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Primary Care/Hospitalist

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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.

  • Navigating Hypoglycemia in Diabetes Care: Clinical Management Strategies and Glucagon Treatment Options

    Hypoglycemia, defined as a blood glucose level less than 70 mg/dL, can be life-threatening, particularly with insulin therapy, and imposes a significant risk factor leading to severe morbidity and increased medical costs. As a preventable and potentially acute complication of diabetes management, providing proper patient education, identifying key risk factors, and tailoring treatment approaches are crucial for prevention.

  • 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.

  • The Silent Epidemic: Hepatitis C Virus

    Hepatitis C accounts for a significant burden of disease. There are many barriers to the eradication of hepatitis C virus (HCV), from infection identification to treatment, making it a very complex public health concern. Unfortunately, no vaccine for HCV exists yet, and development proves difficult because of the overwhelming genetic diversity. HCV can be treated by a patient’s primary care physician; this group is instrumental in screening for and treating hepatitis C.

  • Identifying and Responding to Potential Cases of Human Trafficking in the Primary Care Setting

    This paper aims to equip the primary care provider with the knowledge and skills to identify and respond effectively to potential cases of human trafficking in a primary care setting. When seeking care, individuals caught up in trafficking are most likely to present to an emergency room or urgent care, but about 40% go to private practices or clinics. An astute primary care provider has a unique opportunity to educate, intervene, or assist a patient at this point, should the individual be looking for this type of intervention.

  • An Update on What Is New During the 2023-2024 Flu Season

    As the fall and winter months descend in the Northern Hemisphere, it is time for healthcare providers to focus on preventing and treating the influenza virus. The Centers for Disease Control and Prevention estimates from the current flu season (Oct. 1, 2023, to present) suggest 1 million cases of flu illness and between 5,000 to 12,000 hospitalizations. Healthcare practitioners on the frontline must have current knowledge of prevention and treatment strategies.

  • The Many Controversies of Cannabidiol

    Current trends in cannabinoid research, federal and state cannabis legislation, multi-sourced information, as well as misinformation, all drive consumer interest in cannabidiol (CBD). With the increased use of CBD products, increased incidents of poisonings are being reported. With confusion on policy, on potential benefits and harms, and on long-term chronic effects often seen with excessive use, determining the facts is increasingly problematic for healthcare practitioners and consumers. These issues prioritize the need for clinicians, especially in primary care, to stay current on developments related to CBD and other cannabinoids.

  • Diagnosing and Managing Complications of Alcohol-Related Liver Disease

    Alcohol, or ethanol, is the most frequently misused drug across the world. It is estimated that, in the United States, 67.3% of the population consumes alcohol, and 7.4% of the population meets diagnostic criteria for substance use disorder. Alcohol use is the leading cause of liver disease and the second most common reason for liver transplantation in the United States. This article discusses the complications seen in alcohol-related liver disease.

  • Chronic Obstructive Pulmonary Disease Update for Primary Care Providers

    The Global Initiative for Chronic Obstructive Lung Disease 2023 report defines chronic obstructive pulmonary disease (COPD) as a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, and/or exacerbations) caused by abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that result in persistent, often progressive, airflow obstruction. COPD was the fourth leading cause of death in the United States in 2018 and is estimated to be responsible for 3 million deaths annually around the world, with expected increases to 5.4 million annual deaths from COPD and related conditions by 2060.

  • Preventing and Reversing Cardiovascular Disease Through Lifestyle Modification

    Cardiovascular disease (CVD) is the leading cause of death globally and in the United States. Identifying and targeting cardiovascular risk factors is essential for the prevention and long-term management of CVD. Traditionally, factors for the onset and progression of CVD were thought to be mostly genetic. It is now well established that several of these factors are lifestyle mediated. Behavioral changes significantly influence the interplay between a healthy lifestyle and the genetic risk of heart disease. To further understand the challenges with preventing and reversing CVD, providers need to consider the alarming prevalence of risk factors among the U.S. population.