New and Updated Topics

Updated Health and Disease Topics

A primary care physician or a specialist in the field reviewed the following topics. All information has been verified for medical accuracy and new medical information has been added if available.

• Abscessed Tooth: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Acne: We have deleted the names of discontinued drugs and have added new brand names. And we have updated the efficacy information for many of the drugs. We have added information on blue light (Clearlight) therapy to the Other Treatment section. And we now mention the ability of azelaic acid to improve the appearance of brown spots resulting from healed acne lesions.
• Alcohol Effects on a Fetus: In the Symptoms section we have added that many children and teens who have FASD also have mental health problems. And in the Home Treatment section we've added information about school programs that can help a child who has FASD.
• Altitude Sickness: In this updated targeted topic we no longer include age in the list of factors that do not play a role in altitude sickness. Age can affect who gets altitude sickness.
• Ankylosing Spondylitis: We have added information about digestive system and kidney complications. And we now mention that a CT scan is a test that may detect changes from ankylosing spondylitis earlier than an X-ray can.
• Appendicitis: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Ask-the-Doctor Checklist: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Asthma During Pregnancy: The information in this topic was updated based on a new practice bulletin from the American College of Obstetricians and Gynecologists (ACOG). Also, the daily treatment plan and the action plan were combined into one asthma action plan based on the 2007 NIH asthma guidelines.
• Asthma in Children: The treatment plan and action plan have been combined into one asthma action plan. In the Exams and Tests section, we now mention the lack of evidence for the usefulness of the NIOX test in monitoring asthma. We have updated this topic to reflect the use of long-acting beta2-agonists only when combined with an inhaled corticosteroid for asthma control. We have added to the Prevention section information on managing nighttime asthma symptoms. And in the Other Treatment section, we now include information about complementary medicine treatments for asthma. We have removed drug brand names that are no longer available.
• Asthma in Teens and Adults: The daily treatment plan and the action plan have been combined into one asthma action plan based on the 2007 NIH asthma guidelines. We have removed mention of nedocromil because this drug is no longer used for asthma treatment. The Exams and Tests section now mentions that blood tests may be done to check for conditions that have symptoms similar to asthma. To the Treatment Overview section we have added information about dealing with nocturnal asthma symptoms. Per new CDC guidelines, we have added a recommendation for all people with asthma to receive a pneumococcal vaccination. We now include additional information on complementary therapies for asthma in the Other Treatment section.
• Basic Dental Care: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Bipolar Disorder in Children and Teens: In this updated topic we clarify that manic symptoms in children and teens can include irritability, extreme happiness, high energy, talking too fast, and engaging in risky, wild, thrill-seeking behavior. We explain that temper tantrums and happy or silly moods in this disorder are more extreme than what most children experience. Depressive symptoms now include moving slowly. We have removed information on the FIND screening instrument as it is no longer included the AACAP practice parameter recommendations. And we have added more emphasis on antipsychotic medicines for the treatment of manic episodes.
• Birthmarks: In the Treatment Overview section we have added some of the side effects of corticosteroids.
• Bladder Cancer: In this topic we now say that changes in the DNA of a person's cells seem to play a role in bladder cancer. We also say that when the lining of the bladder is irritated for a long time, cell changes that lead to cancer may occur. Treatment options for bladder cancer now include surgery, chemotherapy, immunotherapy, and radiation. We no longer use the term superficial bladder cancer but refer to noninvasive or early-stage bladder cancer. The term "biological therapy" has been replaced with "immunotherapy." We have added the side effects for radiation therapy and immunotherapy. We also say that having an experienced surgeon who does many cystectomies will reduce side effects and shorten the recovery time.
• Borderline Personality Disorder: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Bowel Obstruction: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Breast-Feeding: In this updated topic we have changed the recommended number of feedings to about 8 to 12 feedings in a 24-hour period, based on the American Academy of Pediatrics guidelines. We have replaced the previous latching illustration with a new latching slideshow. We have added blisters on the nipple to the When to Call section. We also have added a link to content about diet, breast-feeding, and colic. We no longer include the information about oxytocin nasal spray because oxytocin for breast-feeding is not often used and the commercial oxytocin nasal spray is no longer available. In the breast appearance information in the Common Concerns section, we have added a link to the information about inverted nipples.
