Family Medicine Commons^™

Preparation Of Physician Assistant Students To Manage Patients Living With Hiv/Aids In A Primary Care Setting, Austin Parrish

SIU Journal of Medical Science Scholarly Works

This study examined Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), Pre-Exposure Prophylaxis (PrEP), and Post-Exposure Prophylaxis (PEP) educational exposure among clinical-phase physician assistant (PA) students and evaluated how well current curricula prepare future providers for HIV prevention and care. A cross-sectional survey of 109 PA students assessed HIV-related knowledge, clinical exposure, and awareness of key public health concepts, while lecture materials from 30 PA programs were analyzed for curricular content. Students demonstrated moderate but incomplete baseline knowledge, and fewer than one-quarter reported observing PrEP prescribing during primary care rotations. Awareness of Undetectable = Untransmittable (U=U) was limited, with only …

Barriers To Breast Cancer Screening In Native Hawaiian Women, Luna M. Noel

SIU Journal of Medical Science Scholarly Works

ABSTRACT:

Purpose: The purpose of this article is to identify barriers for breast cancer screening in Native Hawaiian (NH) Women, identify ways to overcome those barriers, and increase breast cancer screening in NH Women.

Method: A PubMed literature search was conducted with search terms barriers to reasons to screen for breast cancer, barriers to breast cancer screening, barriers to breast cancer screening in Hawaii, barriers to breast cancer screening in Native Hawaiian women, breast cancer screening AND Native Hawaiian Women. Seventeen pertinent articles were retrieved and serve as the basis for this clinical review.

Results: Some barriers to mammography for …

Factors Associated With Colorectal Cancer Screening Decision-Making Among Older Adults At The Comprehensive Geriatric Clinic, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Chalisa Thanapura, Nawasiri Siriprasert, Thacha Pithayapibulpong, Bhorn-Ake Manasvanich, Vichai Viriyautsahakul

Chulalongkorn Medical Journal

Abstract

Background: The incidence of colorectal cancer (CRC) in Thailand is constantly increasing, and is highest in individuals aged 60-75 years. However, the number of older individuals undergoing CRC screening remains suboptimal.

Objective: This study aimed to identify factors associated with CRC screening decision-making among Thai older adults attending the Comprehensive Geriatric Clinic at King Chulalongkorn Memorial Hospital. The secondary objective was to identify factors associated with the choice of screening method—colonoscopy versus fecal occult blood testing (FOBT)

Methods: A cross-sectional study was conducted using a data record form at the Comprehensive Geriatrics Clinic, King Chulalongkorn Memorial Hospital in Bangkok, …

Measuring Family Involvement In Early Intervention Services For Children Who Are Dhh: A Scoping Review, Marie Martinez, Blair Richlin, Kristina Blaiser

Journal of Early Hearing Detection and Intervention

Background: Family involvement after a child has been identified as deaf or hard of hearing (DHH) is often recommended as “best practice” for Family Centered Early Intervention (FCEI; Szarkowski et al., 2024) and a catalyst for improved outcomes. Defining actions of a family will inform high-quality family support programs. This scoping review aims to explore and document family involvement as well as the current systems of measurement used in early intervention DHH family-centered services.

Purpose: The specific aim of this scoping review was to identify the operational definitions of family involvement and metrics used with families of children who are …

Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide

HCA Healthcare Journal of Medicine

More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered …

The Geography Of Faces, Faith Abraham

be Still

The Geography of Faces takes its title from the idea that a face, seen across decades, becomes a kind of landscape—something you learn to read not at a glance but through accumulated return visits. For Dr. Vasquez, an older physician who has seen so much, her patients' faces are the territory she has spent a lifetime learning to navigate.

