Recurrent kidney stones are unpleasant and may lead to kidney damage, sepsis, or invasive procedures.

Atopic dermatitis affects approximately 10% of the U.S. population and is more common in children than adults. Up to 99% of physician visits for atopic dermatitis are in primary care. Most cases can be managed successfully with topical treatments, including moisturizers and prescription anti-inflammatory treatments, such as corticosteroids, calcineurin inhibitors, phosphodiesterase-4 inhibitors, Janus kinase (JAK) inhibitors, and aryl hydrocarbon receptor agonists. For more refractory or severe atopic dermatitis, ultraviolet phototherapy and systemic treatments, usually prescribed by specialists, can be used. Systemic treatments include older off-label immunomodulators, such as methotrexate. Since 2017, multiple on-label injectable biologics and oral JAK inhibitors have been approved.

Respiratory syncytial virus (RSV) causes respiratory disease with a high disease burden in older adults and people with comorbid conditions.

Adults with sickle cell disease (SCD) are living longer due to advances in care but face a growing burden of chronic comorbid conditions that fall within the scope of primary care. However, primary care providers often lack structured guidance because literature on managing these conditions in the context of SCD is limited. This article outlines clinical approaches to hypertension, diabetes, obesity, chronic constipation, reproductive health, cognitive impairments, depression, and anxiety in people living with SCD. The authors highlight relevant epidemiology, screening recommendations, and treatment considerations that differ from those in the general population. Primary care providers play a crucial role in delivering comprehensive and preventive care to people living with SCD. Specific management of common chronic conditions in this population is necessary to reduce morbidity and improve quality of life.

The SARS-CoV-2 Omicron variant continues to pose a global health burden.

Frailty is a syndrome of decreased reserve across multiple physiologic systems that is associated with greater risk for hospitalizations, disability, institutionalization, and other adverse outcomes, including mortality. Patients with frailty, most of whom are older adults, may be more likely to experience adverse outcomes due to iatrogenic causes, such as higher-risk medications or procedures. Guidelines recommend frailty screening for both chronic disease management and in-hospital care, as identification of frailty allows for risk mitigation and alignment of care with patients' goals. In addition, some interventions may delay or reverse frailty, thus increasing physiologic reserve and improving day-to-day function. This article reviews frailty definitions, approaches to assessment in different care settings, and management.

Clinicians and patients need updated information on antiviral treatments for COVID-19.

Bereavement after the death of someone close is universal, and clinicians may be uncertain if or what interventions may be beneficial.

Real-time federal surveillance of diseases and health care delivery informs clinical guidance and public health policy. However, in 2025, some U.S. Centers for Disease Control and Prevention (CDC) databases seemed to have "unexplained pauses" and ceased or delayed updates. The CDC public data catalog was audited to identify paused databases that had previously been updated at least monthly and evaluated their characteristics. Of 1359 catalog records examined on 28 October 2025, eighty-two were previously updated at least monthly. On the basis of each database's stated periodicity, allowing for an additional 30-day grace period, their status was classified as either current or paused as of 28 October 2025. Forty-four databases (54%) were current, and 38 (46%) were paused. Thirty-four of the 38 databases (89%) had no data entries dated within 6 months of the date of analysis, whereas 4 (11%) paused more recently. Of the 38 paused databases, 33 (87%) were vaccination-related topics compared with none of the 44 current databases. Of the 5 paused databases on other topics, 4 addressed respiratory diseases, including disease burden and nonvaccine prevention measures, whereas 1 addressed public health (drug overdose deaths). The persistence of pauses as of 2 December 2025 was examined. Only 1 of the 38 paused databases had been updated. Such long pauses may have compromised evidence for decision making and policies by clinicians, administrators, professional organizations, and policymakers. Federal databases should adopt minimum transparency standards, including displaying the current update status, with a rationale if paused, and next expected update with criteria for resumption. Without such standards, unexplained pauses in surveillance risk undermining evidence-based medicine and public trust.