• Broken Nose (Nasal Fracture): This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Brushing and Flossing A Child's Teeth: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Cellulitis: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Chronic Fatigue Syndrome: We have updated the Symptoms section to match the Centers for Disease Control (CDC) criteria for diagnosing chronic fatigue syndrome (CFS). We have added low grade fever and feeling unwell after exercise to the information on other long-term symptoms you may have. We have revised the information about corticosteroids for CFS. Studies have shown that these medicines do not work very well to treat CFS. And the side effects associated with long-term corticosteroid therapy outweigh their use in most cases.
• Chronic Lung Disease in Infants: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Cochlear Implants: In this targeted topic, we have added a warning about magnetic resonance imagine (MRI) scans and cochlear implants. It is possible that a cochlear implant can be affected by MRI scans. This could cause the implant to stop working.
• Collapsed Lung (Pneumothorax): This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Colon Polyps: This topic no longer lists fiber as a preventive measure for colon polyps or colon cancer. Based on the latest evidence, there is no proof that a diet high in fiber decreases a person's risk for colon cancer. We have removed calcium supplements from the information on preventing colon polyps. The evidence for calcium to prevent colon polyps is controversial, and high amounts of calcium may cause other problems. We have also removed double-contrast barium enema as a possible screening test for colon cancer. The American College of Gastroenterology and the United States Preventive Services Task Force no longer list that test as an option. We have updated the recommendations for screening according to the latest guidelines from the American College of Gastroenterology. The American College of Gastroenterology recommends that African Americans begin routine testing for colorectal cancer at age 45.
• Depression: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Depression in Children and Teens: In this topic we have clarified precautions about possible interactions between MAOIs and some foods or other medicines.
• Developmental Dysplasia of the Hip: We now say that DDH does not cause pain and that most children with DDH do not need surgery. We've added information about giving your child a sponge bath if he or she is in a Pavlik harness.
• Diabetic Retinopathy: In this topic we clarify that macular edema may occur at any stage of diabetic retinopathy. We include the recommendation that people with diabetes have their eyes examined every year. And we add that doctors may recommend less frequent follow-up exams for those at low risk for vision problems.
• Drooping Eyelids: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Dry Skin and Itching: This topic now mentions sun exposure as a cause for dry skin and itching. It also includes actions to reduce the effect of sun exposure on the skin.
• Early Disease Detection: Regarding children, we have added the new USPSTF recommendation that all adolescents be screened for depression. The frequency of testing for type 2 diabetes in children has been updated from every 2 years to every 3 years. We now state the American Academy of Pediatrics (AAP) recommendations for when developmental testing and autism testing should occur. Our content also reflects the newest AAP recommendations for hearing tests. (A formal hearing test is no longer recommended at ages 12, 15, and 18 years.) Regarding adults, we have updated the colon cancer screening guidelines. For instance, we now say that some people older than 75 may benefit from screening tests. And one expert group recommends that African Americans begin routine testing for colon cancer at age 45. Regarding skin cancer screening, we now talk about the ABCDEs rather than ABCDs of early detection.
• Ectopic Pregnancy: In this topic we have added a link to the definition of depression from the Topic Overview and the Home Treatment sections. We also include encouragement to women to talk to their doctors if any symptoms of depression last longer than a couple of weeks.
• Endocarditis: We have added that dentists as well as physicians may prescribe antibiotics for people who may need them before certain dental or surgical procedures to help prevent endocarditis.
• Eyelid Problems (Blepharitis): In this topic we have added that itchiness is a symptom of blepharitis, along with redness, irritation, and scaliness.
• Fibrocystic Breasts: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Fifth Disease: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Food Allergies: In this topic we now say that most children outgrow food allergies by the age of 5. We also say that 20% of children outgrow allergies to peanuts and that allergies to tree nuts in childhood seem to last for life. We now include the American Academy of Pediatrics recommendation of breast-feeding only for at least the first 4 months for all babies with family members who have food allergies. We also state that when doctors are taking a personal medical history, they will likely ask about any family history of food allergies.
• Gonorrhea: In this topic we have clarified the information about the types of tests, and we have added that you may have a urine test for gonorrhea. We now include information about PID, including that PID and epididymitis can be treated on an outpatient basis with oral antibiotics and close observation.
