Journal of the Osteopathic Family Physicians of California最新文献

{"title":"Gout: A Case Report","authors":"Samarth Bhatnagar, C. MacInnis","doi":"10.58858/010106","DOIUrl":"https://doi.org/10.58858/010106","url":null,"abstract":"Gout is a common clinical condition, usually seen with typical manifestations of swelling, erythema, tophi, and heat at joint(s). However, in rare circumstances, gout can present atypically, and it is important to recognize and manage it with appropriate medical therapy. This case study dives into a particularly atypical presentation of tophaceous gout in a patient with numerous comorbidities that complicate management. Visually appreciating the tophi, in this case, allows one to get an idea of their distribution on the digits, their unique chalky-white appearance, and how the presentation changed after therapy was initiated. Additionally, learning about the in-depth management and step-wise escalation of treatment is a crucial takeaway from this case, especially in the backdrop of the patient’s CKD3b and CHF - making selecting pharmacotherapy a challenge. After some trial and co-consultation with nephrology, the final effective treatment course for this patient involved using a combination of Allopurinol and Pegloticase (Krystexxa) together; this provided both a clinical improvement and a decrease in lab values of uric acid, dropping from 11.4mg/dL at peak to 4.4mg/dL.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134565080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-Linked Hypophosphatemia","authors":"Steven H. Barag, Ajith Raja, J. Shieh","doi":"10.58858/010104","DOIUrl":"https://doi.org/10.58858/010104","url":null,"abstract":"Linked Hypophosphatemia (XLH) is a genetic disorder that affects the bones and teeth, primarily characterized by low levels of phosphate in the blood. XLH is a rare disorder but is considered the most common inherited form of rickets. The clinical presentation of XLH varies widely with the most common symptoms of XLH being short stature, bowing of the legs, and dental defects. Diagnosis of XLH is typically made through clinical evaluation and genetic testing. Treatment options include monoclonal antibody therapy, oral phosphates, and bisphosphonates. This article will discuss the general clinical presentation of XLH, including the common symptoms and signs, the age of onset, diagnosis and treatment options, and the importance of primary care physician screening.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116607670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Loneliness in Older Adults: A Way to Better Address Mental Health in Primary Care Since the COVID-19 Pandemic","authors":"Mandy Helle","doi":"10.58858/010107","DOIUrl":"https://doi.org/10.58858/010107","url":null,"abstract":"The winner of the ACOFP-CA 2022 Student Writing Awards on the topic of the COVID-19 pandemic’s effect on mental health in primary care.\u0000\u0000Mandy Helle, OMS (California Health Sciences University College of Osteopathic Medicine – Class of 2025), submission “Screening for Loneliness in Older Adults: A Way to Better Address Mental Health in Primary Care Since the COVID-19 Pandemic” was an outstanding example of thoughtfulness and research and was awarded first place.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122593807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteomyelitis of Unknown Origin","authors":"J. Uy, Verna Marquez, A. Chetha, Namdeep Grewal, Sapna Patel","doi":"10.58858/010105","DOIUrl":"https://doi.org/10.58858/010105","url":null,"abstract":"Osteomyelitis is inflammation and or swelling of the bone. The infection site can either be at the bone or from another part of the body that has spread to the bone. Staphylococcus aureus and staphylococcus epidermis are responsible for most cases due to being a part of normal skin flora. Salmonella is rarely reported and accounts for 0.45% of all causative agents of salmonella. Salmonella osteomyelitis in immunocompetent adults is uncommon and occurs in approximately 0.8% of all Salmonella infections. \u0000\u0000Myositis is muscle inflammation that can be due to both infectious and non-infectious causes. Infectious causes can be classified into pyogenic or non-pyogenic. Infection-related myositis occurs due to bacterial, viral, fungal, mycobacterial, or parasitic infections as the root cause. Bacteria and fungi are the most common cause of focal myositis. Myositis with Salmonella species is rare and has been reported with Salmonella Typhi and Salmonella Enteritidis.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123430850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Point of Care Ultrasound in the Removal of Non-Palpable Nexplanon in a Teaching Community Health Center","authors":"Timiiye Yomi, Verna Marquez, Sally Wonderly, Rupam Sharma","doi":"10.58858/010101","DOIUrl":"https://doi.org/10.58858/010101","url":null,"abstract":"Background \u0000Nexplanon is a reversible non-biodegradable progestin-only long-acting hormonal contraceptive subdermal implant removed after three years. Superficial palpable implants are easy to remove in the outpatient setting. However, deep non-palpable implants are traditionally referred to surgery for elective removal. In the wake of Covid-19, emergency cases were prioritized, leaving patients with non-palpable implants unattended. Herein described are five cases of reproductive-age women who presented