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Journal of Family Practice

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https://www.readbyqxmd.com/read/28863208/individualizing-immunization-for-international-travelers
#1
Vini Vijayan
Take into account routine childhood vaccinations, those that are mandatory for specific destinations, and these highly recommended immunizations.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863207/does-treating-obstructive-sleep-apnea-improve-control-of-tx-resistant-hypertension
#2
Steven Solum, Thomas Satre
Maybe. Treating obstructive sleep apnea with continuous positive airway pressure is associated with decreases in both systolic and diastolic blood pressure of 3 to 5 mm Hg in patients with treatment-resistant hypertension. The clinical significance of this small decrease hasn't been evaluated, however.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863206/periorbital-ecchymoses-and-breathlessness
#3
Sudip Kumar Ghosh, Biswajit Majumder, Sandip Ghosh, Dilip Kumar Das, Sharmistha Chatterjee
A 54-year-old man presented at our facility with a 3-month history of exertional breathlessness and purple blotches around his eyes. Examination revealed bilateral periorbital and perioral ecchymosis, purpuric spots along his waist, and waxy papules on his eyelids. In addition, the patient had macroglossia with nodular infiltration and irregular indentations at the lateral margin of his tongue. The patient also had a raised jugular venous pressure and prominent atrial and ventricular waves. Further examination revealed a fourth heart sound over the left ventricular apex, as well as bilateral basal rales...
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863205/bruises-on-the-ears-and-body
#4
Diana M Sarmiento, Thomas F Northrup, Yu Wah
Over the course of a month, this 34-year-old woman had sought care at our facility--and another--on 3 separate occasions for painful bruises (visits #1 and #3) and deep vein thrombosis (visit #2). The bruises first appeared acutely on her arms, prompting her first visit to our ED and leading to a hospital stay. Several weeks later, the patient developed new bruise-like lesions on her earlobes, face, trunk, and lower extremities. In between these 2 visits, the patient was seen in another ED (and admitted) for right upper extremity DVT and was started on enoxaparin, followed by warfarin...
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863204/latest-recommendations-for-the-2017-2018-flu-season
#5
Doug Campos-Outcalt
This season's vaccine has a new H1N1 component and any vaccine, except the live attenuated virus formulation, is suitable for pregnant women.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863203/purls-ssris-for-depression-heart-failure-patients-not-so-fast
#6
Jason Ricco, Janice Benson, Shailendra Prasad
This study should put to rest the practice of starting SSRIs in depressed patients with heart failure in an attempt to affect CVD outcomes.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863202/immigrant-with-stomach-pain-distension-nausea-and-fever-%C3%A2-dx
#7
Joshua Tessier, Callie Waller
A 34-year-old Eritrean man presented to the emergency department with complaints of diffuse abdominal pain and distention. He had emigrated to the United States 3 months earlier, following 5 years in a refugee camp in Ethiopia. Two weeks earlier, the patient sought care at his primary care clinic and was diagnosed with post-operative urinary retention and constipation following a recent hemorrhoidectomy. A Foley catheter was inserted and provided a short period of relief. Following the visit, however, his abdominal pain worsened...
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863201/cervical-artery-dissection-related-to-chiropractic-manipulation-one-institution-s-experience
#8
Kelly A Kennell, Megan M Daghfal, Shyam G Patel, Jeffery R DeSanto, G Scott Waterman, Raymond E Bertino
PURPOSE: The purpose of this study was to determine the frequency of patients seen at a single institution who were diagnosed with a cervical vessel dissection related to chiropractic neck manipulation. METHODS: We identified cases through a retrospective chart review of patients seen between April 2008 and March 2012 who had a diagnosis of cervical artery dissection following a recent chiropractic manipulation. Relevant imaging studies were reviewed by a board-certified neuroradiologist to confirm the findings of a cervical artery dissection and stroke...