• Group B Streptococcal Infections in Newborns: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Growth and Development, Ages 12 to 24 Months: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Growth and Development, Ages 2 to 5 Years: We now include limiting TV time to 2 hours a day or less in the information about helping your preschooler grow and learn by being active. In the Promoting Healthy Growth and Development section, we've added information about getting help if your child has special needs. We also say to seek help if you think you have a problem with alcohol, drugs, anger, depression, stress, or other issues that affect your mental health. In the When to Call a Doctor section we've added a bullet about cognitive readiness skills in children by age 5.
• Growth and Development, Ages 6 to 10 Years: We have added FAQs about exercise and healthy eating. We now mention the importance of teaching your child how to resist using tobacco and other drugs. We have also added learning disability and ADHD signs to the When to Call A Doctor section.
• Growth and Development, Newborn: We have added a Frequently Asked Question (FAQ) about postpartum blues and depression. And we now mention baby's skin under Common Concerns.
• Hand-Foot-and-Mouth Disease: The statement that hand-foot-and-mouth disease is a condition reportable to the health department has been removed from this topic, because reporting is no longer required.
• Healthwise Self-Care Checklist: We have added information to help a person address pressing health concerns.
• Hearing Aids: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Hearing Loss: In this topic the information on newborn hearing screening has been updated. All 50 states now require newborn hearing tests. The recommendations for hearing tests in children have been updated according to the most recent American Academy of Pediatrics recommendations. Children ages 15, 18, 24, and 30 months and age 3 years should be tested subjectively. Children between the ages of 5 and 10 years should be tested objectively at ages 5, 6, 8, and 10 years and be tested subjectively at the other yearly checkups. Children and teens ages 11 to 21 years should be tested subjectively.
• Heart Attack and Unstable Angina: We have added that lowering C-reactive protein (CRP) levels, by taking a statin, may lower the risk of a heart attack in people who have normal cholesterol levels but have high CRP levels. We have added that you might take angiotensin II receptor blocker medicines (ARBs) if you cannot tolerate angiotensin-converting enzyme (ACE) inhibitor medicines. Also we have added that your doctor may recommend taking a proton-pump inhibitor (PPI) medicine if you have a high risk of bleeding from antiplatelet medicine (like clopidogrel). And we have added that it is best to talk with your doctor about taking a PPI with an antiplatelet because a PPI may keep the antiplatelet from working as well.
• Hemochromatosis: We have added the U.S. Preventive Service Task Force recommendation against genetic screening for hemochromatosis in the general population.
• High Blood Pressure (Hypertension): We have clarified that angiotensin II receptor blocker (ARB) medicines are less likely to cause a cough, which is a common side effect of an angiotensin-converting enzyme (ACE) inhibitor medicine. We have added the American Heart Association patient education Web site hearthub.org to the Other Places To Get Help section.
• Hip Fracture: Testing for homocysteine has been deleted from the topic, because the test is not widely used at this time. This topic now notes that the doctor might recommend bisphosphonates after a fragility fracture. To show the importance not only of fall prevention to prevent fracture but also of rehabilitation after a hip fracture, the topic now discusses the difficulty of recovering from this injury. Recommendations for vitamin D and calcium have been updated. Suggested limits on alcohol have been updated to 1 drink a day for women and 2 drinks a day for men. Information on hip protectors has been deleted. They do not prevent hip fracture in people who live at home, and they are of questionable value in facilities such as nursing homes.
• Human Immunodeficiency Virus (HIV) Infection: This topic now reflects that HIV-positive people benefit from early treatment (before symptoms occur and before CD4+ cell count drops below 350). We have added that viral load is a consideration when a decision is being made about when to start treatment and what treatment regimen to use. We have added the link between abacavir use and the higher risk of heart attack in people who have other cardiac risk factors. And we have added that depression may cause a loss of appetite in HIV-positive people.
• Hypoglycemia (Low Blood Sugar) in People Without Diabetes: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Immunizations: We've added that some adults may need a booster shot of meningococcal vaccine. And we link to the updated version of the PPSV Vaccine Information Statement.