The patients are chosen to represent different dimensions of that longevity. They show affection built on years of small battles, continuity across a family, autonomy that is respected. Together, these patients make the case that primary care is less about problems …

Impact Of Innovative Interprofessional Practice And Education Intervention Led By Graduate Medical Education Resident Physicians With School-Based Nursing In 32 School Districts, Christoffer A. Amdahl, Hans Drawbert, Sadra Forati, Tyler Fields, James Mantil, Afsha Rais Kaisani, Marci Ayers, Michele L. Mccarroll Phd

HCA Healthcare Journal of Medicine

Background

School nurses play a critical role in student well-being, underscoring their growing importance in both education and health care systems. Research consistently demonstrates their contributions to individual student care and broader population health.

Methods

This resident-led project explored community-based partnerships to facilitate mutual learning between school nurses and graduate medical education (GME) physicians. Conducted during the 2023–2024 academic year, this quality initiative (QI) involved the Medical City Healthcare (HCA Healthcare) GME programs and North Texas school districts. Educational resources were delivered through in-person teaching sessions led by resident physicians and hands-on medical simulations. School nurses who attended the Continuing …

A Mild Case Of Pseudoachondroplasia In A Child: Lessons For Long-Term Primary Care, Alec J. Pupo D.O., Connor J. Stinson D.O., Autumn Dye D.O.

The Journal of Integrated Primary Care

Background: Pseudoachondroplasia (PSACH) is a rare autosomal dominant skeletal dysplasia caused by pathogenic variants in the cartilage oligomeric matrix protein (COMP) gene. It is classically characterized by early-onset growth failure, disproportionate short stature, progressive epiphyseal dysplasia, and premature degenerative joint disease. Although phenotypic variability has been reported, PSACH is often regarded as a uniformly severe condition with predictable orthopedic morbidity.

Case Presentation: We report an eleven-year-old female with genetically confirmed PSACH who demonstrates an unexpectedly mild clinical phenotype, despite a maternal history of severe disease requiring bilateral total hip replacement during adolescence. The patient exhibited mild hip dysplasia, evolving genu …

Superior Mediastinal Cut-Off Measurements In Chest Radiographs For Screening Of Silent Thoracic Aortic Diseases, Kantheera Leesmidt, Boonyarit Sintuvikaiwong, Apichaya Sripariwuth

Chulalongkorn Medical Journal

Objective: To determine cut-off values for superior mediastinal width and the mediastinal width-to-thoracic cage ratio from chest radiographs for the early detection of unrecognized thoracic aortic diseases. Additionally, this study aims to enhance diagnostic strategies for identifying aortic abnormalities.

Materials and Methods: This retrospective analysis included 152 subjects who underwent both computed tomography angiography (CTA) of the thoracic aorta and chest radiograph between April 2007 and January 2021. Superior mediastinal width was measured at 3 levels on chest radiographs. Thoracic CTA findings were categorized into normal and abnormal groups, the latter comprising aortic dissection, intramural hematoma, penetrating atherosclerotic …

Diagnosis And Characterization Of Thyroid Dysfunction In Patients Evaluated In Primary Care In A Rural Zone Of Honduras, Javier Shafick Asfura, Travis Wesley Harris, Amanda Reeck, María Fernanda Chévez

Journal of Community Hospital Internal Medicine Perspectives

Background: Thyroid disorders are prevalent and frequently underdiagnosed in primary care, particularly in resource-limited rural areas. Their nonspecific symptoms complicate early recognition and treatment. This study aimed to determine the prevalence of thyroid dysfunction and describe the clinical reasoning, diagnostic strategies, and laboratory findings among adults evaluated with TSH testing in rural Honduras. Methods: A retrospective, descriptive, cross-sectional study was conducted at Hospital Loma de Luz in Balfate, Honduras. Adult patients aged ≥18 years who underwent diagnostic TSH testing between January 1, 2022, and January 31, 2023, were included. Patients with prior thyroid diagnoses or current pregnancy were …

Rates And Predictors Of Intention To Get Preventive Screenings Among Individuals In Recovery From Substance Use Disorders, Afsha Hossain, Ban A. Majeed, Lia Pierson Bruner

Journal of the Georgia Public Health Association

Background: Individuals with substance use disorders (SUDs) are at greater risk for chronic disease but often face barriers to access and uptake of preventive screenings, so the aim of this study was to identify rates and predictors for intention to get preventive screenings among residents at two recovery centers.

