Primary Care Reports
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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.
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Zika Virus Disease: A Primer for the Primary Care Physician
Zika virus disease is a global issue, but with the recent hurricanes and flooding in Texas and Florida, mosquito-borne illnesses may become more prevalent. This article discusses the latest recommendations for the prevention of Zika viral disease, the populations and regions still at increased risk, and the latest and most promising research being conducted to develop a Zika virus vaccine and treatment.
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Value-based Payments and Primary Care
Over the past two decades, Medicare and commercial payers have increasing linked healthcare payments to quality. These new payment models are broadly referred to as value-based, as payers primarily focus on clinical and financial outcomes of patients rather than simply paying for services in an unsustainable fee-for-service model. This shift provides a unique opportunity for primary care to recapture its place in healthcare delivery as the original advocate for patient-centered care and the center of value. Primary care clinicians can be rewarded with additional revenue for creating efficient care delivery by developing the skill sets to manage value-based care.
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Fungus Among Us? Dermatophyte Infections, Mimickers, and Treatment Options
Tinea refers to a superficial fungal infection of the skin, hair, and nails caused by dermatophytes, which are filamentous fungi. Trichophyton rubrum is the most common cause of dermatophyte infection, accounting for nearly 70% of infections worldwide. These infections are extremely common, but are more prominent in warm, tropical climates. Tinea is seen more commonly in black and Asian patients, has a predilection for young adults, and is three to four times more common in males.
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Stroke: Rehabilitation and Recovery
Rehabilitation is a critical component of stroke treatment, as most stroke survivors are left with significant neurological impairments and other sequelae, such as spasticity and pain. Stroke rehabilitation aims to reverse these impairments to the extent possible, maximize functionality through the use of compensatory approaches, prevent complications, and manage comorbidities. This article reviews the basic principles of rehabilitation, current practices, and evidence supporting various aspects of stroke rehabilitation.
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Dementia Updates for Primary Care Providers
The diagnostic criteria for Alzheimer’s disease (AD) have changed in recent years, with a growing focus on pathologic and genetic biomarkers. The diagnosis itself now is divided into three distinct stages: the preclinical stage, mild cognitive impairment, and clinical AD. Dementia is a common and growing problem that is associated with significant caregiver burden and immense cost. A growing focus on disease prevention and management of risk factors in mid-life is vital to attempt to mitigate the daunting impact of this illness on patients, caregivers, and the healthcare system as a whole.
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Diabetes Microvascular Complications
Diabetes mellitus is expensive, but most of the costs are attributed to complications and hospital care. This article will review the recommendations from the ADA 2017 Standards of Care for microvascular complications and relevant position statements, and will highlight preventive screening and clinical pearls for the primary care physician treating patients with diabetes.
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2017 Update on Adult Vaccinations
Vaccinations to directly prevent disease in adults likewise have reduced morbidity and mortality from a wide variety of viral and bacterial infections. This article will review the vaccines recommended for all adults as well as those vaccines recommended for special populations, such as immunosuppressed patients and pregnant women. In addition, the article will examine strategies that can be employed to increase vaccination rates in adults.