• Inflammatory Breast Cancer: We now say that in this type of cancer, the cancer cells do not form lumps in the breast but instead block the lymph vessels that normally keep lymph fluid moving in the breast. We also say that more than one type of treatment may be needed. In the treatment information, we now list the test for estrogen and progesterone receptor status and the test for HER-2 receptor status as tests that will be done to identify which medicine may work best. Also we now say that with improved treatment methods, some women are living free of cancer for up to 15 years and longer. We now include information on clinical trials and tell women to talk to their doctors about whether they are good candidates for genetic testing.
• Inguinal Hernia: In this topic the information on surgery for inguinal hernia has been updated. The chance that a hernia will come back after surgery is higher for surgeries that do not use mesh (a synthetic patch).
• Iron Deficiency Anemia: We have clarified the information about making sure babies and toddlers get enough iron in their food. We have added that if you cannot tolerate the side effects of your iron pills, you can ask your doctor if there is another type of iron pill you can take.
• Jock Itch: We now say that itching and pain are common with jock itch. We no longer say to use antifungal powder to prevent jock itch. And we now say that if you have athlete's foot, it's best to dry your feet last when toweling off after a bath or shower, to prevent spreading infection from your feet to your groin.
• Kidney Stones: Updates to this topic include new information on ureteral stents and alpha-blocker medicines as treatment for kidney stones. Alpha-blocker medicines work better than calcium channel blockers to help kidney stones pass more quickly. The information on grapefruit juice has been updated. Drinking grapefruit juice may increase your risk for getting kidney stones, but avoiding grapefruit juice when you have a kidney stone will not help it pass. The medicine cholestyramine (Questran) has been removed from this topic because this medicine is not used often.
• Lipoma: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Mad Cow Disease: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Making Wise Health Decisions: In this topic we now state that sometimes the best choice is to say “noâ€? to care you don't need.
• Malaria: This topic now includes information about Plasmodium knowlesi. The methods to prevent being bitten by mosquitoes have been updated based on the most current evidence. Because the data changes too rapidly to ensure it was always up-to-date, we have removed extremely detailed information about the locations where specific Plasmodium species have developed resistance to particular drugs. Instead, readers are directed to the CDC or WHO Web sites about malaria.
• Managing Job Stress: This targeted topic has undergone a new medical review and was found to be accurate and up to date.
• Measles (Rubeola): We now say that a blood test will be done to confirm diagnosis of measles. We've added that some people have complications from measles. We've stated throughout to stay away from others while you are infected. And we've added information about how to relieve a cough.>
• Menarche: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Methicillin-Resistant Staphylococcus aureus (MRSA): We have modified the topic to reflect the uncertainty of drug resistance being caused by discontinuing antibiotic treatment.>
• Miscarriage: In this topic we have added a link to symptoms of depression. And we now include an encouragement to women to talk to a health professional if the depression symptoms do not go away after a couple of weeks.
• Motion Sickness: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Mumps: In this topic we've added information about the importance of staying hydrated if you have mumps.
• Necrotizing Enterocolitis: This topic now mentions that a course of antibiotics may be used to treat necrotizing enterocolitis. The information about studies using MRI to determine the extent of intestinal tissue damage has been removed because recent literature does not indicate these investigations are continuing.
• Normal Menstrual Cycle: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Obesity: In this topic we no longer say that drinking alcohol causes more weight gain around the stomach. We have added information about lifestyle changes after weight-loss surgery. We have also added that weight-loss surgery may reduce the chance of dying from heart problems, diabetes, or cancer.
• Occupational Therapy: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Oral Cancer: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Osteoarthritis: The Symptoms section now notes that osteoarthritis can lead to spinal stenosis. The topic still notes that controlling weight is important, but does not say that controlling weight is the single most important thing to do to prevent osteoarthritis. Acupuncture and the dietary supplements glucosamine and chondroitin are still in the information, but the topic has been updated to note that some evidence shows that they are not helpful for most people. Information on shoulder, hip, and knee replacements clarifies that whether regional or general anesthesia is used depends on the doctor, the patient's health, and to some degree on patient preference. Precautions for after a total hip replacement are no longer as stringent as they used to be. The topic now reflects this change, and we note that the most important thing to avoid is combination movements such as flexion at the same time as abduction (as with crossing the legs). Antibiotics are no longer recommended "for life" for most people who have joint replacement surgery. The topic notes that most people need antibiotics before procedures such as dental work or surgery for at least 2 years, then the doctor or dentist will determine whether they are still needed. The exercise for knee extension has been removed from the topic because it is good for after surgery but not as good for osteoarthritis. Information on paraffin now includes that paraffin should not be used if a person has lost feeling in the hand or foot. Information on using a walker no longer gives instructions for using a walker on stairs because this is not safe for most people.
