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American Family Physician November 1, 2003 Zoorob & Campbell	Acute Dyspnea in the Office Shortness of breath, or dyspnea, is a common problem in the outpatient primary care setting. Establishing a diagnosis can be challenging because dyspnea appears in multiple diagnostic categories. Underlying disorders range from the relatively simple to the more serious.
American Family Physician February 15, 2006 Dewar & Curry	Chronic Obstructive Pulmonary Disease: Diagnostic Considerations Chronic obstructive pulmonary disease is characterized by the gradual progression of irreversible airflow obstruction and increased inflammation in the airways and lung parenchyma that is generally distinguishable from the inflammation caused by asthma.
American Family Physician May 1, 2001 Trenton D. Nauser & Steven W. Stites	Diagnosis and Treatment of Pulmonary Hypertension Regardless of the etiology, unrelieved pulmonary hypertension can lead to right-sided heart failure. Signs and symptoms of pulmonary hypertension are often subtle and nonspecific...
American Family Physician October 1, 2005 Bidwell & Pachner	Hemoptysis: Diagnosis and Management Hemoptysis is the spitting of blood that originated in the lungs or bronchial tubes. The patient's history should help determine the amount of blood and differentiate between hemoptysis, pseudohemoptysis, and hematemesis.
American Family Physician March 1, 2004 Barreiro & Perillo	An Approach to Interpreting Spirometry Spirometry is a powerful tool that can be used to detect, follow, and manage patients with lung disorders. Technology advancements have made spirometry much more reliable and relatively simple to incorporate into a routine office visit.
American Family Physician December 1, 2004 Steven A. Dosh	Diagnosis of Heart Failure in Adults The evaluation of symptomatic patients with suspected heart failure is directed at confirming the diagnosis, determining the cause, identifying concomitant illnesses, establishing the severity of heart failure, and guiding therapy.
Nurse Practitioner May 2011 Chris Garvey	Best Practices in Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease is a common, preventable, treatable, and often progressive disorder characterized by airflow limitation that is not fully reversible.
American Journal of Nursing March 2012 Corbridge et al.	An Evidence-Based Approach to COPD: Part 1 This article, the first in a two-part series on COPD, outlines current guidelines and other evidence-based recommendations on diagnosing and managing stable COPD in the outpatient setting.
Nursing August 2008 Bill Pruitt	Loosening the Bonds of Restrictive Lung Disease Find out about restrictive lung disease and how to help your patient.
Nursing November 2011 Lawson & Pruitt	Issues in Obesity, Part 2: Obesity Weighs Heavily on Lung Function A look at the impact of obesity on asthma, chronic obstructive pulmonary disease (COPD), and sleep apnea.
American Family Physician November 15, 2005 William E. Cayley	Diagnosing the Cause of Chest Pain Distinguishing between serious and benign causes of chest pain is imperative, and diagnostic and prognostic questions are important in making this determination.
Nursing April 2011 Smith & Tasota	Smoking Out the Dangers of COPD An overview of the guidelines for preventing, diagnosing, and treating COPD.
Nursing December 2009 Vincent M. Vacca	On the Alert for Pulmonary Arterial Hypertension Progressive and ultimately fatal, pulmonary arterial hypertension is a disease of the pulmonary arterial vasculature with no known cause.
American Family Physician July 15, 2000 Mitchell S. King	Preoperative Evaluation The purpose of a preoperative evaluation is not to "clear" patients for elective surgery, but rather to evaluate and, if necessary, implement measures to prepare higher risk patients for surgery...
American Family Physician March 1, 2006 Satpathy et al.	Diagnosis and Management of Diastolic Dysfunction and Heart Failure With early diagnosis and proper management the prognosis of diastolic dysfunction is more favorable than that of systolic dysfunction. Distinguishing diastolic from systolic heart failure is essential because the optimal therapy for one may aggravate the other.
American Family Physician May 1, 2004 Holmes & Fadden	Evaluation of the Patient with Chronic Cough Diagnostic and treatment options for adults and children with chronic coughs.
American Family Physician June 1, 2004 Gutierrez & Blanchard	Diastolic Heart Failure: Challenges of Diagnosis and Treatment The outcomes of ongoing clinical trials may provide much-needed information about diastolic heart failure to move from intuitive treatment to therapy based on evidence that matters: decreased morbidity and mortality and improved quality of life.
