherence, comorbidity screening, lifestyle counseling, and patient education. Antiseizure medication adherence should be assessed at every visit because nonadherence is associated with increased risk of seizure recurrence. All patients and caregivers should receive counseling regarding sudden unexpected death in epilepsy, ideally at or near the time of diagnosis. Achieving freedom from seizures, particularly from generalized tonic-clonic seizures, is the most effective strategy for reducing risk of sudden unexpected death in epilepsy. Regular screening for psychiatric comorbidities, especially depression and anxiety, is essential given the prevalence of these conditions in epilepsy and their impact on quality of life and treatment adherence. Lifestyle counseling should address sleep hygiene, stress management, alcohol moderation, and avoidance of other seizure triggers that can precipitate breakthrough seizures. Comprehensive epilepsy care also includes individualized safety counseling, seizure action planning, and guidance on driving restrictions and workplace accommodations under the Americans with Disabilities Act. Women of childbearing potential require targeted counseling regarding potential teratogenic risks of treatment, with valproate avoided when possible and lamotrigine or levetiracetam generally preferred.</p>","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"568 ","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seizure Disorders in Adults. 成人癫痫发作障碍。
FP essentials Pub Date : 2026-09-01
Karl T Rew
{"title":"Seizure Disorders in Adults.","authors":"Karl T Rew","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"568 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seizure Disorders in Adults: Evaluation of a First Seizure. 成人癫痫性疾病:首次发作的评估。
FP essentials Pub Date : 2026-09-01
Kiran Mullur, Kimberly Burbank
{"title":"Seizure Disorders in Adults: Evaluation of a First Seizure.","authors":"Kiran Mullur, Kimberly Burbank","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A first seizure in adulthood is a common reason for emergency department evaluation and subsequent follow-up in primary care. Family physicians are often responsible for confirming the diagnosis, identifying reversible causes, ordering appropriate diagnostic tests, and counseling patients regarding prognosis and safety issues. The evaluation of an event suspected to be a first seizure requires an understanding of seizure epidemiology, common etiologies, and risk factors that influence recurrence and long-term outcomes. The diagnostic approach includes a careful history and physical examination; laboratory studies as clinically indicated for any possible seizure; electroencephalography for all patients with a suspected unprovoked seizure; and neuroimaging for most after a first unprovoked seizure. Treatment considerations after an initial seizure include indications for antiseizure medication in the acute setting, maintenance antiseizure medication, hospitalization, and referral to neurology. Prognostic issues such as recurrence and mortality risks, return to work, driving restrictions, and counseling regarding emotional and financial impacts are important to consider after a first seizure.</p>","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"568 ","pages":"7-11"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seizure Disorders in Adults: Principles of Treatment of Epilepsy. 成人癫痫性疾病:癫痫治疗原则。
FP essentials Pub Date : 2026-09-01
Kiran Mullur, Gina Bertelli
{"title":"Seizure Disorders in Adults: Principles of Treatment of Epilepsy.","authors":"Kiran Mullur, Gina Bertelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Management of epilepsy requires an individualized, longitudinal approach that incorporates seizure type, recurrence risk, comorbidities, lifestyle, reproductive planning, and safety implications of recurrent seizures. Family physicians play a central role in early counseling, initial medication discussions, monitoring for adverse effects, and recognizing when referral for advanced therapies is warranted. Evidence shows that early initiation of maintenance antiseizure medication after a first unprovoked seizure lowers short-term recurrence but does not change long-term remission or mortality, underscoring the need for shared decision-making grounded in patient preferences and psychosocial or occupational needs. Because epilepsy is increasingly viewed as a heterogeneous group of disorders rather than a single entity, treatment must integrate mechanism-based medication selection, titration principles, therapeutic monitoring, and nonpharmacologic options such as dietary therapy, neuromodulation, and surgery. This section provides a primary care–focused overview of medication strategy, emphasizing when to start medication, how to choose and adjust therapy, and how to manage breakthrough seizures, drug resistance, and pregnancy-related issues.</p>","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"568 ","pages":"18-25"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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