Items in FPM with MESH term: Family Practice
Food Allergies: Detection and Management - Article
ABSTRACT: Family physicians play a central role in the suspicion and diagnosis of immunoglobulin E-mediated food allergies, but they are also critical in redirecting the evaluation for symptoms that patients are falsely attributing to allergies. Although any food is a potential allergen, more than 90 percent of acute systemic reactions to food in children are from eggs, milk, soy, wheat, or peanuts, and in adults are from crustaceans, tree nuts, peanuts, or fish. The oral allergy syndrome is more common than anaphylactic reactions to food, but symptoms are transient and limited to the mouth and throat. Skin-prick and radioallergosorbent tests for particular foods have about an 85 percent sensitivity and 30 to 60 percent specificity. Intradermal testing has a higher false-positive rate and greater risk of adverse reactions; therefore, it should not be used for initial evaluations. The double-blind, placebo-controlled food challenge remains the most specific test for confirming diagnosis. Treatment is through recognition and avoidance of the responsible food. Patients with anaphylactic reactions need emergent epinephrine and instruction in self-administration in the event of inadvertent exposure. Antihistamines can be used for more minor reactions.
Finding High-Quality Review Articles - Article
ABSTRACT: A wide array of resources summarizing medical information are available, and physicians must carefully choose the most trustworthy sources. Treatment decisions should be based on the best available evidence, which should be carefully critiqued for both relevance and validity. Paying particular attention to sources that use the Strength of Recommendation Taxonomy can help guide busy physicians to the most useful information sources.
Oral Anticoagulants vs. Antiplatelet Therapy - Cochrane for Clinicians
Fracture Prevention in Postmenopausal Women - Clinical Evidence Handbook
Promoting Oral Health: The Family Physicians' Role - Editorials
ABSTRACT: There are few studies comparing the outcomes of patients who are treated with oral versus intramuscular antibiotics, corticosteroids, nonsteroidal anti-inflammatory drugs, or vitamin B12. This may lead to confusion about when the intramuscular route is indicated. For example, intramuscular ceftriaxone for Neisseria gonorrhoeae infection and intramuscular penicillin G benzathine for Treponema pallidum infection are the treatments of choice. However, oral antibiotics are the treatment of choice for the outpatient treatment of pneumonia and most other outpatient bacterial infections. Oral corticosteroids are as effective as intramuscular corticosteroids and are well-tolerated by most patients. High daily doses of oral vitamin B12 with ongoing clinical surveillance appear to be as effective as intramuscular treatment. Few data support choosing intramuscular ketorolac over an oral nonsteroidal anti-inflammatory drug unless the patient is unable to tolerate an oral medication. For other indications, the intramuscular route should be considered only when the delivery of a medication must be confirmed, such as when a patient cannot tolerate an oral medication, or when compliance is uncertain.
Treatment of Bulimia Nervosa - FPIN's Clinical Inquiries
ABSTRACT: The best way to keep up with the medical literature is to set up a system that delivers valid, relevant information while filtering out extraneous information. Useful information is patient-oriented, practical, and innovative. Good information systems are available that are inexpensive and easy to use.