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Journal of Family Practice

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https://www.readbyqxmd.com/read/28375411/severe-polyarthralgia-high-grade-fever-diffuse-maculopapular-rash-on-trunk-and-extremities-%C3%A2-dx
#1
Stephen D Hoag, Karen Chung
The patient was nauseous, and had been experiencing headaches, generalized weakness, and fatigue. Her physical exam revealed a maculopapular rash on her trunk and upper extremities. She had tenderness and pain, as well as decreased range of motion in her ankles, knees, and wrists. The patient had no erythema, swelling, petechiae, or bruising. She had a past medical history of Graves' disease and had received all of her childhood immunizations.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375410/hot-topics-in-primary-care-sublingual-immunotherapy-a-guide-for-primary-care
#2
REVIEW
Eli O Meltzer
Allergen immunotherapy (AIT), the only potential disease-modifying treatment for allergic disease, has been used for more than a century. Hankin et al showed significant reduction in pharmacy, outpatient, and inpatient resources in the 6 months following vs the 6 months preceding AIT in Medicaid-enrolled children with allergic rhinitis (AR). A 2013 analysis showed sustained cost reduction over 18 months in patients with AR treated with AIT compared with matched control subjects not treated with AIT.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375409/hot-topics-in-primary-care-the-cardiovascular-safety-of-nonsteroidal-anti-inflammatory-drugs-putting-the-evidence-in-perspective
#3
REVIEW
Martin Quan
The Vioxx Gastrointestinal Outcomes Research (VIGOR) trial, published in 2000, was the first to raise concerns that NSAIDs (specifically, the COX-2 selective inhibitor rofecoxib) might be associated with a higher risk for cardiovascular (CV) events. As discussed in this article, subsequent trials and meta-analyses have demonstrated a higher CV risk with use of not only COX-2 inhibitors (coxibs) but also certain tNSAIDs. These investigations have contributed to actions by the US Food and Drug Administration (FDA), most recently in July 2015, requiring strengthening of CV risk warnings on labels for all prescription and over-the-counter NSAIDs, despite evidence suggesting that differences in CV risk may exist among the NSAIDs...
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375408/hot-topics-in-primary-care-medication-adherence-in-type-2-diabetes-mellitus-real-world-strategies-for-addressing-a-common-problem
#4
REVIEW
Stephen A Brunton, William H Polonsky
The importance of treatment adherence is well established, as poor adherence contributes to disease progression and increased morbidity and mortality. Analysis of 11,272 veterans with T2DM with a mean follow-up of 5 years showed that for each 10% increase in the medication possession ratio, the mean glycated hemoglobin (HbA1c) decreased by 0.24%. Poor adherence also leads to increased health care resource utilization and costs, including more frequent hospitalizations. Conversely, while improved adherence increases medication costs, it can decrease overall health care resource utilization and costs...
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375407/hot-topics-in-primary-care-role-of-the-microbiome-in-disease-implications-for-treatment-of-irritable-bowel-syndrome
#5
REVIEW
Brian E Lacy
Dietary and some other treatments for IBS are supported by a growing body of evidence, much of which comes from programs such as the Human Microbiome Project and Human Gut Microbiome Initiative, which were intended to identify and characterize microorganisms found in association with both healthy and diseased humans. These programs used state-of-the-art technology to characterize the human microbiome from multiple body sites. This evidence indicates that the gut microbiome plays an important role in IBS and some other gastrointestinal (GI) disorders...
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375406/hot-topics-in-primary-care-diagnosis-of-cirrhosis-and-evaluation-of-hepatic-encephalopathy-common-errors-and-their-significance-for-the-pcp
#6
REVIEW
Steven L Flamm
Cirrhosis has become the focus of greater attention in recent years largely because of the increasing prevalence of 2 of its most common causes: chronic viral hepatitis and steatohepatitis (a subset of nonalcoholic fatty liver disease [NAFLD]). Cirrhosis is the result of progressive destruction and regeneration of the liver parenchyma due to chronic liver disease (CLD).
