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Primary Care

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https://www.readbyqxmd.com/read/29132535/gastroenterology
#1
EDITORIAL
Rick Kellerman, Laura Mayans
No abstract text is available yet for this article.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132534/bugs-drugs-and-the-unknown
#2
EDITORIAL
Joel J Heidelbaugh
No abstract text is available yet for this article.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132533/erratum
#3
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132532/emerging-topics-in-gastroenterology
#4
REVIEW
Gretchen Irwin, Laura Mayans, Rick Kellerman
The bacteria and fungi in the human gut make up a community of microorganisms that lives in symbiosis with humans, engaging in numerous diverse interactions that influence health. This article outlines the current knowledge on emerging topics in gastroenterology, including microbiome and probiotics, fecal microbiota transplantation, cyclic vomiting syndrome, eosinophilic esophagitis, and microscopic colitis.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132531/gastrointestinal-malignancies
#5
REVIEW
William R Sonnenberg
This article reviews esophageal, gastric, and colon cancers for the primary care physician. Risk factors, demographics, and screening are discussed. The rise of Western lifestyle has been a mixed blessing for these cancers. Our modern world has led to the decline of gastric cancer from the leading cause of cancer death before the 1930s to the 13th leading cause of cancer death now. Conversely, esophageal cancer is increasing faster than any other cancer. Screening for esophageal and gastric cancer is not practical in the West, but screening for colon cancer is gratifying for the patient and physician...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132530/diagnosis-and-management-of-anorectal-disorders-in-the-primary-care-setting
#6
REVIEW
Danielle Davies, Justin Bailey
Anorectal disorders are very common among a wide population of patients. Because patients may be embarrassed about the anatomic location of their symptoms, they may present to care late in the course of their illness. Care should be taken to validate patient concerns and normalize fears. This article discusses the diagnoses and management of common anorectal disorders among patients presenting to a primary care physician.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132529/celiac-disease-and-gluten-sensitivity
#7
REVIEW
Katharine C DeGeorge, Jeanetta W Frye, Kim M Stein, Lisa K Rollins, Daniel F McCarter
Celiac disease is an immune-mediated enteropathy triggered by gluten that affects genetically predisposed individuals, typically causing intestinal symptoms and malabsorption. Diagnosis requires stepwise evaluation with anti-tissue transglutaminase IgA and histologic analysis of the small bowel. Strict adherence to a gluten-free diet is the primary treatment. Patients with symptoms thought to be related to gluten but without evidence of celiac disease are difficult to diagnose and treat. Consider first advising general nutritional improvements...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132528/an-update-on-inflammatory-bowel-disease
#8
REVIEW
Tomoko Sairenji, Kimberly L Collins, David V Evans
Inflammatory bowel disease (IBD) includes 2 chronic idiopathic inflammatory diseases: ulcerative colitis and Crohn disease. The incidence and prevalence of IBD is increasing worldwide. It can affect people of all ages, including children and geriatric populations, and can impact all aspects of life. In this article, diagnosis and treatment of IBD in adults, pediatric, pregnant, and elderly populations are explored from the perspective of a primary care physician.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132527/irritable-bowel-syndrome-epidemiology-pathophysiology-diagnosis-and-treatment
#9
REVIEW
Dean Nathanial Defrees, Justin Bailey
Irritable bowel syndrome is a common medical condition that significantly alters patient quality of life and presents a series of diagnostic and treatment challenges to the treating provider. This article provides an updated and straightforward overview of the disease, its pathophysiology, diagnosis, and treatment options.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132526/diverticular-disease-of-the-gastrointestinal-tract
#10
REVIEW
Aaron Sinclair
Almost all gastrointestinal tract diverticula require no intervention if they are asymptomatic. There is no clear diagnostic modality of choice for diagnosis and surveillance of diverticulum. Medical treatment should be attempted before surgical intervention because significant morbidity is may be associated with resection.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132525/hepatitis-c-a-new-era
#11
REVIEW
Dee Ann Bragg, Ashley Crowl, Emily Manlove
