FP essentials最新文献_第2页

Seizure Disorders in Adults: Understanding the Types of Epilepsy and Nonepileptic Events. 成人癫痫性疾病：了解癫痫和非癫痫事件的类型。

FP essentials Pub Date : 2026-09-01

Kiran Mullur, Kimberly Burbank

{"title":"Seizure Disorders in Adults: Understanding the Types of Epilepsy and Nonepileptic Events.","authors":"Kiran Mullur, Kimberly Burbank","doi":"","DOIUrl":"","url":null,"abstract":"Epilepsy encompasses a diverse group of disorders characterized by recurrent unprovoked seizures and requires careful evaluation to classify seizure type, identify underlying etiology, and distinguish epileptic events from common mimicking conditions. The International League Against Epilepsy classification provides a standardized framework that separates seizures into focal, generalized, or unknown classes, improving diagnostic consistency across care settings. Accurate identification is essential because misdiagnosis can lead to unnecessary treatment, inappropriate restrictions, and delayed care for the true underlying condition. The most common seizure mimics are syncope, psychogenic nonepileptic attacks (functional neurologic disorder), migraine with aura, transient ischemic attack, movement disorders, metabolic disturbances, and sleep disorders. Epidemiologic studies indicate that epilepsy affects 5 to 9 per 1,000 people in high-income countries, with a higher incidence in older adults due to cerebrovascular disease, dementia and neurodegeneration, and metabolic or systemic disorders. Morbidity and mortality remain significant, with increased risk attributable to status epilepticus, sudden unexpected death in epilepsy, injuries, drowning, and comorbid medical conditions. Understanding of seizure classification, mimic differentiation, and long-term prognosis allows clinicians to provide accurate counseling, initiate appropriate workup, and facilitate specialist referral when needed.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"568 ","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065043","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

Common Male Genitourinary Issues: Benign Prostatic Hyperplasia and Overactive Bladder. 常见的男性泌尿生殖系统问题：良性前列腺增生和膀胱过度活跃。

FP essentials Pub Date : 2026-08-01

Gretchen Irwin

{"title":"Common Male Genitourinary Issues: Benign Prostatic Hyperplasia and Overactive Bladder.","authors":"Gretchen Irwin","doi":"","DOIUrl":"","url":null,"abstract":"Lower urinary tract symptoms that significantly impair quality of life in men may result from benign prostatic hyperplasia, overactive bladder, or a combination of both conditions. The diagnosis of benign prostatic hyperplasia, a voiding dysfunction due to outlet obstruction, can be made with a thorough history and physical examination. A validated questionnaire should be used to make an accurate initial diagnosis and to monitor treatment effect over time. Selective alpha-1 blockers are an appropriate first-line drug choice for most patients; however, 5-alpha reductase inhibitors and phosphodiesterase type 5 inhibitors may also be used, alone or in combination with each other, depending on symptom severity and if alternative treatment options are needed. If medical therapy is ineffective, surgical and interventional procedures aimed at opening the prostatic urethra are available to ameliorate symptoms. Overactive bladder manifests with urinary urgency, frequency, and nocturia with or without incontinence. The diagnosis of this storage dysfunction due to detrusor overactivity can be made with a thorough history, physical examination, urinalysis, and assessment of the residual volume of urine in the bladder after voiding. First-line treatment for overactive bladder includes beta-3 agonists as well as pelvic floor physical therapy and behavioral interventions. If left untreated, benign prostatic hyperplasia and overactive bladder can result in significant social isolation and relationship strain.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"567 ","pages":"14-22"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763063","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

Common Male Genitourinary Issues: Family Planning in Men. 常见男性泌尿生殖系统问题：男性计划生育。

FP essentials Pub Date : 2026-08-01

Gretchen Irwin

引用次数: 0

Common Male Genitourinary Issues: Prostate Cancer Screening and Treatment. 常见的男性泌尿生殖系统问题：前列腺癌的筛查和治疗。

