Primary Care Reports
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A Review of Insulin Transition
Diabetes mellitus is a collection of chronic metabolic diseases that occur either as the result of insulin deficiency or insulin resistance. One of the primary goals in diabetes treatment includes lowering blood glucose levels sufficiently to prevent microvascular and macrovascular complications. The type of insulin prescribed depends on multiple factors, and insulins frequently are interchanged. Before choosing or transitioning to an appropriate insulin, consider all social determinants and individualize the treatment regimen as “one size does not fit all.”
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Pediatric Exposures to Toxic Substances in the Home
A high percentage of calls to poison centers each year are for exposures in children younger than the age of 6 years. Many of these calls are prompted by exposures to substances commonly found in the home and can lead to significant morbidity and mortality even when the result of a small, exploratory exposure. An index of suspicion and a knowledge of toxidromes is critical to make an accurate diagnosis in cases of pediatric toxic exposures. Consultation with a medical toxicologist or poison control center is recommended for all suspected toxic ingestions, both for management recommendations and for reporting purposes.
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Concerns and Complications of Measles and Mumps and the Increasing Threat of Monkeypox
Measles and mumps, while clinically dissimilar, share important characteristics that are valuable to discuss in tandem. This review will seek to inform the practitioner about current outbreak concerns regarding measles and mumps, clinical manifestations and complications of each, diagnostic and treatment options, and prevention of further exposures. The emerging threat of monkeypox also is discussed.
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CDC: U.S. Adult Obesity Rate Up Sharply
At least 35% of adults are obese in 19 states and two territories.
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A Guide to Change: Modifying Unhealthy Behaviors in Patients
Motivational interviewing is an evidence-based, empathic approach to the patient interview incorporating techniques that encourage patients to self-reflect and voice reasons for change, while recognizing underlying ambivalence. This article presents approaches recommended for use in a primary care office when the clinical interview indicates a need for behavioral change.
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Identifying and Treating Non-COVID Viral Respiratory Infections
Respiratory viruses are omnipresent and can cause a variety of clinical manifestations, from asymptomatic infections to life-threatening illnesses with multi-organ failure. About 25 million people visit their primary care physician every year with uncomplicated upper respiratory infections in the United States. Viral respiratory infections are recognized as key triggering factors in exacerbations of chronic respiratory diseases, such as bronchiectasis, asthma, and chronic obstructive pulmonary disease (COPD).
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Answering Patient Questions About COVID-19
Wright State University Boonshoft School of Medicine formed an educational task force to educate clinicians and answer community members’ questions about all things COVID-19. Easily referenced resources on COVID-19 are essential for healthcare professionals in speaking with patients. Easy-to-navigate, dependable, up-to-date sources of information help serve patients requiring specific and timely answers to questions. Having a “go-to” list of resources can reduce confusion about COVID-19, making vaccination updates and other conversations more productive.
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Outpatient Management of COVID-19
The COVID-19 pandemic continues to be a major public health concern. The availability of new therapies, as well as their use, continues to be shrouded in confusion. This discussion provides a brief clinical overview of COVID-19, followed by a focus on outpatient management and therapy based on our current understanding and available therapies.
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Stress-Related Disorders in Primary Care
More than 80% of U.S. adults can expect to experience a traumatic event during their lifetime. Traumatic events are major risk factors for the development of various chronic diseases, including mental disorders, such as depression, post-traumatic stress disorder, complex post-traumatic stress disorder (a newly recognized condition), substance use disorders, and chronic medical conditions, such as cardiovascular disorders, obesity, and autoimmune disorders. Implementing universal trauma-informed practice strategies and techniques can assist in addressing these situations in a timely and clinically appropriate manner.
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Identifying Community-Acquired Pneumonia During the COVID-19 Pandemic
Pneumonia is an infection of the alveoli of the lungs. Alveolar infection results in inflammation that disrupts normal pulmonary function, producing impaired gas exchange. Pneumonia can be caused by bacteria, viruses, or fungi. Pathogens can infect the lung parenchyma through three routes: inhalation, aspiration, or hematogenous spread. In community-acquired pneumonia, the infection is initiated outside the hospital. The prevalence of COVID-19, the clinical disease caused by the SARS-CoV-2 virus, has changed the landscape of pneumonia.