Upstream Ethics in Primary Care Truth Telling, Errors, and Economics Create Ethical Conflicts Case Study Louise, a 58-year-old member of your church, has insulin-dependent diabetes. She has no insurance and your community has no free health services. You have provided free care for years, defraying cost with services that carry a high reimbursement. She is morbidly obese; her circulation and vision are poor and declining; you hesitate to order testing that will pose a finacial burden because she already... more >>
Urogenital Dysfunction: It's Not Just in Her Head Jeanne Leventhal Alexander, MD Patient complaints of lower urinary tract symptoms (LUTS) require an immediate medical evaluation and workup. LUTS include recurrent or post-coital cystitis, cystalgia or urethral pain after intercourse; pain at intercourse or other sexual pain disorder; low desire or low sexual arousal. The recently demonstrated high comorbidity of these disorders among female patients makes any single complaint... more >>
Managing Pain in Primary Care Practices
FDA Ruling Creates Unintended Consequences Roger K. Cady, MD The withdrawal of Cox-2 inhibitor valdecoxib from the market and the black box warnings on celecoxib and all other remaining prescription non-steroidal anti-inflammatory drugs (NSAIDs) have forced clinicians to rethink and reconstruct their strategies for pain management. They are also finding they need to allocate extra time to allay their... more >>
Nurse Case Management Benefits
Patient Care The role of nurses has changed dramatically in the past 25 years. Increasingly, nurses around the world are relied upon to educate and advocate for patients and to improve the delivery of care. Clinics that take advantage of the new case management model reap benefits in efficiency, reduced costs, and improved satisfaction of staff... more >>
Living with Genital Herpes
Facts Dispel Widely Held Misconceptions By: Terri Warren, MSN, MEd, ANP Patients usually receive a diagnosis of genital herpes with a range of emotions, including anger, frustration, sadness, and guilt. They may also be dismayed to learn that both types of herpes can be transmitted when there are no apparent lesions. In fact, many cases... more >>
Migraine Masquerades as Sinus Headache Up to half of the nation's 28 million people who experience migraine headaches remain undiagnosed. Becasue they are not receiving the most effective medications available, they may exoerience unnessary pain and develop a negative view of medicine. Although headache specialists and primary practitioners have observed that runny nose, congestion, and ocular symptoms do occur with migraine... more >>
Metabolic Syndrome Threatens Children
and Adults Regardless of the cause, vigorous lifestyle modification is the primary treatment recommendation, with appropriate medication as secondary treatment. Metabolic syndrome, defined as three or more cardiovascular risk factors, is predicted to soon overtake cigarette smoking as the top risk factor for heart disease in America... more >>
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