FP essentials Pub Date : 2026-08-01

Joseph Jenkins Saffold

{"title":"Common Male Genitourinary Issues: Prostate Cancer Screening and Treatment.","authors":"Joseph Jenkins Saffold","doi":"","DOIUrl":"","url":null,"abstract":"Prostate cancer is the second most common cancer in US men. Guidelines for screening vary, underscoring the need to engage patients in shared decision-making and counsel them about potential benefits and harms. When screening is undertaken, it is based on the prostate-specific antigen test, with digital rectal examination used selectively as an adjunct. Men with an abnormal prostate-specific antigen level should have a repeat test within a few months, before proceeding to biomarker testing, referral to urology, biopsy, and potentially imaging. Patients with newly diagnosed prostate cancer should be risk-stratified using clinical tumor (T) stage as determined by digital rectal examination, International Society of Urological Pathology grade group (Gleason score), prostate-specific antigen level, and tumor volume on biopsy. Treatment options vary by risk. Active surveillance is recommended for patients with low-risk disease, typically those with grade group 1/Gleason score of 6 (3 + 3). For patients with favorable intermediate-risk prostate cancer, treatment options are active surveillance, radiation therapy, or radical prostatectomy. For patients with unfavorable intermediate- or high-risk prostate cancer and estimated life expectancy greater than 10 years, options are radical prostatectomy or radiation therapy plus androgen deprivation therapy. For patients with prostate-specific antigen levels greater than 40 ng/dL, a Gleason score of 9 or higher, or locally advanced prostate cancer, treatment with radiation therapy and androgen deprivation therapy can additionally include concurrent abiraterone plus prednisone for 2 years. Focal ablation is also an option for some patients. Prognosis varies by disease features; men with low-risk prostate cancer are much more likely to die from other causes, whereas those with distant metastases have a 5-year relative survival rate of 38.3%.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"567 ","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760776","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

Common Male Genitourinary Issues. 常见的男性泌尿生殖系统问题。

FP essentials Pub Date : 2026-08-01

Kate Rowland

引用次数: 0

Common Male Genitourinary Issues: Chronic Pelvic Pain Syndrome. 常见的男性泌尿生殖系统问题：慢性盆腔疼痛综合征。

FP essentials Pub Date : 2026-08-01

Gretchen Irwin

{"title":"Common Male Genitourinary Issues: Chronic Pelvic Pain Syndrome.","authors":"Gretchen Irwin","doi":"","DOIUrl":"","url":null,"abstract":"Chronic prostatitis/chronic pelvic pain syndrome is a common male genitourinary condition comprising urinary, musculoskeletal, gastrointestinal, and/or psychological concerns with pain as a prominent feature. It is a diagnosis of exclusion. Physicians should use validated patient questionnaires to inventory presenting symptoms and symptom evolution over time. Questionnaires, such as the National Institutes of Health Chronic Prostatitis Symptom Index, can be particularly helpful in monitoring treatment effect on symptoms. Standardized classification systems can prove useful in choosing therapeutic modalities. Treatment should be individualized for each patient and multimodal; it should focus on symptomatic improvement, with a 25% or 6-point reduction in the National Institutes of Health Chronic Prostatitis Symptom Index score being defined as success. Chronic prostatitis/chronic pelvic pain syndrome is a chronic pain condition. Although pharmacologic and nonpharmacologic treatment modalities have variable proven benefit, few are supported by robust evidence. Chronic prostatitis/chronic pelvic pain syndrome does not predispose men to prostate cancer, but it may be associated with male infertility. Physicians should also be alert for its mental health effects on men.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"567 ","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762088","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