More than 2 million Americans are infected with hepatitis C virus (HCV), and only about half are aware that they are infected. Primarily blood-borne, risk factors for the virus include injection or intranasal drug use, unregulated tattoos, incarceration, and blood transfusion before 1992. In addition, 75% of those with the virus were born between 1945 and 1965, thus making the baby-boomer cohort a population of screening interest. Because acute and early chronic HCV are often asymptomatic, screening of at-risk individuals is of utmost importance...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132524/hepatitis-a-and-b-infections
#12
REVIEW
Jennifer Thuener
Hepatitis A virus causes acute viral hepatitis, presenting with jaundice, nausea, and vomiting. Symptoms are self-limited and treated symptomatically. Routine vaccination of infants has greatly reduced the incidence in the United States. Vaccination is recommended for all infants and adults at increased risk. Hepatitis B virus can cause acute and chronic viral hepatitis. Acute hepatitis B is usually self-limited, but can develop into a chronic infection. Patients are at highest risk for developing chronic disease if they are infected at a younger age...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132523/pancreatitis-and-pancreatic-cancer
#13
REVIEW
Anne Walling, Robert Freelove
Most cases of acute pancreatitis are related to gallstones. More than 80% resolve within a few days. The diagnosis is based on upper abdominal pain, elevated lipase and/or amylase, and transabdominal ultrasound findings. Management requires early aggressive hydration, pain control, nutritional support, and monitoring for progression. Patients who develop hypovolemia, systemic inflammatory response, pancreatic necrosis, and organ failure have high mortality, risk of recurrence, and progression to chronic pancreatitis (CP)...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132522/nonalcoholic-fatty-liver-disease
#14
REVIEW
Patrick H Sweet, Teresa Khoo, Steven Nguyen
Nonalcoholic fatty liver disease (NAFLD) defines a condition of hepatic steatosis with or without hepatic injury. NAFLD is increasing in prevalence worldwide and presents a public health burden. Most patients are asymptomatic, although some present with fatigue and right upper quadrant pain. NAFLD is discovered incidentally when patients have elevated liver enzymes or fatty liver is seen on imaging modalities. Imaging studies can confirm fatty deposits in the liver, but needle biopsy is needed to determine degree of inflammation...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132521/gallbladder-dysfunction-cholecystitis-choledocholithiasis-cholangitis-and-biliary-dyskinesia
#15
REVIEW
Thad Wilkins, Edward Agabin, Jason Varghese, Asif Talukder
The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132520/gastroesophageal-reflux-disease
#16
REVIEW
Rick Kellerman, Thomas Kintanar
Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity resulting in symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. GERD affects quality of life and may cause erosive esophagitis, esophageal strictures, and Barrett esophagus, a precursor to esophageal adenocarcinoma. GERD is a clinical diagnosis and is most effectively treated with proton-pump inhibitors (PPIs)...
December 2017: Primary Care
https://www.readbyqxmd.com/read/28797381/the-urgent-need-for-robust-geriatric-patient-care-skills-in-primary-care
#17
EDITORIAL
Demetra Antimisiaris, Laura Morton
No abstract text is available yet for this article.
September 2017: Primary Care
https://www.readbyqxmd.com/read/28797380/the-art-of-managing-complexity-the-joy-of-aging-gracefully
#18
EDITORIAL
Joel J Heidelbaugh
No abstract text is available yet for this article.
September 2017: Primary Care
https://www.readbyqxmd.com/read/28797379/delirium
#19
REVIEW
Belinda Setters, Laurence M Solberg
Delirium is a common, often underdiagnosed, geriatric syndrome characterized by an acute change in attention and consciousness. As a neuropsychiatric disorder with an underlying organic cause, delirium has been considered a diagnosis reserved for the hospital setting. However, delirium is known to occur as both an acute and subacute condition that carries significant morbidity and mortality. Combined with its association with dementia and aging, this makes delirium an important topic for primary care providers to become more familiar with as they are tasked with caring for an aging population...
September 2017: Primary Care
https://www.readbyqxmd.com/read/28797378/hypertension-in-the-older-adult
#20
REVIEW
Belinda Setters, Holly M Holmes
Hypertension is common among adults and is associated with significant morbidity and mortality and should be routinely addressed in primary care practice. Optimal blood pressure targets have evolved in the past decade with the release of large studies including older persons. However, controversy remains regarding the treatment of older and frail patients. The relationship between blood pressure treatment and falls or cognitive impairment is still an area of concern and debate. A strategy to address hypertension in older persons should consider an individual's fitness and the likelihood of adverse effects and worsening of conditions that adversely affect quality of life...
September 2017: Primary Care
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