Family medicine and primary care -- open access最新文献

{"title":"Can Family Practitioners Help with the Early Diagnosis of Sarcopenia?","authors":"C. Biguetti, M. Brotto","doi":"10.29011/2688-7460.100037","DOIUrl":"https://doi.org/10.29011/2688-7460.100037","url":null,"abstract":"Sarcopenia is a high prevalence age-related disorder, defined by involuntary loss of skeletal muscle mass combined with muscle weakness and consequent inability to execute activities of daily living. Furthermore, this clinical entity is a strong predictor of falls, disability and frailty, among other important geriatric morbidities, ultimately leading to a very poor quality of life and increased health care costs. However, Sarcopenia remains largely undiagnosed and undertreated. This editorial highlights the importance for effective methods of diagnosis and management of Sarcopenia by clinicians, particularly family practitioners. In fact, in order to avoid complications related to this condition, we propose that measurement of muscle strength (by measuring grip strength) should be part of patient evaluation as well other vital signs routine and annual checkup consultations.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47658308","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":"Focal Segmental Glomerulosclerosis and the Role of ACTH","authors":"Ann Sedeeq, Akram Al-Salman, Arshdeep Tindni","doi":"10.29011/2688-7460.100035","DOIUrl":"https://doi.org/10.29011/2688-7460.100035","url":null,"abstract":"Focal Segmental Glomerulosclerosis (FSGS) is one of the common causes of nephrotic syndromes, manifested by heavy proteinuria, minimal hematuria and hypoalbuminemia. If left undiagnosed or untreated, FSGS will progressively damage enough glomeruli to cause a fall in Glomerular Filtration Rate (GFR) producing renal failure and require renal replacement therapy. For this reason, early identification and treatment is warranted to delay disease progression. Multiple treatment options such as steroids have been tried but most of these treatments showed partial response, increased relapses after completing treatment course and increased adverse effects due to prolonged use.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45615432","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 Effect of Smoking on Salivary Parameters","authors":"M. Yordanova, N. Shopov","doi":"10.29011/2688-7460.100034","DOIUrl":"https://doi.org/10.29011/2688-7460.100034","url":null,"abstract":"Smoking is a widespread harmful habit and a proven risk factor for a number of inflammatory and malignant diseases of the oral cavity as well as of the respiratory and digestive system. Aim: The aim of this study is to evaluate and compare the effect of smoking on the salivary composition of whole unstimulated saliva. Materials and Methods: The study included 186 people, divided into two groups smokers (77 people) and non-smokers (109) with an average age of 33 (19-57). Ninety-nine of them are men and 87 women. Unstimulated saliva, collected in a passive manner using advanced standard analytical requirements, is used for the analyzes. The following indicators were analyzed: Uric acid (UA), alpha amylase (a-amy), secretory Ig A (sIg A), total protein (TPro), and albumin (alb). Salivary parameters were analyzed with the finished kit of Thermo sciens, Becman Coulter, with the adaptation of the oral fluid methods of the biochemical analyzer Olympus AU 640 and Indiko Plus. Results: We observed a significant increase in the concentration of salivary total protein, and albumin, and respectively a decrease in UA, amylase and sIg A in smokers, resulting in a change in saliva homeostasis and its antioxidant capacity. Conclusion: The results show significant quantitative changes in the saliva parameters between smokers and non-smokers, with smoking adversely affecting oral homeostasis and with an increased risk of inflammatory and degenerative changes in the lining.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49669065","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":"Renal Thrombotic Microangiopathy Associated with Carfilozomib Use in Treatment of Multiple Myeloma","authors":"Omer Saadat, Cyndi Odipo, Arshdeep Tindni","doi":"10.29011/2688-7460.100032","DOIUrl":"https://doi.org/10.29011/2688-7460.100032","url":null,"abstract":"Carfilzomib is a newer class of selective proteasome inhibitor approved by FDA in 2012. It is used for the treatment of refractory multiple myeloma in patients who have received two prior therapies. We report a case of drug induced thrombotic microangiopathy associated with carfilzomib in a patient with refractory multiple myeloma.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43843287","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":"Shared Decision Making in Primary Care: An Overview","authors":"","doi":"10.29011/2688-7460.100029","DOIUrl":"https://doi.org/10.29011/2688-7460.100029","url":null,"abstract":"","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42226200","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":"Parental Perceptions: Effects of Home Acoustics on Children with Autism","authors":"S. Kanakri, M. Gregg, Shelby Haggard","doi":"10.29011/2688-7460.100023","DOIUrl":"https://doi.org/10.29011/2688-7460.100023","url":null,"abstract":"Background: As more children are being diagnosed with Autism Spectrum Disorder (ASD), there is a greater need for research surrounding how the built environment impacts those children. Aim: The aim of this study was to analyze how parents of children with ASD perceive the effects of acoustics on their child. Parents of children with ASD completed a survey detailing their perceptions of their child’s behaviors to different acoustical aspects of the environment and the effectiveness of the current acoustical design of their home. Patients and Methods: The survey included Likert-scale questions, and quantitative