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Infertility: Clinical Pearls for Presentation to Diagnosis in a Primary Care Setting
Get PDFInfertility is defined as a couple’s inability to conceive within 12 months of regular, unprotected intercourse in those under 35 years of age, or within 6 months in women older than 35 years of age. Infertility is a common problem, affecting up to 12% of women of reproductive age. As the prevalence of infertility increases, it is critical that primary care providers can identify, workup, and refer patients in a timely manner. Initial workup should include a thorough past medical, social, and family history, as well as physical examination. Causes of infertility can be divided into categories to include: ovulatory dysfunction, uterine factors, tubal factors, male factors, and peritoneal factors. The initial workup should focus on assessing for pathology in each of these categories
Clinical Pearls to Diagnosing Lyme Arthritis
No full textArthritis is one of the most common long term sequelae of Lyme disease infection in humans. Although the pathophysiology for Lyme arthritis is not concretely understood, there are several key features that are helpful in diagnosing Lyme disease as the culprit for the arthritic symptoms that an individual is experiencing. With a thorough history of an individuals’ age, geographic location, recent travel history and common outdoor recreational activities engaged in, a differential can be narrowed down. With the knowledge of how various arthritides present in the body, along with the use of diagnostic testing with ELISA and Western immunoblot, any provider can properly diagnose and treat arthritis caused by Borrelia burgdorferi
Case Report: Fournier\u27s Gangrene
No full text•Fournier’s gangrene is a rare manifestation of the already sparse skin infection known as necrotizing fasciitis, specifically of the scrotal and perineal region. This case illustrates a patient in the emergency department with a severe necrotizing skin infection who quickly progressed to sepsis and multiorgan damage. It is important to understand the common presentation, complications, and ideal management of patients with necrotizing fasciitis
A paper about methods and timing of stethoscope hygiene
Get PDFHospital acquired infections have been a problem for as long as hospitals have been around. There are a plethora of sterilization protocols and techniques for various pieces of equipment deemed as critical to patient care, however there are common items that are not cleaned regularly or sometimes at all. The key focus of this article will be stethoscopes, and although it is the hallmark image that invokes thoughts of medical professionals, it is often overlooked as a piece of equipment that should be cleaned
Waist-to-Height Ratio as an Alternative to Body Mass Index
Get PDFThe body mass index (BMI) has many limitations. Therefore, it is important to explore alternative options for estimating excess body adiposity and determining obesity-related health risks in the general population. Alternatives have been explored, including waist-to-height ratio, but further research is needed to assess the benefits and barriers that exist to replacing BMI as the standard measure of body composition and weight-related health. The purpose of this article is to examine waist-to-height ratio as an alternative to BMI as an indicator health at the population and individual level. Using existing literature, the disadvantages of BMI are outlined and discussed. Additionally, the benefits of waist-to-height ratio are explored and compared to BMI as a health indicator. Not only is it a simple measurement, but it has been found to be an accurate predictor of excess adiposity. Waist-to-height ratio is a reliable and realistic alternative to BMI as a measurement of health in terms of excessive adiposity and its related health risks. Further research is needed to explore the barriers to implementation of waist-to-height ratio in the place of BMI
Waist-to-Height Ratio as an Alternative to BMI
Get PDFThe body mass index (BMI) has many limitations. Therefore, it is important to explore alternative options for estimating excess body adiposity and determining obesity-related health risks in the general population. Alternatives have been explored, including waist-to-height ratio, but further research is needed to assess the benefits and barriers that exist to replacing BMI as the standard measure of body composition and weight-related health. The purpose of this article is to examine waist-to-height ratio as an alternative to BMI as an indicator health at the population and individual level. Using existing literature, the disadvantages of BMI are outlined and discussed. Additionally, the benefits of waist-to-height ratio are explored and compared to BMI as a health indicator. Not only is it a simple measurement, but it has been found to be an accurate predictor of excess adiposity. Waist-to-height ratio is a reliable and realistic alternative to BMI as a measurement of health in terms of excessive adiposity and its related health risks. Further research is needed to explore the barriers to implementation of waist-to-height ratio in the place of BMI
Commercially Geneticizing Race, Ethnicity, and Nation: The Implications of the Discourse Surrounding Commercialized Genetic Tests on Identity
Get PDFOff-label use of Topical Timolol Maleate for Infantile Hemangioma
No full textThe prevalence of infantile hemangioma or IH is as high as 10%. They represent the most frequently diagnosed vascular tumor in infants. Though most IH do not require extensive treatment and resolve on their own, about 10% of IH can lead to more serious complications and require immediate care. This project reviews the current standards of treatment and proposes topical timolol as an alternative treatment for superficial IH
The Role of Pharmacologic Treatment in Autism Spectrum Disorder
Get PDFBehavioral, educational, and family therapies combined with early recognition and intervention is the current standard for management of children with autism spectrum disorder (ASD). Despite these interventions, many children still retain behavioral disturbances that negatively impact their quality of life. Researchers have estimated more than 50% of adolescents with ASD are prescribed medications to help them manage behaviors or comorbid conditions, over half of whom experience psychotropic polypharmacy. Only risperidone and aripiprazole are FDA-approved for ASD patients, although numerous medications are used off-label and in combination to treat behavioral disturbances. There is limited research supporting greater therapeutic benefits than side effects of other atypical antipsychotics, SSRIs, SNRIs, stimulants, and TCAs for ASD management. The studies currently available have shown possible efficacy for off-label drugs, but the evidence is far from comprehensive or conclusive. Further clinical investigation is needed in order to develop standards of care for the use of psychotropic pharmaceuticals to treat maladaptive behaviors associated with ASD
Percutaneous coronary intervention using second generation drug-eluting stents vs coronary artery bypass graft in left main coronary artery and multivessel coronary artery disease
Get PDFMany of the studies that are used in reference to the clinical decision making between PCI vs CABG use BMS or first-generation DES as a comparison. With the advancement of stent technology, second-generation DES have emerged with improved efficacy and overall outcome rates compared to BMS and first-generation DES. Some of the newer studies such as EXCEL1-2 , demonstrated noninferiority of second-generation DES to CABG but there are limited studies that support this conclusion. Currently, the studies remain divided in the impact of newer-generation PCIs, and 10-year follow up studies may be required to further validate noninferiority before it can be applied clinically for complex lesions