Primary Care Reports
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A Contemporary Review of Hypertension
Hypertension is a common and serious condition that contributes to an estimated 40% of deaths from coronary heart disease and stroke, and is the second leading cause of end-stage renal disease. Because of the importance and frequency of hypertension in primary care practices, we are devoting two issues to the subject. This issue focuses on the definition of blood pressure and current guidelines, risk factors, relationship to cardiovascular disease, blood pressure measurement, patient evaluation, and secondary causes. The next issue will cover treatments (pharmacological and non-pharmacological), initial therapy, relationship to various disease conditions (diabetes, ischemic heart disease, heart failure, chronic kidney disease, cerebrovascular disease, ischemic stroke, stroke prevention, atrial fibrillation, valvular heart disease, aortic regurgitation, sexual dysfunction), resistant hypertension, hypertensive crises and emergencies, preoperative management, and adherence strategies.
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All That Is Round Is Not Fungus: A Differential Diagnosis of Annular Lesions
Annular skin lesions commonly plague many primary care patients, but not all that is round is fungus. This article highlights the differential diagnosis of conditions that can mimic tinea.
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Diabetic Retinopathy, Associated Comorbidities, and Treatment Considerations
Diabetic retinopathy is a complex disorder of the microvascular and neuronal structure of the retina. Although poorly understood, the problem does not start in the retina, but rather begins through systemic metabolic dysfunction, which causes damage to retina vessels. This article will review the structure of the retina, the systemic pathophysiology of diabetes, the resulting damage to retinal structure and function, comorbidities, traditional treatments, and prevention and treatment for diabetic retinopathy and its comorbidities.
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Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) is the most common liver pathology worldwide and is the third leading cause of liver transplantation in the United States.This article reviews the pathogenesis, diagnosis, and natural history of NAFLD as well as known treatments and future therapies.
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Wound Care Management
Primary care physicians usually can care for minor wounds in their offices. This article highlights key elements in first-line management.
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A Review of Heart Failure and Current Therapeutic Strategies
The management of heart failure falls primarily on the primary care physician. Because of the Medicare financial penalty on hospitals for readmissions, primary care physicians need to be cognizant of the updated treatment options and work with colleagues across multiple disciplines to prevent unnecessary hospitalizations and improve outcomes.
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Lifestyle Approaches to Prevent and Manage Cognitive Impairment
Despite billions of dollars in research and nearly 200 medications tested for dementia, pharmacologic treatment for Alzheimer’s disease is severely limited in effectiveness and safety. With the disappointing benefits of drug treatment, the promise of lifestyle changes to prevent and delay cognitive decline appears hopeful.
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Ethics and Science, Cannabinoids and Healthcare
Perhaps no topic is more controversial than the use of marijuana in clinical practice. Within the United States, there are an estimated 55 million recent active users, defined as one to two uses within the previous year, and 35 million regular users, defined as one to two uses per month.
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What Do You Know About Wound Care?
This article will summarize the salient features of wound care, including demographics of a changing population, fundamental phases of wound healing, advances in therapeutic modalities, and steps family physicians can take to become recognized as certified wound care physicians.
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Management of Skin and Soft Tissue Infections
Skin and soft tissue infections are encountered commonly in primary care practices, presenting as a range of disorders, from uncomplicated cellulitis, impetigo, folliculitis, erysipelas, and focal abscesses to necrotizing fasciitis. Each year between 1998-2006 in the United States, there were 650,000 hospital admissions for cellulitis, with estimates of 14.5 million cases annually treated as outpatients, accounting for $3.7 billion in ambulatory care costs.