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863200/autonomic-dysfunction-a-guide-for-fps
#9
Kristen Thornton, Marlon O Mitchell
Impotence, bladder dysfunction, GI symptoms, and orthostatic hypotension can signal autonomic dysfunction. Here's what you'll see and how to respond.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863199/hypertension-treatment-strategies-for-older-adults
#10
REVIEW
Maggie W Hansell, Emily M Mann, Julienne K Kirk
This evidence-based review illustrates how to adjust treatment for comorbidities and incorporate frailty and cognitive impairment into the equation.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863198/skip-the-antidepressant-when-the-patient-has-chronic-disease
#11
EDITORIAL
John Hickner
It makes sense to think that treating patients who have congestive heart failure and depression with an antidepressant would be effective. But common sense is not always supported by empiric observation or evidence.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783775/low-grade-fever-erythematous-rash-in-pregnant-woman-%C3%A2-dx
#12
James M O'Brien, Jonathan D Baum
A 31-year-old woman presented to her obstetrician's office at 16 weeks' gestation with a 2-day history of low-grade fever and an erythematous rash measuring 1 x 4 cm on her right groin. She had a medical history of a penicillin allergy (urticarial) and her outdoor activities included gardening and picnicking. What's your diagnosis?
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783774/progressive-hair-loss
#13
David V Power, Max Disse, Maria Hordinsky
A 66-year-old white woman presented to her primary care clinic with concerns about hair loss, which began 2 years ago. Recently, she had noticed some "bumps" on her cheeks, as well.
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783773/clinical-inquiry-what-is-the-most-effective-treatment-for-scabies
#14
Jonathon J Campbell, Christopher P Paulson, Joan Nashelsky
Topical permethrin is the most effective treatment for classic scabies (strength of recommendation [SOR]: A, meta-analyses with consistent results). Topical lindane and crotamiton are inferior to permethrin but appear equivalent to each other and benzyl benzoate, sulfur, and natural synergized pyrethrins (SOR: B, limited randomized trials). Although not as effective as topical permethrin, oral ivermectin is an effective treatment compared with placebo (SOR: B, a single small randomized trial). Oral ivermectin may reduce the prevalence of scabies at one year in populations with endemic disease more than topical permethrin (SOR: B, a single randomized trial)...
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783772/obsessive-compulsive-disorder-under-recognized-and-responsive-to-treatment
#15
Julia R Craner, Jared Lyon Skillings, Christopher R Barnes
Mood or anxiety concerns, when explored, may reveal associated OCD symptoms. Pharmacotherapy and cognitive behavioral therapy have proven effective.
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783771/purls-direct-oral-anticoagulants-or-warfarin-for-a-fib
#16
Corey Lyon, Alex Reed, Shailendra Prasad
A recent study evaluated the effectiveness of 3 direct oral anticoagulants and warfarin in patients with atrial fibrillation. So which agents came out on top?
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783770/active-46-year-old-man-with-right-sided-visual-loss-and-no-family-history-of-stroke-%C3%A2-dx
#17
Tokunbo Ajayi, Hyun-Sik Yang, Ashmeet Bhatia
A 46-year-old man presented to the emergency department with sudden-onset right-sided visual loss. He had a history of asthma, but no family history of hypercoagulability, deep vein thrombosis, or stroke. The patient had an active lifestyle that included scuba diving, mountain biking, and hockey (coaching and playing). The physical examination revealed a right homonymous upper quadrantanopia. The neurologic examination was within normal limits, except for the visual deficit and unequal pupil size. A computerized tomography scan of the patient's head did not reveal any lesions...
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783769/radiation-therapy-managing-gi-tract-complications
#18
Neshan Tabibian, Aisha Umbreen, Ehab Swehli, Anne Boyd, James H Tabibian
Here's how to recognize radiation-related adverse effects so that you can expedite care and help preserve your patient's quality of life.
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783768/advance-care-planning-making-it-easier-for-patients-and-you
#19
John Liantonio, Michael Liquori, Lilia Lakhtman, Susan Parks
Helpful resources, many of them online, are available to facilitate the process. And this time-intensive service is now billable under 2 CPT codes.
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28783767/hand-and-arm-pain-a-pictorial-guide-to-injections
#20
Gregory R Waryasz, Todd Borenstein, Robert Tambone, Joseph A Gil, Manuel DaSilva
This article, with illustrative figures, will help you get to the cause of your patient's pain and guide your administration of corticosteroid injections.
August 2017: Journal of Family Practice
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