Methods: We used a cross-sectional survey (N=95, response rate 51%) to determine previous screening rates and the intention to get recommended preventive screenings among residents of two long-term recovery programs in Athens, GA, using bivariate analysis with chi-square to look for associations with intention.

Results: Prior use of preventive health services …

Tadalafil Monotherapy Is A Reasonable Alternative For The Treatment Of Lower Urinary Tract Symptoms In Patients With Comorbid Benign Prostatic Hyperplasia And Erectile Dysfunction, Daniel M. Ibrahim, Anam Ahmed, Swetha Reddy, Meet S. Patel, Nabeel Sumbal, Adam Chaban, Aminah I. Fayyaz

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomized, parallel, placebo-controlled clinical trial. Eur Urol. 2012;61(5):917-925. https://doi.org/10.1016/j.eururo.2012.01.0131

for a vigorous 75-year-old man with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) who discontinued dutasteride due to intolerable sexual side effects.

Family Mental Health – A Case Report, Vikrant Arora, Medha Kosireddy, Mathumitha Ananth, Kishor M. Manohar Rao

Digital Journal of Clinical Medicine

Psychiatric illness in India is estimated to be 15% as per National Mental Health Survey 2015-16.  Mental health challenges within families, especially depression, anxiety disorders that are not common and when unaddressed exert cascading effects on all members, disrupting emotional cohesion, relational functioning, and socioeconomic stability. There are few case reports on entire family presenting to psychiatry department.

With informed consent a city-based middle-class family of non-consanguineous origin, where the 40-year-old female, presented with intractable limb pains and health anxiety, she had multiple consultation in last few months and her 48-year-old husband also had with episodic pains, irritability and her …

Assessing Education And Training Of Developmental Screening Tools Among Residents In A Southern Academic Medical Center, Paige Seabrook, Dustin E. Sarver, Susan Buttross

Journal of Public Health in the Deep South

Background: Developmental disabilities are highly common. Early identification of developmental disabilities is critical, but many practitioners, including those in Southern U.S. states like Mississippi, do not utilize developmental screening tools.

Purpose: We aimed to identify modifiable targets within resident training experiences and their correlates using a quality improvement approach to serve as a baseline for intervention efforts.

Methods: Medical residents (N = 57) in pediatrics (n = 26), combined medicine-pediatrics (n = 12), and family medicine (n = 19) completed a survey assessing training, attitudes, practices, and perceived barriers regarding using screening tools. Perceived barriers were …

Blue Light Therapy Improves Sleep Quality And Or Sleep Disturbances In Those With Concussions: A Critically Appraised Topic, Bradlee Wells, Audrey Meche, Aric J. Warren

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Concussions are a form of traumatic brain injury (TBI) that cause problems such as headaches, dizziness, dazed or confusion, difficulty remembering or concentrating, but one of the most common complications that can occur from concussions are sleep disturbances/disorders. About 90% of those affected by TBI reported some type of sleep disturbance that include insomnia, frequent wakefulness after onset sleep, poor sleep quality, increased need for sleep, and/or daytime sleepiness that may possibly interfere with daily living activities. Previous evidence suggests that daily blue wavelength light therapy (BLT) may be effective at reducing fatigue and improving sleep in patients recovering …

Giant Cell Arteritis After Mrna Covid Vaccines: Concerning Or A False Alarm?-A Retrospective Cohort Study, Syed M. F. Zabiullah, Rutwik Pradeep Sharma, Roshan Subedi, Viqarunnisa Faaiza Zahid, Yasir Loai, Sarathlal Mannumbethlal, Aatifa Aatifa

Advances in Clinical Medical Research and Healthcare Delivery

Background: The coronavirus disease (COVID-19) pandemic led to the first large-scale rapid deployment of novel messenger RNA (mRNA) vaccines. Although the effectiveness and safety of these vaccines were rigorously studied, post-vaccination adverse events such as giant cell arteritis (GCA) continue to be reported. More than two hundred and sixty three cases of new-onset GCA occurring after mRNA vaccine administration are listed in the Vaccine Adverse Events Reporting System as of October 2024. We aimed to explore the incidence of GCA after mRNA vaccines among patients in our health system and study their characteristics and outcomes.

