Primary Care Reports
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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.
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Prevalence of Acute Myocarditis Related to COVID-19 Vaccination and SARS-CoV-2
Acute myocarditis is a diagnosis that has had a significant rise in prevalence and is the center of many recent discussions in the medical literature. Much of this recent increase has been secondary to SARS-CoV-2 and the COVID-19 vaccines. Amid the global SARS-CoV-2 pandemic, acute myocarditis has become much more prevalent in patients where it was previously a rare pathology. As a result of this outbreak, it has become a disease entity necessitating new and ever evolving clinical guidelines.
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CGRP Antagonists: What Is Their Role in Headache Therapy?
Migraine is a highly prevalent and debilitating condition that causes significant impairment in quality of life. Preventive therapy for migraine is indicated when migraine attacks interfere with quality of life or are frequent and debilitating. The ability to prevent migraine with pharmacologic therapy has long been a goal of both patients and their physicians. The ideal preventive (prophylactic) migraine treatment should be effective, safe, and well tolerated, with few or no contraindications, few or no drug interactions, safety in pregnancy and breastfeeding, and dosed in a manner to ease adherence.
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Recognizing and Treating Substance Use Disorders
Results from the 2019 National Survey on Drug Use and Health reveal 20.3 million people living in the United States have an addiction or substance use disorder (SUD). Geographic and financial barriers, as well as bias and stigma, work together to present formidable roadblocks for patients with SUD looking for direction. The primary care provider (PCP) may be the only healthcare contact for many of these patients. With expertise in understanding management of other complex, chronic disorders and experience in implementing an integrated, individualized treatment plan, the PCP has the background to take the lead in managing patients with SUD.
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COVID-19 Vaccination: Science, the Antidote for Misinformation
There have been several different attempts to increase COVID-19 vaccination rates, including offering monetary or other benefits for getting vaccinated. Some companies (including healthcare systems) have moved to mandating vaccination as a term of employment. Some do not think mandates are the most effective way to motivate vaccine-hesitant persons to make the choice, but instead think laying out a logical approach to vaccination that addresses the most common concerns and misinformation is the best path forward. This review addresses these concerns and misinformation.
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Recognizing Stroke Mimics: A Guide for Primary Care
Acute ischemic stroke is a common and significant cause of mortality and morbidity in the United States, ranking fifth among all causes of death. However, timely recognition and treatment is complicated by the fact that there are multiple conditions that mimic acute ischemic stroke. A comprehensive review suggested that approximately 74% of patients presenting with apparent acute stroke symptoms ultimately were diagnosed with stroke, thus indicating that 26% of patients had their symptoms produced by “stroke mimics.” Therefore, prompt diagnosis is complicated by a multitude of stroke mimic etiologies, including structural intracranial abnormalities, infection, syncope, vertigo, seizure, and migraine patterns, as well as underlying psychiatric causes and demyelinating diseases.
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Hypertension in Adults: An Update
Hypertension remains the leading cause of death and disability-adjusted life years globally, accounting for 10.4 million deaths per year. In the United States, hypertension accounts for more cardiovascular disease deaths than any other modifiable risk factor and is second only to cigarette smoking as a preventable cause of death for any reason.
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Electronic Cigarette Use and Risk of Lung Injury
Electronic cigarette use has increased rapidly. Although vaping may aid with stopping cigarette smoking, cases of severe pulmonary disease and several deaths related to vaping have been reported.
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Recognizing Personality Disorders in Patients Presenting to the Primary Care Provider
Often not well understood by the medical community and surrounded in stigma, patients with personality disorders frequently are labeled difficult. Understanding that the behaviors responsible for this label may be the result of a personality disorder allows the provider to adopt a more nuanced approach to treatment.