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Journal of Family Practice

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https://www.readbyqxmd.com/read/28459896/green-fingernail
#1
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
https://www.readbyqxmd.com/read/28459895/management-of-bow-legs-in-children-a-primary-care-protocol
#2
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
https://www.readbyqxmd.com/read/28459894/fever-petechiae-and-joint-pain
#3
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
https://www.readbyqxmd.com/read/28459893/purls-consider-melatonin-for-migraine-prevention
#4
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
https://www.readbyqxmd.com/read/28459892/severe-headache-neck-pain-intermittent-cough-%C3%A2-dx
#5
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
https://www.readbyqxmd.com/read/28459891/uspstf-recommendations-a-2017-roundup
#6
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
https://www.readbyqxmd.com/read/28459890/reducing-cv-risk-in-diabetes-an-ada-update
#7
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
https://www.readbyqxmd.com/read/28459889/assessment-steps-and-treatment-tips-for-ankle-arthritis
#8
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
https://www.readbyqxmd.com/read/28459888/a-stepwise-approach-to-pediatric-asthma
#9
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
https://www.readbyqxmd.com/read/28459887/these-agents-do-double-duty-by-reducing-cv-risk-in-diabetes
#10
EDITORIAL
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
https://www.readbyqxmd.com/read/28375411/severe-polyarthralgia-high-grade-fever-diffuse-maculopapular-rash-on-trunk-and-extremities-%C3%A2-dx
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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