Methods: We conducted a …

Hepatocellular Carcinoma Surveillance In Patients With Cirrhosis, Identifying Gaps In Clinical Practice, Abdullah Orakzai, Muhammad Hammad Sharif, Basil George Verghese, Shiamak Cooper, Venkat Arutla, Purva Shah, Himal Kharel, Aditya Sanjeevi, Aniket-Vijay Rao

Advances in Clinical Medical Research and Healthcare Delivery

Background:Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide, with rising mortality rates in the United States. Early detection of HCC through routine screening significantly improves survival rates in patients with cirrhosis. Current guidelines recommend bi-annual screening using abdominal ultrasound with or without serum AFP levels; however, adherence to these guidelines is suboptimal in clinical practice.

Methods:We conducted a retrospective study of 320 adult patients diagnosed with HCC at our institution between January 1, 2023, and July 31, 2023. Patients aged >22 years were included, and their medical records were reviewed to evaluate routine surveillance …

Clinical Images Of Cutaneous Horns In Patients Presenting To A Family Medicine Residency Practice, Julia Fashner, Tillie Schumann

HCA Healthcare Journal of Medicine

We detail 2 cases of cutaneous horn, also referred to as cornu cutaneum, which is a hard-compacted linear outgrowth of keratin that projects above the skin. We present these images to increase awareness for all medical specialties who may see a patient with this skin lesion.

America's Physician Shortage: Look To Pas, Not Abroad, Raquelle Akavan, Laura Juarez

Lynchburg Journal of Medical Science

The United States has long addressed physician shortages by recruiting international medical graduates (IMGs), often from low- and- middle income countries. This "brain drain" deprives already fragile health systems and adds to worldwide health disparities. New state legislation has eased licensing standards for IMGs and generated variable training pathways creating patient safety risk in underserved groups. At the same time, the U.S. has a sustainable, highly trained, and proven ready workforce: physician associates (PA). Created in the 1960s to address physician shortages, PAs undergo intensive graduate-degree education, uniform clinical education, and national certification on par with physicians. Nonetheless, obsolete laws …

A Complex Case Of A Large Fibroid Uterus Compressing The Inferior Vena Cava Causing Recurrent Deep Vein Thrombosis And Pulmonary Embolisms, Jessica Gil, Jessica Klingensmith, Lauren Hendrix, Patrick J. Stocker, Olugbenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Uterine fibroids have been found to increase the risk for venous thromboembolism. There have been other case reports linking large uterine fibroids, pulmonary embolisms, and deep vein thrombosis (DVT) together due to compression of blood vessels and increased venous stasis. This case report will discuss a case of a large fibroid uterus compressing the inferior vena cava causing a patient with few risk factors to have recurrent DVTs and pulmonary embolisms.

Case Presentation

The patient was a 35-year-old woman who presented with repeated unprovoked thrombosis episodes. The patient had a full workup after the first episode of DVT and …

Exploring Effective Weight Loss Interventions Among Three Fqhc-Based Clinical Programs In Central And Southern Illinois, Patrick Bruch, Oluwaseun Adeleke, Mia Lambert, Taylor Sutton, Georgia Luckey, Rebecca M. Hoffman Md,Msph

SIU Journal of Medical Science Scholarly Works

Background: Obesity affects 1 in 3 United States adults is associated with several chronic diseases. Disparities in obesity are seen in many vulnerable populations such as low-income groups, racial and ethnic minorities, and rural residents. Although primary care is often presented as a solution to the obesity crisis, management of obesity is complex and numerous challenges in helping patients achieve weight loss are still present. The U.S. Preventive Services Task Force recommended in 2018 that primary care providers screen for obesity and offer obese patients to intensive, multicomponent behavioral obesity treatment. However, there is little research involving primary care physicians …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

