Deprecated: Return type of DrupalCacheArray::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 362

Deprecated: Return type of DrupalCacheArray::offsetGet($offset) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 369

Deprecated: Return type of DrupalCacheArray::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 381

Deprecated: Return type of DrupalCacheArray::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 388
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  • Deprecated function: Return type of DatabaseStatementBase::execute($args = [], $options = []) should either be compatible with PDOStatement::execute(?array $params = null): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2244 of /home/rprlib/prod72/www/includes/database/database.inc).
  • Deprecated function: Return type of DatabaseStatementEmpty::current() should either be compatible with Iterator::current(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
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  • Deprecated function: Return type of DatabaseStatementEmpty::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
  • Deprecated function: Return type of DatabaseStatementEmpty::valid() should either be compatible with Iterator::valid(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
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Monitoring After Treatment of Precancerous Cervical Lesions

Author/s: George F Sawaya, Bennett Lareau, Robyn Lamar

Each year in the US, an estimated 200 000 patients1 receive a diagnosis of precancerous cervical lesions caused by human papillomavirus (HPV), the most common of which are cervical intraepithelial neoplasia (CIN) grades 2 (CIN2) and 3 (CIN3), also known as high-grade squamous intraepithelial...

Keywords/Tags:
Uterine Cervical Neoplasms Adenocarcinoma in Situ Papillomavirus Infections Uterine Cervical Dysplasia Precancerous Conditions

Chronic, Noninfectious Diarrhea: A Review

Author/s: Prashant Singh, Allen Lee, Neil M. Sheth

Importance: Chronic diarrhea is defined as loose or watery stools lasting longer than 4 weeks and affects approximately 6% to 7% of adults in the US. More than 90% of patients with chronic diarrhea have a noninfectious etiology.

Observations: The most common causes of chronic,...

Keywords/Tags:
Diarrhea infectious diarrhea Irritable Bowel Syndrome abdominal pain Defecation Steatorrhea

Secondary Prevention after Ischemic Stroke

Author/s: Karen L. Furie, Peter J. Kelly

The risk of recurrent ischemic stroke can be reduced by managing modifiable risk factors and instituting a regimen of mechanism-specific secondary stroke prevention. Strategies for secondary prevention should be instituted as early as possible. Poststroke monitoring of risk metrics, lifestyle...

Keywords/Tags:
Acute Ischemic Stroke prevention Strokes

Female pattern hair loss

Author/s: Eric McMullen, Ammar Saed Aldien, Cathryn Sibbald, Jeffrey Donovan

Female pattern hair loss (FPHL) is a common, nonscarring hair-loss disorder. Prevalence of FPHL increases with age; 12% of females will have symptoms by age 29 years, 25% by age 50 years, and 41% to 50% at age 70 years and older. Risk factors include genetics and endocrinological diseases (e.g...

Keywords/Tags:
Female Pattern Hair Loss Hair Loss Alopecia

IgA Nephropathy in Adults: A Review

Author/s: Sinead Stoneman, Jia Wei Teh, Michelle Marie O’Shaughnessy

Importance IgA nephropathy (IgAN) is a chronic kidney disease involving deposition of IgA-containing immune complexes in the glomerulus, causing glomerular inflammation and scarring. It is the most common immune-mediated glomerular disease worldwide, and affects an estimated 198 887 to 208 184...

Keywords/Tags:
Antigen-Antibody Complex IgA Nephropathy Renal Insufficiency Angiotensin Receptor Antagonists renin-angiotensin system

Restless Legs Syndrome: A Review

Author/s: John W. Winkelman, Benjamin Wipper

Importance Restless legs syndrome (RLS) is a sleep-related movement disorder that affects approximately 3% of US adults to a clinically significant extent and can cause substantial sleep disturbance.

Observations Restless legs syndrome is characterized by an overwhelming urge to move...

Keywords/Tags:
Restless Legs Syndrome Restless Leg Sleep-related movement disorder sleep disorders

Does This Patient Have Volume Overload? The Rational Clinical Examination

Author/s: Benjamin Drum, Bryce La Course, Mark Kelly, Audrey York, Emily Worrall, Jennifer Martins, Stacy Johnson, Edmund A Liles Jr

Importance: Accurate assessment of intravascular volume facilitates management decisions about fluid management in patients with volume overload.

Objective: To identify the most accurate clinical examination, radiographic, and laboratory findings for assessing volume overload in...

Keywords/Tags:
Intravascular Volume Overload Venous Pressure Natriuretic Peptides Auscultation

Vulvar cancer

Author/s: Jennifer Davis, Jacob McGee, Anjali Kulkarni

Vulvar cancer is an underrecognized gynecologic malignant disease. The incidence of vulvar cancer is 2.3 per 100 000 people in Canada, and is increasing with the rising prevalence of human papillomavirus (HPV). More than 90% of vulvar cancers are squamous cell carcinomas (SCC), mostly diagnosed...

Keywords/Tags:
Vulvar cancer Human Papillomavirus Viruses human papillomavirus Uterine Cervical Neoplasms

Private Well Water Safety: Practical Counseling Strategies for Primary Care

Author/s: Dominika A. Jegen, Matthew E. Bernard, Paul J. Jannetto

In the US, 23 million households rely on private wells for their drinking water, yet these wells are unregulated and unmonitored, and thus vulnerable to contamination. These exposures may lead to significant health consequences, including both acute manifestations and chronic disease. Primary...

Keywords/Tags:
Drinking water Well water Environmental exposure Rural health Water pollutants

Pertussis Infection in Adults

Author/s: Paul B. Cornia, Benjamin A. Lipsky

Pertussis, or whooping cough, is a highly contagious respiratory illness caused by Bordetella pertussis, a fastidious gram-negative coccobacillus that is a human pathogen without known animal or environmental reservoirs. There are 8 additional known Bordetella species, 3 of which can cause...

Keywords/Tags:
Pertussis Bordetella pertussis whooping cough

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