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Journal of Family Practice

Joyce C Hollander-Rodriguez, Holly L Montjoy, Brynn Smedra, J P Prouty
It is unclear. Pseudoephedrine causes an average increase of 1.2 mm Hg in systolic blood pressure (BP) in patients with controlled hypertension. However, the studies are not adequately powered to provide evidence about whether this rise in systolic BP is linked to patient-oriented outcomes (strength of recommendation: C, multiple randomized controlled trials supporting disease-oriented evidence). Significant variations in BP are defined differently among studies. In addition, we do not have data on chronic use of oral decongestants; the longest time on medication in these trials was 4 weeks...
June 2017: Journal of Family Practice
Anthony P Trace, Kimberly Hoang, Joseph S McMonagle
While this patient had osteoporosis, she hadn't experienced any recent trauma or falls that would explain her pain.
June 2017: Journal of Family Practice
Jennie B Jarrett, David Moss
An inexpensive and well-tolerated anticholinergic reduces sweating in those with localized--and generalized--hyperhidrosis.
June 2017: Journal of Family Practice
Adam D Keesling, Meg Wilson, Robert Wilkins
A 57-year-old African American woman was being treated at our clinic for neurogenic urinary incontinence (UI). The UI, which occurred day and night, began 2 years earlier following a laminectomy of vertebrae C3 to C6 with spinal fusion of C3 to C7 for cervical spinal stenosis. The UI persisted despite physical therapy and trials of oxybutynin and imipramine. Since the surgery, the patient had also been experiencing chronic (debilitating) neuropathic pain in both legs, and the sensation of incomplete bladder emptying...
June 2017: Journal of Family Practice
Michael Jason Wells, Charles M Kodner
A 23-year-old woman seeks medical attention at the request of her boyfriend because she's been "miserable" for 3 weeks. In the examination room, she slouches in the chair and says her mood is low, her grades have dropped, and she no longer enjoys social gatherings or her other usual activities. She has no thoughts of suicide, no weight loss, and no somatic symptoms.
June 2017: Journal of Family Practice
Amy Kreykes, Hetal Choxi, Amy Rothberg
Nutritional deficiencies, decreased bone mineral density,and dumping syndrome are just some of the challenges these patients face. Here's how to optimize their care.
June 2017: Journal of Family Practice
Joel J Heidelbaugh
A novel explanatory model, Rome IV diagnostic criteria,and evidence-based therapeutic guidelines are making it easier to care for patients with this complex disorder.
June 2017: Journal of Family Practice
Jane G Morris, Emily L Carter, Stephen A Martin
Time is of the essence when a patient has signs and symptoms suggestive of a stroke or TIA. What should your initial approach and diagnostic work-up be?
June 2017: Journal of Family Practice
John Hickner
If we control the cost of providing care, insurance premiums will follow suit.
June 2017: Journal of Family Practice
David Gish, Bryan J Romero
The patient hadn't injured her thumb and it didn't hurt. So why had her nail turned green?
May 2017: Journal of Family Practice
Samuel Dettling, Dennis S Weiner
Objective: To reduce unnecessary orthopedic referrals by developing a protocol for managing physiologic bow legs in the primary care environment through the use of a noninvasive technique that simultaneously tracks normal varus progression and screens for potential pathologic bowing requiring an orthopedic referral. Methods: Retrospective study of 155 patients with physiologic genu varum and 10 with infantile Blount`s disease. We used fingerbreadth measurements to document progression or resolution of bow legs...
May 2017: Journal of Family Practice
Syed Rahman, Adetunji Adegboyega, Kate Rowland
Our patient's signs and symptoms developed one week after being bitten by a rat that she was feeding to her son's pet snake.
May 2017: Journal of Family Practice
Corey Lyon, Shannon Langner
This affordable, over-the-counter hormone is as effective as amitriptyline, causes fewer adverse effects, and may have a surprising added benefit.
May 2017: Journal of Family Practice
Claudia Lyon, Swapna Sayeneni, Jeanne Carey
A 32-year-old Chinese woman sought care from our family medicine clinic because she had a headache, neck pain, and an intermittent cough that had produced white sputum for 7 days. She described the headache as severe and pressure-like, and said that it had progressively worsened over the previous 3 weeks, coinciding with her first trip outside of China to the United States. The patient indicated that she also had occasional vomiting, dizziness, a low-grade fever, chills, night sweats, and increasing fatigue...
May 2017: Journal of Family Practice
Doug Campos-Outcalt
Colorectal cancer screening and primary CVD prevention have general and selectively applied updates. This review also covers medical services to avoid and those without sufficient evidence to recommend.
May 2017: Journal of Family Practice
Neil Skolnik, Florence M Jaffa, Rita R Kalyani, Eric Johnson, Jay H Shubrook
This Q&A highlights changes to the ADA's 2017 Standards of Care to help you fine-tune your approach to patients who have, or are at risk for, atherosclerotic CV disease.
May 2017: Journal of Family Practice
Adam Bitterman, Jeremy Alland, Johnny Lin, Simon Lee
The tibiotalar joint's unique biomechanics and associated structures carry management implications that vary from those in knee or hip arthritis.
May 2017: Journal of Family Practice
Noel A Dunn, Laurel A Neff, Douglas M Maurer
Two guidelines and several recent studies are available to guide your care. This review--with handy figure--puts it all at your fingertips.
May 2017: Journal of Family Practice
John Hickner
For patients with type 2 diabetes mellitus who have established or are at high risk for cardiovascular disease, prescribing these drugs makes good sense.
May 2017: Journal of Family Practice
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
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