Pcsk-9 Inhibitors Treatment: The Cardiovascular Disparity, Julia Lees, Seana-Pierre Williams, Tahir Razzaq, Michael B. Roberts

The Journal of Integrated Primary Care

Introduction: According to the Center for Disease Control and Prevention (CDC) and American Heart Association (AHA), cardiovascular disease is the leading cause of death in the United States. This phenomenon disproportionally affects the African American population, who have a 31% higher mortality rate than non-Hispanic Caucasian individuals. A retrospective review of PCSK-9 medication use, specifically in a patient population that had minimal representation in the large, landmark clinical trials, can lead to better understanding about the therapeutic potential in cardiovascular disease reduction and patient outcomes attributed to medication use. Education regarding this novel drug class, medication access and patient support, …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

Iron Deficiency—More Than Just Anemia: A Literature Review, Arianna S Moss, Zahra Pakbaz

Journal of Community Hospital Internal Medicine Perspectives

Iron deficiency (ID) is a global public health concern, as it can be a prodrome of gastrointestinal (GI) malignancies, exacerbate chronic conditions, and lead to an overall decreased quality of life. Despite being the most prevalent nutritional deficiency, it remains underdiagnosed by many healthcare professionals. Misconceptions regarding the clinical and laboratory manifestations of ID lead to delayed or missed diagnoses, contributing to poor patient outcomes. Though anemia is a commonly known consequence of ID, there are additional consequences that remain underrecognized by the medical community, including vague signs and symptoms, such as fatigue, depression, and abnormalities in white blood cell …

Clinical Decision-Making And Artificial Intelligence: The Role Of Large Language Models In Medicine, Richa Bhasin, Wassim El-Sayed, Kassim Salami, Mura Abdul-Nabi, Ahmed Elashmawy, M. Ellis Jaruzel Ii

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Goh E, Gallo R, Hom J, et al. Large Language Model Influence on Diagnostic Reasoning: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(10):e2440969. https://doi.org/10.1001/jamanetworkopen.2024.40969

to explore the role of artificial intelligence in clinical settings.

Off-Label Long-Term Use Of Phentermine For Weight Management, Monique Morin, Yamini Pandey, Sarah Bdeir, Rumyah Rafique, Taim-Allah Al-Jarrah, Ali Farhat

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Hendricks EJ, Greenway FL, Westman EC, Gupta AK. Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity. Obesity. 2011;19(12):2351-2360 https://doi.org/10.1038/oby.2011.94

for a patient struggling at the intersection of weight loss and financial instability.

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Tattoos As A Risk Factor For Malignant Lymphoma, Michael Escobar, Hajirah Farah, Anna Zhao, Hafsah Umerani, Rubab Imtiaz

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Nielsen C, Jerkeman M, Jöud AS. Tattoos as a risk factor for malignant lymphoma: a population-based case-control study. EClinicalMedicine. 2024;72:102649. Published 2024 May 21. https://doi.org/10.1016/j.eclinm.2024.102649

for a teenage patient contemplating getting a tattoo.

Common Misconceptions In Hormone Therapy (Ht) Treatment In Menopause, Miranda Zuhlke

Lynchburg Journal of Medical Science

ABSTRACT
The purpose of this review is to address the misconceptions surrounding Hormone Therapy (HT) in menopause largely surrounding the findings from Women’s Health Initiative (WHI). The review explores the history of HT, the risks and benefits, along with current guidelines for HT and non-hormonal options. A comprehensive search was conducted using electronic databases focusing on the effect of HT on breast cancer, cardiovascular health, bone health, and quality of life. Studies that analyzed the implications from the WHI were included as well as the North American Menopause Society (NAMS) current recommendations and guidelines for treatment options in menopause. Findings …