• Peanut Allergy: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Pericarditis: We have added that the pain associated with pericarditis might spread to the shoulder blade.
• Periodic Limb Movement Disorder: In this targeted topic we have added exercise to the information on treatment. Routine, moderate exercise may help with symptoms.
• Physical Therapy: A statement on cooling lotions or sprays has been added to the content on ice and cold. Research does not show that core stability exercise is better than other exercise programs, so the information on core stability has been softened and made a little less definitive. The diaphragm has been added to the picture of inner core muscles.
• Pneumonia: We have clarified the role of antibiotics for pneumonia. We have added information about the benefit of frequent hand-washing for preventing pneumonia. The topic now contains information on the contagious period for pneumonia. Information on the two types of pneumococcal vaccines available has been added. Blood urea nitrogen (BUN) is now mentioned as a test that may be done to investigate symptoms of pneumonia. The terms "hospital-based pneumonia" and "community-based pneumonia" have been changed to the correct terms "healthcare-associated pneumonia" and "community-associated pneumonia," respectively.
• Polymyalgia Rheumatica and Giant Cell Arteritis: We have updated the recommended amounts of calcium and vitamin D to protect against osteoporosis. We have removed dosage ranges from the section on corticosteroids, because the dosages were discussed in such broad ranges that the numbers were not useful. This dosage information still appears in the table comparing treatment for polymyalgia rheumatica with treatment for giant cell arteritis. The topic now says a temporal artery biopsy should be performed within about a week of starting high-dose corticosteroids.
• Post-Polio Syndrome: We have updated the risk factors for post-polio syndrome to reflect information in recent research. And based on current theories, we have updated the possible reasons for the weakness associated with post-polio syndrome.
• Prehypertension: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Premature Infant: We no longer say that babies born closer to 37 weeks do not have problems. We've added information about group B strep. We've introduced the term neonatologist. We now talk about the importance of adults getting immunized in order to help protect premature infants. And we say more about feeding options.
• Pressure Sores: In this topic we have added deep tissue injury (DTI) to the Symptoms section. We have added X-rays and MRI as possible tests that may be used to stage pressure sores. We now say changing position every 2 hours is important for people who are bedridden. And it is important for people who are in wheelchairs to change their position more frequently, perhaps as often as every 15 minutes. We also say to talk with your doctor about how often you or the person you are caring for should change position. We say that when you are checking the skin of a person at risk for pressure sores, check them from head to toe. This includes the folds of their skin, especially in overweight or obese persons. Also, we say to check the tops of their ears if they have oxygen tubing that goes over their ears or straps from an oxygen mask. We no longer say to avoid air-filled boots, as there are now versions that relieve pressure. We also recommend talking with your doctor about other products that may help to prevent pressure sores.
• Restless Legs Syndrome (RLS): This topic no longer includes the dopamine agonists apomorphine (Apokyn), bromocriptine (Parlodel), and cabergoline (Dostinex) as treatment for RLS. These medicines are dopamine agonists but they are not routinely used to treat restless legs syndrome. Exercise has been added to the information on treatment for periodic limb movement disorder. Routine, moderate exercise may help with symptoms of PLMD.
• Ringworm of the Scalp or Beard: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Ringworm of the Skin: In this topic we no longer say to use talcum or other drying powder on the affected area to prevent ringworm. Under Medication Choices, we have added that terbinafine is available as oral granules that can be sprinkled over food and easily swallowed. We also say that people taking antifungals need to have their kidney function monitored by a doctor.
• Scabies: This topic now contains additional information about the use of oral ivermectin for treatment of scabies. The information about products to treat lice has been removed from the topic, because it is inappropriate in a topic about scabies. We have updated the information about the effectiveness of treatments for scabies.
