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Journal of Family Practice

Caitlyn T Reed, Allison R Cruse, Jeremy D Jackson
A 74-YEAR-OLD CAUCASIAN MAN presented to the hospital with intractable back and chest pain, a diffuse skin rash, and altered mental status. He said that 2 days ago, he'd gone to a different local hospital for treatment of back pain and a headache that had begun 3 days earlier. He was treated with intravenous hydromorphone and sent home with a prescription for meperidine. He said that several hours after being treated with the hydromorphone, the rash developed on his head and then spread to his trunk and upper extremities...
November 2017: Journal of Family Practice
William Bassett, Jeremy Korsch, Kenneth G Swan
What role does arthroscopic surgery have in the treatment of patients with atraumatic meniscal tears and osteoarthritis? The authors reviewed the literature to find out.
November 2017: Journal of Family Practice
Steven Lippmann, Devina Singh
No abstract text is available yet for this article.
November 2017: Journal of Family Practice
John Geyman
No abstract text is available yet for this article.
November 2017: Journal of Family Practice
Thomas W Hahn, Connie Kraus, Christopher Hooper-Lane
IT IS UNCLEAR, but studies suggest that it should be based largely on individual risk. The American Academy of Pediatric Dentistry recommends a 6-month interval for preventive dental visits (strength of recommendation [SOR]: C, expert opinion), but a 24-month interval does not result in an increased incidence of dental caries in healthy children and young adults or increased incidence of gingivitis in healthy adults (SOR: B, a single randomized controlled trial [RCT]). In adults with risk factors (eg, smoking or diabetes), visits at 6-month intervals are associated with a lower incidence of tooth loss (SOR: C, a retrospective cohort study)...
November 2017: Journal of Family Practice
Emily Mann, Rochelle Kramer, C Randall Clinch
A 15-month-old black male was brought to the pediatric emergency department by his grandmother because she was concerned about his 2 swollen big toes. The patient's grandmother said that the swelling began 36 hours prior and that her grandson's big toes had continued to increase in size. She denied trauma, bites, or unusual exposures and said that although her grandson had been fussier than usual that day, he was eating and drinking normally and had normal urine output. What is your diagnosis? How would you treat this patient?...
November 2017: Journal of Family Practice
Laura E Fink, Gerald W Morris, Linda A Mansfield
A 14-year-old Caucasian boy presented to our clinic with a complaint of left anterior hip pain. The patient had been running during a flag football match when he suddenly developed a sharp, stabbing pain in his left hip. He said he felt a "pop" in his left groin while his left foot was planted and he was cutting to the right. The patient said this was followed by worsening pain with ambulation and hip flexion. The patient had considerable difficulty walking into the exam room. On physical examination, he had significant tenderness to palpation along the anteromedial thigh and groin...
November 2017: Journal of Family Practice
Alicia Ludden-Schlatter, James J Stevermer
Patients on warfarin plus antiplatelet/NSAID regimens are likely to benefit from the gastroprotective effect of PPIs. For patients taking warfarin alone, it's a different story.
November 2017: Journal of Family Practice
Mary Onysko, Holly M Anderson, Songlin Cai, Bradford T Winslow
These interactions can affect contraceptive efficacy, increase bleeding risk, or lead to rhabdomyolysis. This practical guide can help you avoid trouble.
November 2017: Journal of Family Practice
Allan S Vann
The author's wife struggled with Alzheimer's disease for 10 years. The insights he provides here are drawn from his experience--and the literature.
November 2017: Journal of Family Practice
Renee T Sullender, Jessica Dalby, Stacy Loerch
These 5 practice-changing initiatives can help reduce the number of unwanted pregnancies and allow women to take more control of their reproductive health.
November 2017: Journal of Family Practice
Ian M Deutchki
Changes related to aging alone typically don't interfere with one's ability to function independently. These tips and tools can help ensure an accurate evaluation.
November 2017: Journal of Family Practice
Doug Campos-Outcalt
No abstract text is available yet for this article.
November 2017: Journal of Family Practice
Connie Kraus, Christopher Hooper-Lane
Yes, but not as effective as some other methods. Annual pregnancy rates in women using pericoital levonorgestrel 150 mcg to 1 mg range from 4.9% to 8.9%; menstrual irregularity is the most common adverse effect (strength of recommendation [SOR]: B, Cochrane review of lower-quality trials). In women younger than 35 years who have sexual intercourse 6 or fewer times per month, correct and consistent use of pericoital levonorgestrel 1.5 mg results in an annual pregnancy rate of 11% (SOR: B, one large prospective, open-label trial)...
October 2017: Journal of Family Practice
Nick Koneri, Andrew Muck, Bruce D Adams
A 77-year-old woman presented to the emergency department complaining of a headache following a syncopal episode (while standing) earlier that day. She said that she'd lost consciousness for several minutes, and then experienced several minutes of mild confusion that resolved spontaneously. On physical exam, she was oriented to person and place, but not time. She had a contusion in her left occipitoparietal region without extensive bruising or deformity. The patient had normal cardiopulmonary, abdominal, and neurologic exams...
October 2017: Journal of Family Practice
Robert Gauer, Collin Hu, Lindsey Beaman
A 32-year-old man was admitted to our hospital with fever, chills, malaise, leukopenia, and a rash. About 3 weeks earlier, he'd had oral maxillofacial surgery and started a 10-day course of prophylactic amoxicillin/clavulanic acid. Fifteen days after the surgery, he developed a fever (temperature, 103° F), chills, arthralgia, myalgia, cough, diarrhea, and malaise. He was seen by his physician, who obtained a chest x-ray showing a lingular infiltrate. The physician diagnosed influenza and pneumonia in this patient, and prescribed oseltamivir, azithromycin, and an additional course of amoxicillin/clavulanic acid...
October 2017: Journal of Family Practice
Adrienne A Williams
DeSean W, a 47-year-old man, returned to his primary care clinic with a new complaint of epigastric burning that had been bothering him for the past 4 months. He had tried several over-the-counter remedies, which provided no relief. He also remained concerned--despite assurances to the contrary at previous clinic visits--that he had contracted a sexually-transmitted disease (STD) after going to a bar one night 4 to 5 months ago. At 2 other clinic visits since that time, STD test results were negative. At this current visit, symptoms and details of sexual history were unchanged since the last visit, with the exception of the epigastric pain...
October 2017: Journal of Family Practice
Gregory Castelli, Jennie B Jarrett
Prescribe 5 days of antibiotic treatment for inpatients with community-acquired pneumonia because it produces the same clinical success rates as longer treatment regimens, but is associated with fewer negative patient outcomes.
October 2017: Journal of Family Practice
Ezinne I Ogbureke, Ruth E Conn, Dennis E Garcia, Cleverick D Johnson
A 56-year-old white man presented at our dental clinic for routine care. The intraoral examination revealed an asymptomatic red lesion with white vesicle-like areas on the right side of the soft palate. The extraoral examination was normal, and regional lymph nodes were nonpalpable. The patient's medical history included liver cirrhosis and pancreatitis. He also had a 30-year history of alcohol misuse (1-5 drinks per day) and a 30-pack-year smoking history. (The patient had stopped drinking at the time of presentation, and had quit smoking 2 years earlier...
October 2017: Journal of Family Practice
David J Satin, Sarah A Swenson, Steven D Stovitz
You can improve health outcomes and patient satisfaction--without increasing the length of the patient visit--by employing the tenets of shared decision-making.
October 2017: Journal of Family Practice
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