American Family Physician March 1, 2007 O'Reilly et al.	Asbestos-Related Lung Disease The inhalation of asbestos fibers may lead to a number of respiratory diseases. Although exposure is now regulated, patients continue to present with these diseases because of the long latent period between exposure and clinical disease.
American Family Physician December 1, 2006 Dout, Lehman & Glasziou	The Role of BNP Testing in Heart Failure With the increasing availability of assays for the measurement of brain natriuretic peptide (BNP), a cardiac hormone, blood tests may have a role in detecting, monitoring, and perhaps preventing chronic heart failure.
American Journal of Nursing May 2010 Corbridge & Corbridge	Asthma in Adolescents and Adults This article outlines current guideline recommendations for asthma and reviews what clinicians need to teach patients about its pathophysiology, pharmacotherapy, self monitoring, and environmental control.
American Family Physician January 1, 2007 Collins et al.	Lung Cancer: Diagnosis and Management Smoking cessation remains the critical component of preventive primary care of lung cancer. Treatment and prognosis are closely tied to the type and stage of the tumor identified.
American Family Physician September 1, 2004 Matthew Mintz	Asthma Update: Part I. Diagnosis, Monitoring, and Prevention of Disease Progression The National Asthma Education and Prevention Program Expert Panel has updated its clinical guidelines on asthma medications, prevention of disease progression, and patient self-management.
Nursing October 2009 John J. Gallagher	Taking aim at ARDS Among many complications that threaten a critically ill patient is a potentially fatal syndrome of lung inflammation and injury: acute respiratory distress syndrome.
American Family Physician May 1, 2002 Michael P. Mortelliti	Acute Respiratory Distress Syndrome Acute respiratory distress syndrome is the clinical manifestation of severe, acute lung injury. It is characterized by the acute onset of diffuse, bilateral pulmonary infiltrates secondary to noncardiogenic pulmonary edema, refractory hypoxia, and decreased lung compliance...
American Family Physician January 15, 2003 Udobi et al.	Acute Respiratory Distress Syndrome Family physicians can play an essential role in the early recognition of ARDS and contribute to the multispecialty team required to manage this life-threatening condition. This article reviews the current understanding of the pathophysiology, management, and prognosis of ARDS.
American Family Physician March 1, 2003 James C. Higgins	The 'Crashing Asthmatic' Asthma is one of the most common chronic disorders managed by family physicians. A "crashing asthmatic" is a patient with asthma who is clinically deteriorating into respiratory failure or arrest despite initial treatment. Managing such a patient can be a major challenge.
American Family Physician September 15, 2000 Anne D. Walling, M.D.	Family Practice International Notes from international family physicians' journals: Traumatic Coronary Artery Damage... Morton's Neuroma... Diagnosing Acute Dyspnea...
Nursing March 2009 Kate J. Morse	Focusing on the Surgical Patient with Cardiac Problems Learn about the latest guidelines for assessing cardiac risk and protecting his heart during noncardiac surgery.
Nurse Practitioner November 2009 Ann Marie Hart	Treatment Strategies for Cough Illnesses in Adults Adults who experience a cough for 2 or more weeks along with vomiting or an inspiratory whooping sound should be evaluated and tested for B. pertussis infection.
Nurse Practitioner September 2009 Laura LaRue	Sarcoidosis: A Granular View The NP integrates detailed history, physical exam, and diagnostic testing into determining the treatment plan for sarcoidosis.
American Family Physician May 1, 2006 Luma & Spiotta	Hypertension in Children and Adolescents The prevalence and rate of diagnosis of hypertension in children and adolescents appear to be increasing. Most childhood hypertension, particularly in preadolescents, is secondary to an underlying disorder.
American Family Physician July 15, 2004 Wu & Schiff	Sarcoidosis This systemic granulomatous disease of unknown cause predominately affects young and middle-aged adults. Diagnosis is based on clinicoradiologic findings plus histologic evidence of noncaseating epithelioid granulomas, and exclusion of other granulomatous diseases.
American Family Physician August 15, 2001 Melissa H. Hunter	COPD: Management of Acute Exacerbations and Chronic Stable Disease Outpatient management of patients with stable COPD should be directed at improving quality of life by preventing acute exacerbations, relieving symptoms and slowing the progressive deterioration of lung function...
