Primary Care Reports
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Evaluation of Hair Loss in a Primary Care Setting
Hair loss is a common complaint for both male and female patients, who often first present to their family physician for evaluation. However, the vast array of underlying etiologies can present a diagnostic challenge for physicians. Reviewing the main principles of hair biology will help provide a better understanding of the basic science behind hair loss. One of the most important steps in patient evaluation is conducting a thorough history and physical exam. This article will discuss key questions to ask, as well as how to interpret exam findings. In general, hair loss is categorized into scarring alopecia, non-scarring alopecia, and structural hair disorders. This article will focus on the most common causes of scarring and non-scarring alopecia that will be encountered in a primary care setting, as well as first-line treatments for each.
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Use of a Low-carbohydrate, Ketogenic Diet to Treat Obesity
Overweight and obesity have reached epidemic proportions in the United States. For individuals affected by obesity, clinical studies have shown that carbohydrate restriction, including a low-carbohydrate, ketogenic diet, can be a safe and effective treatment. This article includes a narrative review of clinical research studies and a practical description of implementing a “keto” diet for obesity.
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Therapeutic Strategies for Hypertension
This article on hypertension will cover treatments (pharmacological and nonpharmacological), initial therapy, relationship to various disease conditions (diabetes, ischemic heart disease, heart failure, chronic kidney disease, cerebrovascular disease, ischemic stroke, stroke prevention, atrial fibrillation, valvular heart disease, aortic regurgitation, sexual dysfunction), resistant hypertension, hypertensive crises and emergencies, preoperative management, and adherence strategies.
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A Contemporary Review of Hypertension
Hypertension is a common and serious condition that contributes to an estimated 40% of deaths from coronary heart disease and stroke, and is the second leading cause of end-stage renal disease. Because of the importance and frequency of hypertension in primary care practices, we are devoting two issues to the subject. This issue focuses on the definition of blood pressure and current guidelines, risk factors, relationship to cardiovascular disease, blood pressure measurement, patient evaluation, and secondary causes. The next issue will cover treatments (pharmacological and non-pharmacological), initial therapy, relationship to various disease conditions (diabetes, ischemic heart disease, heart failure, chronic kidney disease, cerebrovascular disease, ischemic stroke, stroke prevention, atrial fibrillation, valvular heart disease, aortic regurgitation, sexual dysfunction), resistant hypertension, hypertensive crises and emergencies, preoperative management, and adherence strategies.
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All That Is Round Is Not Fungus: A Differential Diagnosis of Annular Lesions
Annular skin lesions commonly plague many primary care patients, but not all that is round is fungus. This article highlights the differential diagnosis of conditions that can mimic tinea.
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Diabetic Retinopathy, Associated Comorbidities, and Treatment Considerations
Diabetic retinopathy is a complex disorder of the microvascular and neuronal structure of the retina. Although poorly understood, the problem does not start in the retina, but rather begins through systemic metabolic dysfunction, which causes damage to retina vessels. This article will review the structure of the retina, the systemic pathophysiology of diabetes, the resulting damage to retinal structure and function, comorbidities, traditional treatments, and prevention and treatment for diabetic retinopathy and its comorbidities.
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Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) is the most common liver pathology worldwide and is the third leading cause of liver transplantation in the United States.This article reviews the pathogenesis, diagnosis, and natural history of NAFLD as well as known treatments and future therapies.
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Wound Care Management
Primary care physicians usually can care for minor wounds in their offices. This article highlights key elements in first-line management.
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A Review of Heart Failure and Current Therapeutic Strategies
The management of heart failure falls primarily on the primary care physician. Because of the Medicare financial penalty on hospitals for readmissions, primary care physicians need to be cognizant of the updated treatment options and work with colleagues across multiple disciplines to prevent unnecessary hospitalizations and improve outcomes.
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Lifestyle Approaches to Prevent and Manage Cognitive Impairment
Despite billions of dollars in research and nearly 200 medications tested for dementia, pharmacologic treatment for Alzheimer’s disease is severely limited in effectiveness and safety. With the disappointing benefits of drug treatment, the promise of lifestyle changes to prevent and delay cognitive decline appears hopeful.