Hepatitis Overview: Viral Hepatitis. 肝炎概述：病毒性肝炎。

FP essentials Pub Date : 2026-07-01

Richard A Moore Ii

{"title":"Hepatitis Overview: Viral Hepatitis.","authors":"Richard A Moore Ii","doi":"","DOIUrl":"","url":null,"abstract":"More than 300 million people globally have viral hepatitis. Predominantly caused by hepatitis A, B, and C viruses, viral hepatitis continues to confer high levels of morbidity and mortality despite the availability of vaccines and advances in therapies. Symptom severity varies during acute infection, with management focused on stabilization and serial monitoring to ensure resolution of liver injury. Infection with hepatitis A virus is generally self-limited, with low but increasing rates of mortality and hospitalization due to factors such as poorer baseline health status, older age, and coexisting liver disease. About 95% of acute hepatitis B cases in adults resolve spontaneously; treatment is rarely needed in acute infection. In contrast, only about 25% of acute hepatitis C cases resolve spontaneously, and immediate initiation of treatment at diagnosis is recommended. Screening for hepatitis B and C is recommended for all adults. Hepatocellular carcinoma screening is recommended for those with hepatitis B and cirrhosis or specific risk factors, and for those with hepatitis C and advanced liver fibrosis or cirrhosis. Treatment of hepatitis B involves assessment of specific factors to determine antiviral need; the goal of treatment is suppression of viral replication, thereby reducing risks of liver disease progression and hepatocellular carcinoma. Curative medications are available for hepatitis C.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"566 ","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760768","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

Hepatitis Overview. 肝炎的概述。

FP essentials Pub Date : 2026-07-01

Michelle Nelson, Karl T Rew

引用次数: 0

Hepatitis Overview: Less Common Causes of Hepatitis. 肝炎概述：不常见的肝炎原因。

FP essentials Pub Date : 2026-07-01

Jama M Darling

{"title":"Hepatitis Overview: Less Common Causes of Hepatitis.","authors":"Jama M Darling","doi":"","DOIUrl":"","url":null,"abstract":"Although metabolic, viral, and drug- and alcohol-related etiologies are a familiar part of the evaluation of elevated liver enzymes, less common causes include autoimmune hepatitis, Wilson disease, and hereditary hemochromatosis. Each has a progressive course to end-organ damage underscoring the importance of early recognition, as effective therapies are available. Autoimmune hepatitis is an immune-mediated liver disease, with a female predominance and autoantibodies present in about 80% of cases. It can progress rapidly without treatment. Liver biopsy featuring lymphoplasmacytic hepatitis is needed for diagnosis and to determine the intensity of immunosuppression. Wilson disease is caused by biallelic variants in the ATP7B gene resulting in copper accumulation in the liver, brain, kidneys, and corneas. Diagnosis relies on clinical findings, laboratory data, and genetic testing results. Lifelong chelation therapy is required. Hereditary hemochromatosis is characterized by iron overload, usually due to a common variant in the HFE gene with variable disease penetrance; it is prevalent in people of Northern European ancestry. Untreated hemochromatosis leads to cirrhosis and hepatocellular carcinoma. Early diagnosis and initiation of phlebotomy can result in normal life expectancy. To facilitate early diagnosis, genetic testing of first-degree relatives is recommended for those with Wilson disease or hemochromatosis.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"566 ","pages":"37-46"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759247","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

Hepatitis Overview: Metabolic Dysfunction-Associated Steatotic Liver Disease. 综述：代谢功能障碍相关的脂肪变性肝病。

FP essentials Pub Date : 2026-07-01

Jonathan T Mitchell, Claire L Porter

{"title":"Hepatitis Overview: Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Jonathan T Mitchell, Claire L Porter","doi":"","DOIUrl":"","url":null,"abstract":"Metabolic dysfunction-associated steatotic liver disease (MASLD) is a complex disease closely related to obesity and other cardiometabolic processes. It affects millions worldwide and is on track to markedly increase cases of end-stage liver disease requiring transplantation as well as cases of hepatocellular carcinoma in the coming years. Noninvasive assessments such as the Fibrosis-4 index are useful tools for identifying those at risk of clinically significant fibrosis and cirrhosis caused by MASLD. Other noninvasive tests, including liver stiffness measured with transient elastography, help to stratify risk, guide therapy, and inform surveillance and prognosis. Weight loss is the cornerstone of treatment for MASLD. The condition can progress to metabolic dysfunction-associated steatohepatitis (MASH), characterized by stage F2 or F3 fibrosis, and ultimately cirrhosis (stage F4 fibrosis). For patients with MASH who have comorbid obesity, bariatric surgery or pharmacologic approaches to weight loss should be considered. Progression to advanced fibrosis and cirrhosis (stage F3 or F4) is slow and depends on multiple factors. Screening for hepatocellular carcinoma with abdominal ultrasonography and alpha-fetoprotein testing every 6 months is indicated in patients with MASH-related cirrhosis.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"566 ","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763210","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