American Family Physician January 1, 2003 Edward Onusko	Diagnosing Secondary Hypertension Secondary hypertension is elevated blood pressure that results from an underlying, identifiable, often correctable cause. Only about 5 to 10 percent of hypertension cases are thought to result from secondary causes. The ABCDE mnemonic can be used to help determine a secondary cause of hypertension.
Nursing May 2010 Debra Castner	Understanding the stages of chronic kidney disease This article will help you to recognize CKD and understand its stages so you can help your patient to modify risk factors, prevent further kidney damage, and manage complications. First, consider the scope of the problem.
American Family Physician June 15, 2004 Ramzi & Leeper	DVT and Pulmonary Embolism: Part I. Diagnosis The incidence of venous thromboembolic diseases is increasing as the U.S. population ages. Evidence-based algorithms help guide the diagnosis of these diseases.
Nurse Practitioner November 2011 Tracy Brazziel et al.	Stopping the Wave of PAD Early detection and diagnosis of atherosclerotic disease is imperative. Here, learn the risk factors, screening and diagnosis for this disease.
American Family Physician July 15, 2000 Mark A. Van Kooy	Postobstructive Pulmonary Edema Pulmonary edema is a potentially life-threatening complication of acute airway obstruction. It develops rapidly, without warning, in persons who are otherwise well. Two forms of postobstructive pulmonary edema (POPE) have been identified...
American Journal of Nursing May 2009 Kristen J. Overbaugh	Acute Coronary Syndrome Coronary artery disease, in which atherosclerotic plaque builds up inside the coronary arteries and restricts the flow of blood (and therefore the delivery of oxygen) to the heart, continues to be the number-one killer of Americans.
American Family Physician November 15, 2006 Fletcher, Mills & Taylor	Update on Exercise Stress Testing Exercise stress testing is an important diagnostic tool for the evaluation of suspected or known cardiac disease.
Nurse Practitioner December 2010 Kathy J. Morris	Management of Exercise-Induced Bronchospasm in Adolescents with Asthma Collaboration between the nurse practitioner and adolescent is essential to develop an asthma management plan that will provide for optimal physical activity and prevent asthma exacerbations while exercising.
American Family Physician July 15, 2006 Mehta et al.	Opportunities to Improve Outcomes in Sickle Cell Disease Family physicians play a crucial role in instituting evidence-based preventive sickle cell care strategies, initiating timely treatment of acute illness, recognizing life-threatening episodes, and providing a medical home for multidisciplinary management.
American Family Physician December 1, 2003 Roth & Basello	Approach to the Adult Patient with Fever of Unknown Origin A thorough history, physical examination, and standard laboratory testing remain the basis of the initial evaluation of the patient with FUO.
American Family Physician December 15, 2002 Kurowski & Ostapchuk	Overview of Histoplasmosis Histoplasmosis is an endemic infection in most of the United States and can be found worldwide. This article presents the manifestations, diagnosis, and treatment of histoplasmosis, beginning with the case of an immunocompetent child who developed disseminated disease.
American Family Physician September 1, 2001 William E. Chavey	Guideline for the Management of Heart Failure Caused by Systolic Dysfunction Part I: Guideline development, etiology and diagnosis...
American Family Physician June 1, 2001 Benjamin Shipton & Haney Wahba	Valvular Heart Disease: Review and Update People with valvular heart disease are living longer, with less morbidity, than ever before. Advances in surgical techniques and a better understanding of timing for surgical intervention account for increased rates of survival...
Nurse Practitioner April 2010 Benninger & McCallister	Asthma in pregnancy: Reading between the lines Asthma is one of the most common, chronic medical conditions that can complicate pregnancy, affecting between 4% and 8% of this population.
American Journal of Nursing November 2011 Christine L. Cutugno	The 'Graying' of Trauma Care: Addressing Traumatic Injury in Older Adults Evidence-based strategies for managing trauma and its complications in this population.
American Family Physician July 1, 2005 Achar, Kundu & Norcross	Diagnosis of Acute Coronary Syndrome Differentiating acute coronary syndrome from noncardiac chest pain is the primary diagnostic challenge. The initial assessment requires a focused history (including risk factor analysis), a physical examination, an ECG and, frequently, serum cardiac marker determinations.
American Family Physician February 1, 2006 Lutfiyya et al.	Diagnosis and Treatment of Community-Acquired Pneumonia When a patient presents with suspected community-acquired pneumonia, the physician should first assess the need for hospitalization using a mortality prediction tool, such as the Pneumonia Severity Index, combined with clinical judgment.