Acute otitis media (AOM) was the third most frequent diagnosis in ambulatory care for patients under age 15 in the most recent National Ambulatory Medical Care Survey and is the most common cause of antibiotic prescription for infants and children.
Ethical dilemmas face physicians frequently, but unlike the show, THE PRICE IS RIGHT, the price one pays for medical care encompasses not only money, but issues of quality of life, unintended consequences, and possibly life itself. Options and decisions are not always black or white and the person or group tasked to render best practices advice does so from a complex of diverse educational and cultural backgrounds.
A quick primer on the importance of stepping back from the routine of the history and physical to read some non-verbal cues, note gaps in fluent speech and pick up on my emotional reaction to the patient. A pneumonic is revealed to help us incorporate this assessment into our daily interactions with our patients.
Hormone replacement therapy (HRT) in postmenopausal women has been more controversial since the publication of the Women’s Health Initiative findings in 2003. Many women have stopped taking estrogen on their own, or have been told to do so by their healthcare provider, and now those women are having hot flashes or other sequelae of menopause.
I thought my knowledge of Parkinson’s disease (PD) was adequate for primary care. I had been taught that Parkinson’s disease is a movement disorder caused by the loss of dopamine-producing cells in the substantia nigra of the brain.
Daily behaviors account for maintaining one’s health, both physically and emotionally. In terms of mental health, 27% of Americans suffer mental health symptoms and disorders that impact families, the workplace, and quality of life.
Renal Medication Dosing. One of the most difficult propositions for practitioners is the adjustment of medications when dosing for Chronic Kidney Disease (CKD). This article serves to update the non-nephrology practitioner on the practical dosing of medications for the CKD patient in 2012.
Chronic Kidney Disease: A New Paradigm. Since diabetes and hypertension are diseases of aging, the increase in the number of CKD patients will continue for the foreseeable future. The Government’s Healthy People 2020 goals acknowledges the burden of CKD and encourages practitioners to aggressively treat these patients to attempt to lower the morbidity and mortality caused by CKD. This article highlights outcome-driven treatments that can assist the practitioner in accomplishing that goal.
Herpes Zoster, Post Herpetic Neuralgia, and Zoster Vaccine Live. ‘Prevention is worth a pound of cure” is particularly true for older adults who are at risk for developing post herpetic neuralgia (PHN) and herpes zoster (HZV). PHN is the post sequelae that can occur in people who have had a previous bout of herpes zoster, also known as shingles. HZV is an infection attributable to the human herpes virus-3, also known as the varicella zoster virus.
Sexual Health: Communicate, Inquire, and Promote. Healthy People 2020 identify Reproduction and Sexual Health as a leading health indicator. Leading health indicators, or high priority health issues, list objectives to improve the health of the US population. Providers and healthcare organizations are encouraged to implement these objectives in their practice in order to meet these health care goals for the nation.
Asthma Management: Recent Insights and Updates. Asthma, characterized by reversible airflow obstruction, has afflicted people since ancient times. Described by Galen in the second century as epilepsy of the lungs, an array of famous people have suffered from asthma—from Ludwig von Beethoven to Billy Joel, from the ancient Roman philosopher and politician, Seneca to President Bill Clinton, and from baseball pitcher, Jim “Catfish” Hunter to Olympic medalist, Jackie Joyner-Kersee. [1,2] Today, it is estimated that asthma affects 300 million individuals worldwide. In the US, its prevalence has increased dramatically in the last decade and now affects more than 25 million. Asthma is the most common chronic disease among children under 5 years old, and is the leading cause of morbidity reflected in absence from daycare,
Irritable Bowel Syndrome. Irritable bowel syndrome (IBS) is a common disorder that affects the colon, causing cramping, abdominal pain, bloating, gas, diarrhea or constipation. Despite these uncomfortable symptoms, IBS doesn't cause permanent damage to the colon – it doesn't cause changes in bowel tissue or increase the risk of colorectal cancer. This distinguishes it from more serious structural intestinal diseases such as ulcerative colitis and Crohn's disease.
Celiac Disease: The Great Pretender. Celiac disease is an immune-mediated disorder characterized by chronic inflammation of the small intestinal mucosa, which can result in malabsorption and a variety of clinical manifestations. While considerable scientific progress has been made in the understanding and management of celiac disease, unfamiliarity with the multidisciplinary presentation is a significant barrier to diagnosis and treatment.
Primary Care Clinicians Play an Important Role in the Early Diagnosis of Lupus. Lupus is an autoimmune inflammatory disease that can lead to significant disability and organ damage. Recognizing the early signs and symptoms of this complex condition can help primary care clinicians play a key role in early diagnosis and referral while they provide ongoing and supportive care.
Providing Care for Soldiers Returning From Iraq and Afghanistan. Since September 11, 2001, approximately 2.4 million military personnel have deployed to Iraq and Afghanistan. To date, roughly 1.44 million have separated from the military; when they return to the states, approximately half will use Veterans Affairs healthcare and the other half will be seen by non-VA primary care providers.