Primary Care Commons^™

Approach To Ruq Pain, Jose Medina, Md, Msw

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Highlight the prevalence of RUQ pain
• Review the anatomy relevant to RUQ pain
• Discuss the broad differential associated
• Walk through important history, physical exam, and lab work components of the work up for RUQ pain
• Review the appropriateness/clinical utility of different imaging modalities
• Highlight common US findings associated with RUQ pain
• Case review and management of common RUQ diagnoses

Induced Lactation, Katherine M. Evans

Family Medicine Scholarly Works

Induced lactation refers to the production of breast milk in a woman who has never been pregnant. While induced lactation has been practiced developing nations for centuries, it has only recently been introduced to the United States. Induced lactation allows a woman to provide both nutrition and nurture an emotional bond with an infant in cases of adoption, surrogacy, same-sex couples, maternal-infant separation, and emergencies/natural disasters. Many protocols for inducing lactation have been described, though all vary widely in methodology and effectiveness. The current review summarizes the physiology of human lactation, psychosocial factors involved with inducing lactation, non-pharmacologic and pharmacologic …

Easy And Accurate Transition Between Common Beta Blockers: A Qi Project, Sam Short, Amalia Kane

Family Medicine Clerkship Student Projects

Hypertension is a common condition that often worsens with disease progression and/or age alone. The management of hypertension often requires multiple drug therapy. Beta blockers can be useful for this, and are often prescribed for other comorbid conditions such as angina or heart failure. Yet, not all beta blockers have the same effect on blood pressure and it can be advantageous to transition patients to non-selective agents such as carvedilol. However, dose conversions are not 1:1 and inappropriate transition can be dangerous. No readily accessible resources are available to aid the clinical management of this problem. This project aims to …

Adipose Tissue As Pain Generator In The Lower Back And Lower Extremity: Application In Musculoskeletal Medicine, Se Won Lee, Craig Van Dien, Sun Jae Won

HCA Healthcare Journal of Medicine

Adipose tissue (AT) has diverse and important functions in body insulation, mechanical protection, energy metabolism and the endocrine system. Despite its relative abundance in the human body, the clinical significance of AT in musculoskeletal (MSK) medicine, particularly its role in painful MSK conditions, is under-recognized. Pain associated with AT can be divided into intrinsic (AT as a primary pain generator), extrinsic (AT as a secondary pain generator) or mixed origin. Understanding AT as an MSK pain generator, both by mechanism and its specific role in pain generation by body region, enhances the clinical decision-making process and guides therapeutic strategies in …

Small Intestinal Bacterial Overgrowth: A Case-Based Review, Kristen H. Reynolds

Journal of Patient-Centered Research and Reviews

Small intestinal bacterial overgrowth (SIBO) is a condition of increased microbial load in the small intestine. The microbes feed on dietary carbohydrates and starches via fermentation, leading to gas production, inflammation and damage to the lining of the small intestine. Clinical presentation is varied, including abdominal pain, bloating, malabsorption and systemic symptoms. SIBO is associated with many challenging and chronic conditions such as fibromyalgia, chronic fatigue and chronic pain syndromes, and has been shown to be a causative factor in two out of three cases of irritable bowel syndrome. Symptoms improve with antimicrobial treatment, but recurrence is common. Many providers …

African American And Caucasian Perceptions And Attitudes Toward Colorectal Cancer Screening: A Qualitative Study, Peter Warren, Stacie Pankow, Yvette Rother, Peggy Wagner

The Qualitative Report

This study examined the attitudes held by both African Americans and Caucasians regarding colorectal cancer screening and the reasons why they avoid screenings even when clinically indicated by their physicians. Colorectal cancer (CRC) is one of the most common and easily preventable types of cancer in the United States. If diagnosed and treated early prior to metastasis, the five-year colorectal cancer survival rate is approximately 90%. However, many patients avoid screening procedures for colorectal cancer due to a number of reasons. Qualitative data was gathered from focus groups and found four major themes that emerged in both groups: (1) reported …

Wound Care In The Homeless Population- Chcb And Safe Harbor Clinic, Niveditha Badrinarayanan

Family Medicine Clerkship Student Projects

Most of the clinician interactions in the homeless community has prioritized acute needs over chronic complaints like wounds. An inherent distrust of the healthcare system is also common in the homeless community due to lack of access to care, transportation, insurance, et. This project is aimed at encouraging preventative care in the homeless community with respect to wound care to reduce their concerns about unaddressed complaints and also decrease the burden on the providers during their healthcare visits.

Conservative Management Of Low Back Pain, Se Won Lee, Dan Nguyen, Denny Mack, Eric Aguila, Mary Thomas, Karyn Doddy

HCA Healthcare Journal of Medicine

Low back pain (LBP) is frequently encountered in outpatient clinics and affects individual patients and society in general with decreased physical function, quality of life, disability, and/or economic burden. Although most acute LBP resolves on its own, recurrent and chronic LBP is a common reason for outpatient clinic visits. This review explores pragmatic approaches to LBP in the clinical setting, focusing on recognizing prognostic factors, initial approaches to evaluation, including selective imaging, and conservative management including patient education, therapeutic exercises and bracing.

Journal Club - Dapa-Hf Trial, Emma De Louw, Pgy-3

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Cost Outcomes Of Physical Therapist Providers Compared To Primary Care Providers In The Treatment Of Musculoskeletal Patients In A Military Treatment Facility: A Retrospective Chart Review”, Troy E. Mcgill, Debra F. Stern, Morey J. Kolber, John Mcgee

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a …