measures. Results: Most parents indicated that they strongly agreed that their home is acoustically well-designed (69.5%) followed by agreed (13.4%), neither agreed nor disagreed (11.0%), strongly disagreed (3.7%), and disagreed (2.4%). Parents were also asked what environmental design features are used in the child’s home to help reduce noise levels. Parents reported using thick or sound-absorbing carpet (17.9%), thick walls (6.0%), wood chairs/desks (15.5%), and transitional spaces (11.0%). No parents reported using wood panels, sound proof material, or sound proof ceilings in the child’s home. Parents rated thick or sound proof walls (Mean = 4.17, Standard Division = 0.92) as being the most important elements of noise control in children’s environments. Results indicated a significant relationship between parental rating of noise control being an important issue and observing complaining in response to noise. Conclusion: The results indicated that there was an association between parents rating noise control as being important for their child and observing behaviors in their children in response to noise. There was no association between observed behaviors and parents rating environmental modifications as being important for noise control. Recommendations: Future research should seek to combine data from parents, teachers, and children with ASD. Further research could aid in the design and implementation of acoustic settings in the built environment that bring about positive behavior from children with ASDs.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45542761","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":"Improving Medication Adherence among Patients with Coronary Heart Disease","authors":"Xinxin Tang and Maureen Courtney","doi":"10.29011/2688-7460.100033","DOIUrl":"https://doi.org/10.29011/2688-7460.100033","url":null,"abstract":"","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69480129","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":"Alendronate Associated Minimal Change Disease: A Case Report and Literature Review","authors":"Swetha Chenna, Arshdeep Tindni, V. Puri, Venu Chippa","doi":"10.29011/2688-7460.100025","DOIUrl":"https://doi.org/10.29011/2688-7460.100025","url":null,"abstract":"Kidney injury associated with bisphosphonates is well known in literature, though its more common with intravenous bisphosphonates. Case reports about focal segmental glomerulosclerosis are reported with oral and intravenous bisphosphonates. We present a case of 87-year-old female with acute renal failure and volume overload found to have minimal change disease on biopsy while on Alendronate for a period of four months. She has failed oral prednisone treatment and is now dependent on hemodialysis. This is probably the first case report of minimal change disease with oral bisphosphonates.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69478083","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":"IgG4 Tubulointerstitial Nephritis- A Rare Autoimmune Presentation","authors":"Cyndi Odipo, Arshdeep Tindni, Omer Saadat","doi":"10.29011/2688-7460.100031","DOIUrl":"https://doi.org/10.29011/2688-7460.100031","url":null,"abstract":"IgG4 related disease is a recently recognized systemic disease involving multiple organs, including the pancreas, salivary glands, kidneys, lymph nodes, and retroperitoneum. It is characterized by dense infiltration of organs with lymphoplasmacytic cells that leads to fibrosclerosis and elevation in serum IgG4 levels. We present an 80-year-old Caucasian male with past medical history of DM2, coronary artery disease, hyperlipidemia, hypertension, and cerebral vascular accident with repeated episodes of acute renal failure (AKI). It initially was presumed as due to volume changes, however, that was ruled out with normal blood pressure readings of 119/73 mmHg. The patients Glomerular Filtration Rate (GFR) ranged from 16 to 24, BUN 33, and Creatinine 2.7 despite treatment with volume resuscitation, discontinuing ACE-inhibitors, and avoidance of NSAIDs. Renal ultrasound studies were negative for obstruction, and urine analysis negative for proteinuria. As time progressed his blood pressure continued to rise in value of 130/67 mmHg, while GFR remained below 25. On renal biopsy the pathology report illustrated chronic tubulointerstitial nephritis with mild mesangial immune complex deposition, a finding that correlates with IgG4-related disease. Congo red stain of the pathology specimen was negative for amyloid deposition, another causal factor for tubulonephritis. Improvement with fatigue and appetite was noted upon starting steroid treatment. Additionally, the GFR improved to an impressive value of 53 with 3 months of treatment.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69480019","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":"Home Visits and Home-Based Care: A Necessary, Impractical, or Humanitarian Primary Care Service?","authors":"M. Verjee","doi":"10.29011/2688-7460.100022","DOIUrl":"https://doi.org/10.29011/2688-7460.100022","url":null,"abstract":"Looking after patients at home may be considered to be more a feature of the past, but delivering quality home-based care may contribute to beneficent and cost effective overall healthcare. While regarding an elderly population of over sixties as more vulnerable, the added workload for primary care physicians is a consideration when using resources, allowing time, providing benefits, and seeking positive outcomes. New models of care studied confirm a perceived need for an extra level of patient-centred care. Nurse practitioners play a greater part compared with physicians, the latter more likely to sustain pressure from overwork. Burnout and loss of professional recognition and service can lead to dissatisfaction.","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69478131","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}