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Full-Text Articles in Social and Behavioral Sciences

Spontaneous Abortion In Primary Care: A Report From Aspn, L Green, L Becker, W Freeman, E Elliott, Donald Iverson, F Reed Jun 2012

Spontaneous Abortion In Primary Care: A Report From Aspn, L Green, L Becker, W Freeman, E Elliott, Donald Iverson, F Reed

Don C. Iverson

The Ambulatory Sentinel Practice Network (ASPN) conducted an observational study of usual primary care of spontaneous abortion (SAB). Forty-nine practices in 18 states and four Canadian provinces reported and audited 171 SABs. Contrary to recommendations in some texts, 40 percent were managed completely in the office and/or at home, and only 51 percent had a dilation and curettage (D&C). SABs occurring later in pregnancy were more likely to be managed in the emergency room/hospital, receive consultation, and have a D&C. Patients managed with D&C had a greater frequency of excessive blood loss at diagnosis, but otherwise they did not differ …


Patients With New Headache In Primary Care: A Report From Aspn, L Becker, Donald Iverson, F Reed, N Calonge, R Miller, W Freeman Jun 2012

Patients With New Headache In Primary Care: A Report From Aspn, L Becker, Donald Iverson, F Reed, N Calonge, R Miller, W Freeman

Don C. Iverson

From a consecutive series of 3,847 headache patients, 1,331 patients who made first visits for new headache to 120 primary care physicians were studied for usual care over a 14-month period. Either tension or vascular headache was the initial diagnosis in 23.8 percent and 12.8 percent of patients, respectively. Nearly one half (47.8 percent) were classified as having headaches other than tension or vascular. A total of 15.3 percent of headaches were undiagnosed or were regarded as a mixture of traditional diagnostic designations. At first visit, most patients (76.6 percent) were managed without diagnostic tests. Drugs were prescribed for 73.6 …


The Development And Management Of A Primary Care Research Network, 1978-87, Donald Iverson, B Calonge, R Miller, L Niebauer, F Reed Jun 2012

The Development And Management Of A Primary Care Research Network, 1978-87, Donald Iverson, B Calonge, R Miller, L Niebauer, F Reed

Don C. Iverson

The Ambulatory Sentinel Practice Network (ASPN) was created to increase the knowledge of primary care. Building on the experiences of other national and regional primary care research networks, ASPN has evolved as a North American network including practices in 25 U.S. states and four Canadian provinces in 1987. This paper summarizes ASPN's growth and development since 1978, the involvement of the ASPN practices, and the mechanisms used in developing and managing studies.


Carpal Tunnel Syndrome In Primary Care: A Report From Aspn. Ambulatory Sentinel Practice Network, R Miller, Donald Iverson, R Fried, L Green, Paul Nutting Jun 2012

Carpal Tunnel Syndrome In Primary Care: A Report From Aspn. Ambulatory Sentinel Practice Network, R Miller, Donald Iverson, R Fried, L Green, Paul Nutting

Don C. Iverson

Carpaltunnelsyndrome is the entrapment neuropathy of the medign nerve at the wrist. It is the most common nerve compression disorder seen by physicians, affecting women up to five times more frequently than men, especially during the reproductive years. Carpaltunnelsyndrome is known to be aggravated during pregnancy and menopause. Primary care physicians can expect to see approximately 1.01 cases of carpaltunnelsyndrome per 1,000 office encounters, with a female age-adjusted rate of 1.49 per 1,000 person-years. Physicians can identify this syndrome with an accurate and detailed history and physical exam. In most cases, electrodiagnostic studies, such as nerve conduction velocities and/or electromyography, …