• Sexuality and Physical Changes With Aging: We now say that most physical changes in men are related to decreasing testosterone levels that affect energy, strength, muscle and fat mass, and bone density, as well as sexual function. We no longer say that with age women may experience orgasms that are uncomfortable but rather that orgasms may be less intense. In the section on sexually transmitted diseases, we now say that because of age-related physical changes, older adults who are exposed to STDs may be more likely than young people to get STDs. We now say to practice safe sex with the use of condoms and lubricants until you are in a monogamous relationship and know your partner's sexual history and HIV status.
• Shaken Baby Syndrome: We have added more Frequently Asked Questions (FAQs) to this topic. In the Home Treatment section we've added information about how to calm a crying child.
• Shingles: We have clarified how shingles and chickenpox are related. And we no longer emphasize the role of corticosteroids in the treatment of shingles, because corticosteroids haven't been proved to help and they may cause disseminated disease.
• Slipped Capital Femoral Epiphysis: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Spina Bifida: In this topic we have removed a lot of the Latin terminology. We've added that a team of health professionals can help you address your child's needs. We now explain the reasons why surgery is done for an exposed spinal cord. And we talk about promoting your child's self-esteem. We mention learning problems, rather than intellectual disability, as one of the things your child may need help with. And we've updated the image of myelomeningocele.
• Stillbirth: In this targeted topic we have added a link to symptoms of depression. And we now include an encouragement to women to talk to a health professional if the depression symptoms do not go away after a couple of weeks.
• Stopping a Nosebleed: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Strabismus: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Stress Management: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Terrorism and Other Public Health Threats: In this topic we now say that anthrax vaccine is given in a series of shots over 18 months rather than saying that it is given in six injections.
• Thyroid Nodules: This topic has undergone a new medical review and was found to be accurate and up-to-date.
• Toilet Training: In the Home Treatment section we now say that you can use books and DVDs to help prepare your child for toilet training. We also say to stop the toilet-training process for a while if you notice your child is not making progress.
• Travel Health: This topic now includes information on the vaccine for typhoid fever. Also, we have added to the information on water safety that swimming with an open cut or sore increases your risk for infection. And we now say in the information on what to do if you get ill that it is important for you not to take antibiotics if you have bloody stool.
• Tremor: This targeted topic has undergone a new medical review and was found to be accurate and up to date.
• Tuberculosis: The Home Treatment section now includes more detailed information on dealing with emotional and physical aspects of tuberculosis. Drugs that have been discontinued have been removed from the topic. And we now include some information on extensively drug-resistant tuberculosis (XDR-TB).
• Umbilical Cord Care: This targeted topic has undergone a new medical review and was found to be accurate and up-to-date.
• Undescended Testicle: We have updated the illustration of undescended testicle.
• Urinary Tract Infections in Children: In the Prevention section we now say to offer your child fluids throughout the day in order to help with regular bladder emptying. And in the FAQs, we've updated prevalence information.
• Using Nitroglycerin for Sudden Chest Pain: We have clarified the differences between quick-acting nitroglycerin and long-acting nitroglycerin. We have clarified that this topic is focused on quick-acting forms. We have added that this topic does not describe how to use long-acting forms of nitroglycerin. We have added instructions for buccal tablets that are dissolved between the cheek and gum.
• Vaccine Information Statements: In this targeted topic, we link to the updated PPSV Vaccine Information Statement from the CDC.
• Vaginal Birth After Cesarean: In this topic we have clarified the information about the number of C-section scars and the safety of VBAC. We clearly state that VBAC is not considered safe if you have two C-section scars and have not delivered vaginally before.
• Vancomycin-Resistant Enterococci (VRE): We have modified the topic to reflect the uncertainty of drug resistance being caused by discontinuing antibiotic treatment.
• Vesicoureteral Reflux (VUR): We no longer list toilet training difficulty as a possible symptom of VUR. And we've added that a kidney ultrasound doesn't detect reflux.
• Women and Coronary Artery Disease: We have added more information about symptoms of coronary artery disease and heart attacks. We have added emphasis for seeking immediate medical care if you think you are having a heart attack. We have also added that women should not be afraid to speak up and ask for the care they need at the hospital if they think they are having a heart attack. We have added a link to the "Are You At Risk for a Heart Attack?" interactive tool.

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