Primary Care/Hospitalist Topics
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Osteoporosis: An Update for Primary Care Providers
Bones, as reservoirs of calcium and phosphorus, continuously remodel to maintain strength and function. However, suboptimal peak bone mass in young adulthood, excessive resorption of bone, or impaired bone formation during remodeling can result in osteoporosis. Among Caucasian adults ages 50 years and older in the United States, about 50% of women and 20% of men will experience an osteoporotic fracture in their remaining lifetime; however, fracture rates differ by ethnic/racial population and skeletal site. Annual fracture-related costs are expected to increase from $57 billion to more than $95 billion by 2040. Therefore, it is imperative that primary care providers address this challenge by implementing practices to screen patients for osteoporosis to prevent and/or treat the disorder and subsequent comorbidities.
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Beyond the Symptoms: A Primary Care Approach to Depression Management
In the vast mosaic of primary care, depression often remains in the shadows, embedded in patient care but easily overlooked. Left unrecognized, the prognosis worsens and complicates the management of other chronic conditions. However, with timely identification and effective treatment, the course of depression can be altered significantly. A comprehensive understanding of this condition, coupled with effective treatment strategies, empowers the primary care physician to mitigate the potentially debilitating effects of this condition.
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Myocarditis in a Post-COVID World
Myocarditis is a rare, typically self-limited inflammatory condition of the heart. Interest in myocarditis has increased in recent years because of the COVID-19 pandemic and COVID-19 vaccinations both being associated with its development. Paralleling this interest is an increase in misinformation about this condition, its frequency associated with both COVID-19 infection and vaccination, and potential linkage to sudden cardiac death. This review article will trace the history of myocarditis from the pre-COVID-19 era to the present day, with special attention being paid to how social media has driven a large portion of the discussion.
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Metabolic Dysfunction-Associated Steatotic Liver Disease
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic metabolic disease that you may never have heard of. MASLD, formerly known as non-alcoholic fatty liver disease (NAFLD), is the most prevalent liver disease worldwide. MASLD affects 30% of the world’s population, more than half of those people with obesity, and more than 70% of people with type 2 diabetes. While many clinicians may see patients with slightly elevated transaminases and assume it is fatty liver, MASLD is not benign and often begins well before laboratory changes. This article reviews the pathogenesis, diagnosis, and natural history of MASLD; known treatments; and future therapies.
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An Updated Review on Metabolic Regulation in the Alzheimer’s Brain: Type 3 Diabetes?
Diabetes is a strong risk factor for the development of Alzheimer's disease (AD) given the mitochondrial, vascular, and inflammatory modalities that contribute to its progression. Therefore, it is vital to understand the pathophysiology of these two diseases as they relate to insulin resistance and mitochondrial dysfunction. Exposing a metabolic relationship between these diseases can provide further understanding of metabolic health and how treatment of insulin resistance can decrease disease burden.
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Non-Marine Envenomations in the United States
Envenomations can be caused by many different species, both marine and non-marine. The presentation can range from minor skin irritation to anaphylaxis, systemic illness, organ failure, and even death. Knowing which species are endemic to the area, and what the presentations of medically important envenomations will look like, can aid in recognition and timely treatment, especially when the bite or sting was unwitnessed. This article will give an overview of medically important non-marine envenomations in the United States, including their clinical manifestations, treatment, and disposition.
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Mosquito-Borne Diseases in the 21st Century
Hundreds of millions of people across the globe are affected by mosquito-borne diseases each year, and travelers who do not exercise caution and take preventive measures are at especially high risk. Mosquito-borne diseases are found mostly in tropical and subtropical destinations, ranging from America to Africa and Asia. Chikungunya virus, dengue, filariasis, Japanese encephalitis virus, malaria, West Nile virus, yellow fever, and Zika virus are particular sources of concern for travelers venturing into regions where these vectors abound. This article will focus on these mosquito-borne illnesses, especially the flaviviruses.
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Sweeping Senate Healthcare Legislation Heads to Markup
The HELP Committee has reached a bipartisan agreement on a crucial bill to expand primary care services and the healthcare workforce.
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Supine Blood Pressure Readings May Reveal Hidden Health Risks
Measuring a patient’s blood pressure while he or she is lying down could help clinicians learn more about possible underlying heart problems.
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Social Determinants Play Outsized Role in Black/White Cardiovascular Health Gap
Lower income levels, less education, tighter insurance access raise risk for cardiovascular disease mortality.