at our community health center with non-palpable implants. \u0000\u0000Purpose \u0000To show that non-palpable implants can be successfully and safely removed in a teaching community health center under ultrasound localization, guidance, and the direct supervision of an experienced healthcare provider without needing specialty referral. \u0000\u0000Method \u0000We performed a retrospective study by reviewing the charts of all patients who presented at our clinic for Nexplanon® removal from September – October 2021. Data was gathered from our electronic medical records system of patients database. Twenty-nine women were identified; twenty-four had palpable implants and five non-palpable implants. Using a high-frequency linear ultrasound probe to localize non-palpable implants, a 3–5 mm incision was made, and implants were removed successfully under local anesthesia and the direct supervision of an experienced provider. All implants were at depths of 0.22 to 0.56 cm from the surface, and their relationship to fascia, muscle, and vascular structures was assessed before removal. The sterile technique was observed throughout the procedure, and the site of removal was secured with steri strips and wrapped with a bandage for 24 hours to secure hemostasis. No sutures were needed post-removal, and all patients tolerated the procedure well, with minimal bleeding. \u0000\u0000Results \u0000Twenty-four patients (82.7%) had palpable implants successfully removed by manual palpation. Five patients (17.3%) had non-palpable implants removed successfully under ultrasound localization and guidance in our clinic with no complications. Four non-palpable implants were located above the fascia, and one was localized in the fascia within the subcutaneous layer. Patients were discharged in stable conditions with no need for follow-up.\u0000\u0000Conclusion\u0000Our study has shown that non-palpable Nexplanon® implants can be successfully removed under ultrasound localization and guidance in a teaching community health center under the direct supervision of an experienced healthcare provider without the need for specialty referral. It is fast, safe, practical, and cost-effective, provides accessibility and availability of expertise without heavy cost bearing to the patient, and increases overall patient satisfaction.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122638728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chelating Foods in Chronic Disease: Treatment and Prevention","authors":"Habib Sadeghi","doi":"10.58858/010103","DOIUrl":"https://doi.org/10.58858/010103","url":null,"abstract":"As increasing numbers of patients present with chronic illnesses each year, healthcare has remained unable to resolve many of these issues' root causes, resorting to symptom management instead. For example, it is becoming increasingly clear that heavy metal toxicity is highly correlated with these conditions. Still, clinical care has focused more on pharmaceutical and surgical interventions than on trying to understand these underlying connections better. Because heavy metals are ubiquitous in modern life, exposure risk is high for nearly everyone. While chelation therapy has a long history and remains an effective method of removing heavy metals from the body, various foods have also been shown to possess powerful chelating properties. In light of these realities, not only is it incumbent upon physicians to make a heavy metal testing standard protocol for certain conditions, but incorporating a diet emphasizing chelating foods can provide powerful support to existing treatment and act as a preventative measure against bioaccumulation and its associated diseases.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126667000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2022 ACOFPCA Research Abstracts and Poster Competition","authors":"Acofpca Staff","doi":"10.58858/010108","DOIUrl":"https://doi.org/10.58858/010108","url":null,"abstract":"This issue of the Journal of Osteopathic Family Physicians of California (JOFP-CA) features abstracts from the posters presented at the 2022 American College of Osteopathic Family\u0000Physicians of California Convention and Scientific Seminars (ACOFPCA’46), which took place on Saturday, July 30, 2022.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130109995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Coffee Revolution: From Politics to Optimized Health","authors":"Steven H. Barag, A. Robichaux, Taryn Kawashima, Avis Ko, David Sanchez, Christine Stull, Daniel Nadeau","doi":"10.58858/010102","DOIUrl":"https://doi.org/10.58858/010102","url":null,"abstract":"This article gives a brief account of the origins and evolution of coffee and its important\u0000role in human society for the last 1200 years. Fast forward to today, and 66% of Americans\u0000consume coffee daily. In the last few decades, a multitude of studies has researched the\u0000claims that coffee drinking offers cardiovascular, neurologic, metabolic, carcinogenic, and\u0000reproductive protections. This review evaluates and summarizes these findings, including the latest discoveries on the impact of caffeine on human health and the protection of human body systems.","PeriodicalId":409706,"journal":{"name":"Journal of the Osteopathic Family Physicians of California","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125212221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}