- Hepatitis C
Essential Evidence Topics, 1-Mar-2021
Overall Bottom Line: Recommend one-time creening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years. All pregnant persons should be screened for HCV during each pregnancy. Offer periodic HCV screening to all persons with persistent risk - Hepatocellular cancer
Essential Evidence Topics, 22-Aug-2019
Overall Bottom Line: Screen all cirrhotic patients for hepatocellular carcinoma (HCC) with a semiannual liver ultrasound. If a liver nodule is noted on ultrasound, follow-up imaging with helical CT or MRI should be performed. Adopt an early multidisci - Hepatorenal syndrome
Essential Evidence Topics, 20-May-2019
Overall Bottom Line: The diagnosis of hepatorenal syndrome in a patient with acute or chronic liver disease is based on elevated creatinine levels or reduced creatinine clearance after excluding other forms of underlying renal insufficiency. Patients wi - Hereditary spherocytosis
Essential Evidence Topics, 1-Feb-2021
Overall Bottom Line: Although most patients with mild disease are asymptomatic, those with severe disease have significant anemia, jaundice, splenomegaly, and an increased risk of pigment gallstones. Hereditary spherocytosis (HS) may be diagnosed on the - Herpangina
Essential Evidence Topics, 22-Jul-2019
Overall Bottom Line: Patients typically present with 1- to 4-mm papulovesicular lesions with an erythematous base in the oropharynx. Symptomatic treatment with oral and topical analgesic medications is recommended. Fever usually resolves within 4 days - Herpes simplex (oral)
Essential Evidence Topics, 17-Dec-2019
Overall Bottom Line: Patients with frequent recurrent herpes labialis may benefit from prophylactic oral antiviral therapy. Viral culture of the lesion for HSV is still the gold standard in most labs (97% sensitive, 100% specific in one study). Topica - Herpes simplex virus
Essential Evidence Topics, 24-Jan-2020
Overall Bottom Line: Herpes simplex virus (HSV) cell culture is the preferred diagnostic test for patients who present with recent-onset genital vesicles or ulcers. Serologic testing can provide guidance for patients who have a history consistent with her - Herpes zoster (shingles)
Essential Evidence Topics, 27-Oct-2020
Overall Bottom Line: Typically herpes zoster is characterized by unilateral dermatomal pain and rash. Initiating treatment within 72 hours with appropriate antivirals will significantly decrease the incidence of acute pain but does not decrease the freq - Hiccups
Essential Evidence Topics, 6-Aug-2019
Overall Bottom Line: Most hiccups are of the benign self-limiting type lasting less than 24 hours, and these require no investigation. The initial treatment of hiccups involves respiratory maneuvers. Patients with chronic or intractable hiccups should - Hidradenitis suppurativa
Essential Evidence Topics, 18-Dec-2019
Overall Bottom Line: Suspect hidradenitis suppurativa (HS) in patients with tender nodular skin lesions in regions of skin folds especially with a history of recurrent symptoms, family history of HS, smoking, or female. Topical clindamycin improves heal - Hip pain
Essential Evidence Topics, 8-Jun-2020
Overall Bottom Line: Order imaging in adults with acute trauma, those with suspicion of malignancy (eg, age, history of cancer, weight loss), and patients with persistent symptoms after conservative treatment. MRI is the preferred study if clinical susp - Hirschsprung’s disease
Essential Evidence Topics, 13-Dec-2019
Overall Bottom Line: Rectal biopsy provides the definitive diagnosis of Hirschsprung’s disease. If less than 3 years old, get suction rectal biopsy. If greater than 3 years old, get barium enema and/or anorectal manometry. Surgery is required to remov - Hirsutism
Essential Evidence Topics, 24-Jun-2019
Overall Bottom Line: Hirsutism is excessive male pattern hair growth in females. Most often it is due to polycystic ovarian syndrome (PCOS) but may be idiopathic. Serum androgen assays (beginning with plasma free testosterone) are the mainstay of diagno - Histoplasmosis
Essential Evidence Topics, 20-Jun-2019
Overall Bottom Line: Infection with histoplasmosis is exceedingly rare outside of endemic areas. Typical symptoms are nonspecific and include fever, productive cough, malaise. Diagnosis can be accomplished by the use of urinary antigen testing, serolo - HIV infection and AIDS
Essential Evidence Topics, 18-Dec-2019
Overall Bottom Line: The USPTF recommends screening everyone with risk factors for contracting human immunodeficiency virus (HIV) annually, anyone requesting HIV testing, and all adults and adolescents age 15 to 65 years at least once. CDC recommends scre - Hoarseness
Essential Evidence Topics, 6-Dec-2019
Overall Bottom Line: Hoarseness is a symptom; a careful and thorough history is necessary to diagnose the possible underlying causes. Improvement after empiric treatment of gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with tw - Hordeolum and chalazion
Essential Evidence Topics, 29-May-2019
Overall Bottom Line: Hordeolum (stye) is an acute, tender, and erythematous lesion of the eyelid that can safely be treated with warm compresses and topical erythromycin. Chalazia usually present as a chronic, nontender, SC nodule within the eyelid, som - Human bite
Essential Evidence Topics, 6-Dec-2019
Overall Bottom Line: Ask specifically if the wounds could have been caused by human teeth. The infection rate can be as high as 47% for human bite wounds that are not treated with antibiotics. Human bites on the hands or feet, overlying a joint capsul - Human papillomavirus infection
Essential Evidence Topics, 1-Mar-2021
Overall Bottom Line: Anogenital warts caused by human papilloma virus (HPV) are flesh-colored, exophytic lesions. They may be flat, verrucous, or pedunculated, and appear as reddish papules or dome-shaped lesions on keratinized skin. Behavioral interven - Huntington disease
Essential Evidence Topics, 4-Jul-2019
Overall Bottom Line: Huntington disease (HD) is an inherited progressive neurodegenerative disorder characterized by choreiform movements, dystonia, psychiatric problems, and dementia. HD affects 5 to 10 per 100,000 of the general population in most Wes
Essential Evidence is a powerful, one-stop, state-of-the-art reference that includes best-evidence answers to your most important clinical questions concerning symptoms, diseases, and treatment. Its concise, highly structured content is tightly integrated and hyperlinked to thousands of calculators, articles, and evidence summaries within Essential Evidence Plus to make searching for answers quick and seamless. Each topic has a “strength of evidence” rating for every recommendation, a “Bottom-line” summary that introduces each section, and a broad array of helpful algorithms.