Patients are sometimes experienced as difficult by their providers.

Iron deficiency anemia (IDA) is caused by iron deficiency, a common yet underrecognized clinical entity. Populations at greatest risk include children, menstruating and pregnant persons, and people of low socioeconomic status. Timely diagnosis and management of iron deficiency are key to preventing IDA and require thorough assessment of the underlying cause and appropriate iron repletion through either oral or parenteral therapy. Blood transfusion does not provide adequate elemental iron but is sometimes indicated along with iron therapy in patients with cardiovascular compromise, active bleeding, or severe anemia where more rapid correction is warranted. Alternative causes of anemia can be differentiated by red blood cell morphology and reticulocyte count and should be considered if anemia persists despite adequate repletion of iron stores.

Management of chronic kidney disease (CKD) has been rapidly evolving, now involving many interventions that can be managed in the primary care setting. In April 2025, leadership within the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved a joint clinical practice guideline (CPG) for the primary care management of CKD. This synopsis reviews the 2025 recommendations related to diagnosis, assessment, and management of CKD.

Benefits and harms of cannabinoids for chronic pain are uncertain.

Debates about optimal saturated fat advice continue.

Clinical guidelines recommend bisphosphonates for complex regional pain syndrome (CRPS) despite limited evidence of efficacy.

The OperA (Optimising Colorectal Cancer Prevention through Personalized Treatment with Artificial Intelligence) project aims to transform colorectal cancer care through artificial intelligence (AI) innovations. Recognizing that legal and ethical challenges remain key obstacles to clinical integration, this Delphi study sought to identify and prioritize such concerns in the context of gastrointestinal (GI) endoscopy. Fourteen international experts participated in a 2-round Delphi process. In round 1, the steering committee, with feedback from participants, proposed legal and ethical issues pertaining to AI in endoscopy. Round 2 involved iterative rating and refinement of these issues to achieve consensus on their importance. Consensus was reached on 10 key statements spanning 3 thematic domains: data governance, medicolegal implications, and equity and bias. Experts emphasized the need for robust data protection, transparent algorithmic development, and institutional clarity on data ownership. Liability concerns related to AI-assisted diagnosis and automated reporting were highlighted, alongside calls for guidance from legal and professional bodies. Finally, participants underscored the importance of demographic diversity in training data sets and transparent reporting practices to mitigate bias and ensure equitable AI deployment. As AI tools become increasingly integrated into the clinical practice of gastroenterology, addressing legal, ethical, and equity-related challenges is essential. This expert consensus provides a foundation for developing guidelines and regulatory frameworks to support responsible AI adoption in GI endoscopy.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used for type 2 diabetes mellitus (T2DM) and overweight or obesity, but their association with cancer is unclear.

Hyponatremia is the most common electrolyte disorder in hospitalized patients. Hospital-associated hyponatremia includes community-acquired (e.g., hyponatremia on admission) and hospital-acquired hyponatremia. Acute-onset hyponatremia requires rapid treatment with hypertonic saline to decrease cerebral edema. In cases of chronic hyponatremia (>48 hours), the brain has time to normalize cell volume by losing solutes. However, even mild chronic cases can have adverse outcomes, such as decreased cognition, osteoporosis, increased risk for falls, and fractures. Hyponatremia is associated with increased hospital length of stay, readmissions, morbidity, and mortality. Prompt recognition and appropriate treatment are therefore necessary to improve outcomes.

The benefit-risk profile of systemic corticosteroids in non-COVID-19 pneumonia and acute respiratory distress syndrome (ARDS) remains debated.

The American College of Physicians (ACP) developed these rapid practice points addressing the comparative effectiveness and harms of trivalent (3 different influenza viruses or viral proteins) and quadrivalent (4 different influenza viruses or viral proteins) influenza vaccines in adults aged 18 years or older who are not pregnant or immunocompromised. These practice points do not address adults aged 18 years or older who are pregnant or immunocompromised.