April 2015

Improving Child Health by Screening for Social Determinants

May 11, 2015

FPR Journal Club

This cluster randomized controlled trial evaluated whether a screening and referral system for social determinants of health (called WE CARE) at well child visits resulted in receipt of more community resources for families.

Are Butter and Full Fat Foods Safe?

May 11, 2015

FPR Journal Club

This was a systemic review and meta-analysis of randomized control trials regarding the relationship between dietary fat consumption, serum cholesterol levels, and subsequent coronary heart disease development.

HPV Vaccination in Adolescent Females Not Associated with Increased Incidence of Sexually Transmitted Infection

May 11, 2015

FPR Journal Club

The prevalence of HPV infection in US females aged 14-19 is approximately 25% and in females aged 20-24 it is increased to approximately 45%. Despite this high risk, in 2013, only 38% of females aged 13-17 have received all three recommended HPV vaccine doses.

Eat Fiber: One Simple Message for Weight Loss

May 11, 2015

FPR Journal Club

This study was a randomized, controlled trial of 240 adults with metabolic syndrome who were assigned to follow either the single-component dietary recommendation of increased fiber consumption (≥30g/d), or the multi-component American Heart Association (AHA) dietary guidelines. The primary outcome measure was weight loss at 12 months.

An Infant Who Swallowed a Coin

May 08, 2015

Radiology Rounds

A mother brought her 1-year-old daughter to the emergency department and reported that the child had swallowed a coin. She had vomited once without recovery of the coin. The mother said the baby had not been coughing or wheezing and had no respiratory distress, but she refused to eat.

The End of SGR: What Took So Long?

May 08, 2015

Editor's Letter

For more than a decade, it has been an annual ritual to read headlines about a crisis brewing in Congress as it struggled to avert a looming Medicare disaster stemming from the imminent pay cut to Medicare physicians mandated by the "SGR". Like a broken record each time, spurred by warnings of physician groups of the dire consequences the slash in Medicare fees would have on medical practices and Medicare patients, Congress scrambled at the 12th hour to put off the mandated cuts for another year.

A Reassuring EKG... Not For Long

May 08, 2015

Cardio Corner

A 51 year-old man with a history of well-controlled hypertension presents to his primary physician's office for an acute care visit with chest discomfort that would come and go.

Strategies for Treating Depression Associated With Chronic Pain Part 1: Psychotherapy

May 08, 2015

Pain Perspectives

In last month's Pain Perspectives, I discussed the importance of assessing patients with chronic pain for depression – as it is extremely prevalent in this population and has been found to interfere with physical treatment. This month, we will begin to look at what the primary care physician can do to ensure that their patients with chronic pain have their depression addressed adequately.

How Would You Manage This Woman Who is a Self Described 'Worry Wart'?

May 08, 2015

Consultant's Corner

A 38 year old female lab technician is seen for "being nervous all the time". She complains of being unable to relax. She relates to you that he has been a "worry wart" for as long as she can remember, always fearing that something is going to go wrong. Although her doctor has told her she is in excellent health, she relates that she sees him frequently for episodic stomach pains and palpitations.

Elderly Woman With an Itchy Scalp

May 08, 2015

Dermatology Quiz

This 76-year-old woman presented to clinic with 8 weeks of severe scalp itching. She had previously been treated with emollient lotion, baby oil, a dandruff shampoo containing pyrithione zinc, and hydroxyzine. Her past medical history includes eczema, hypertension, hyperlipidemia, paroxysmal SVT, GERD, and depression. She is retired, volunteers at an elementary school, and does not drink alcohol, smoke tobacco, or use recreational drugs.