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375405/hot-topics-in-primary-care-titratable-fixed-ratio-combinations-in-type-2-diabetes-mellitus-focus-on-glp-1r-agonists-combined-with-basal-insulin
#7
REVIEW
James LaSalle, John R White
The treatment of hyperglycemia in patients without glycemic control despite metformin monotherapy is the focus of this article, with particular focus on the use of fixed-dose (FDC) and fixed-ratio combination products.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375404/hot-topics-in-primary-care-demystifying-the-differences-follow-on-biologics-biosimilars-and-generics
#8
REVIEW
Eugene E Wright, Thomas C Blevins, Beverly Reed, Roy Daniel Pollom
Sponsors of follow-on biologics can submit their applications for approval by the US Food and Drug Administration (FDA) under 2 distinct pathways. The submission pathway is determined by the pathway previously used by the reference biologic product, which is the biologic product upon which the follow-on product relies for evidence of safety and efficacy.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375403/hot-topics-in-primary-care-cardiovascular-safety-of-medications-for-type-2-diabetes-mellitus
#9
REVIEW
Javed Butler
Besides vascular events, which include myocardial infarction and stroke, patients with diabetes are at a high risk for developing heart failure and heart failure-related death, with a 15% increase in the risk of heart failure for every 1% increase in glycated hemoglobin (HbA1c) above 7.5%.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375402/hot-topics-in-primary-care-community-acquired-bacterial-pneumonia-is-there-anything-new
#10
REVIEW
Hans Liu
The management of patients with community-acquired pneumonia (CAP) is an ongoing challenge in the primary care setting. This is due, in part, to the fact that management guidelines in the United States were published nearly a decade ago. Furthermore, there has been a dearth of new treatments. But that may be about to change. Management guidelines are being updated by the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) and are expected to be released this summer. In addition, several new antibiotics for the treatment of CAP are on the horizon...
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375401/hot-topics-in-primary-care-individualizing-dual-therapy-for-type-2-diabetes-mellitus
#11
REVIEW
Neil S Skolnik, Florence Jaffa, Yan Kiriakov
While many advances in the management of patients with type 2 diabetes mellitus (T2DM) have occurred over the past decade, nearly half of patients with diabetes still have a glycated hemoglobin (HbA1c) above the target of 7.0%.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375400/clinical-inquiry-do-ace-inhibitors-or-arbs-help-prevent-kidney-disease-in-patients-with-diabetes-and-normal-bp
#12
Gregory S Trietley, Stephen A Wilson, Parul Chaudhri, Nicole Payette, Ashley Higbea, Joan Nashelsky
Yes for angiotensin-converting enzyme (ACE) inhibitors, no for angiotensin receptor blockers (ARBs). A 2011 meta-analysis of 5 RCTs (total 2975 patients) that compared ACE inhibitor therapy with placebo in diabetic patients without hypertension and albuminuria found that ACE inhibitors reduced the risk of new-onset microalbuminuria or macroalbuminuria by 18% (relative risk [RR]=0.82; 95% confidence interval [CI], 0.73-0.92).
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375399/single-nontender-ulcer-on-the-glans
#13
Husein Husein-ElAhmed
The patient's history and the clinical appearance of the ulcer led to the diagnosis of this re-emerging condition.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375398/purls-when-can-exercise-supplant-surgery-for-degenerative-meniscal-tears
#14
Jennie B Jarrett, Sandra Sauereisen
Patients with a medial, degenerative meniscal tear and a minimal history of osteoarthritis make good candidates for physical therapy-- and there is an added benefit, too.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375397/behavioral-health-consult-targeting-depression-primary-care-tips-and-tools
#15
Michael Maksimowski, Michael Raddock
The resources provided here can help you determine if depression is to blame for your patient's symptoms. A handy antidepressant guide can inform your Tx choices.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375396/muscle-spasms-twitches-in-arm-upon-throwing-%C3%A2-dx
#16
Kyle Bradford Jones, Juliann Allred, David Shprecher
Involuntary upper right arm muscle contractions and spasms, which began intermittently when the patient was a teenager, were now a real problem for him as an adult. The patient was having difficulty rolling a baseball underhand to players as part of infield practice and he was experiencing muscle spasms when lifting his right arm over his head. "Twitches" in the patient's upper arm were making drinking difficult, but he had no problems feeding himself, writing, or performing other basic activities of daily living...
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375395/partnering-to-optimize-care-of-childhood-cancer-survivors
#17
REVIEW
Bethany D Nugent, Amanda Moore, Aimee Costello, Anna Marie White Lewarchik, Jean M Tersak
Familiarizing yourself with the survivorship care plan can help ensure that survivors receive proper follow-up care. Collaboration among providers is also key.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375394/insomnia-getting-to-the-cause-facilitating-relief
#18
REVIEW
Adam J Sorscher
Chronic insomnia is often the result of multiple underlying physiologic, psychological, and social factors. A sleep log, sleep hygiene, CBT, and medication can help.
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375393/can-scribes-boost-fps-efficiency-and-job-satisfaction
#19
Stephen T Earls, Judith A Savageau, Susan Begley, Barry G Saver, Kate Sullivan, Alan Chuman
Purpose: Research in other medical specialties has shown that the addition of medical scribes to the clinical team enhances physicians' practice experience and increases productivity. To date, literature on the implementation of scribes in primary care is limited. To determine the feasibility and benefits of implementing scribes in family medicine, we undertook a pilot mixed- method quality improvement (QI) study. Methods: In 2014, we incorporated 4 parttime scribes into an academic family medicine practice consisting of 7 physicians...
April 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28375392/screen-for-bullying-but-know-what-to-do-next
#20
LETTER
Ari Magnusson
No abstract text is available yet for this article.
April 2017: Journal of Family Practice
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