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Primary Care Reports



  • Straight Shooting: Primary Care and the Reduction of Harm from Firearms

    Gun violence is a leading cause of premature death in the United States. More than 45,000 Americans died from gun violence in 2020, a substantial increase from previous years. The scope of the problem is such that the American Public Health Association has identified gun violence as a public health problem and recommends a “comprehensive public health approach.” Primary care providers (PCPs) are in a unique position to lead the way in a campaign to reduce harm from firearms.

  • The Hippocratic Oath: Are We Hurting Ourselves and Each Other?

    While there are multiple definitions of well-being, it commonly is described as a dynamic and ongoing process involving self-awareness and healthy choices, resulting in a successful and balanced lifestyle. Burnout results from chronic stress, which leads to emotional exhaustion, depersonalization, and decreased feelings of personal accomplishment. Unfortunately, given the rigor of the healthcare profession, healthcare providers often need to remember to consider their emotional well-being while navigating the shift toward an oligopolistic medical industry that perpetuates the cycle by focusing on profit — totaling 18.3% of the gross domestic product.

  • Stroke Prevention in Nonvalvular Atrial Fibrillation: A Review of the Past, Present, and Future

    Nonvalvular atrial fibrillation is a highly prevalent cardiac arrhythmia in the United States and often can be complicated by a thromboembolic phenomenon, the most concerning of which is stroke. This article reviews the current evidence for the use of various anticoagulants, surgical techniques, and the left atrial appendage occlusion devices currently available for stroke prevention in atrial fibrillation.

  • Financial Coaching Boosts Follow-Up Visit, Vaccination Rates for Babies

    Assisting low-income new parents can lead to better outcomes.

  • Medication Therapy Management: Partnering with Clinical Pharmacists to Improve Patient Outcomes

    The majority of American adults have at least one chronic disease, often requiring the use of multiple chronic medications. Unfortunately, adherence to chronic medications often is suboptimal, leading to inadequate management of chronic conditions and the risk for morbidity and mortality. This review discusses the foundation of medication therapy management, a service that pharmacists and other healthcare professionals provide to optimize therapeutic outcomes via a patient-centered approach.

  • Long-Term Air Pollution Exposure Could Raise Risk for Depression, Anxiety

    Two research groups reported on breathing dirty air and how that affects mental health.

  • Approach and Treatment of Patients with Somatic Symptom and Related Disorders

    The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, nomenclature and diagnostic criteria deemphasize “medically unexplained symptoms” and instead focuses on the presence of unexpected, magnified, or disproportionate physical symptoms, with or without an underlying known medical condition. Given that symptoms are physical in nature, patients with somatic disorders are more likely to present to a primary medical provider than to a mental health provider. Thus, developing a better understanding of this often-perplexing condition has clinical relevance for clinicians on the front lines of medical care.

  • 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.”

  • 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.

  • 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.