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4.6 years and nearly 5 doctor visits. That is what the American Autoimmune Related Diseases Association reports it takes on average to receive a proper autoimmune disease diagnosis. Laboratory testing correlated with clinical findings is key to differential diagnosis, disease classification and better patient care for these challenging diseases. Through this clinical education bulletin, you will learn about the clinical benefits of a new advanced diagnostic test panel offered by Quest Diagnostics—ANA Screen, IFA, Reflex to Titer/Pattern, and Reflex to the 11 Antibody Cascade with IdentRA®. This comprehensive panel starts with the highly sensitive ANA IFA screen—the American College of Rheumatology gold standard—followed by 3 tiers of specific autoantibody testing. Testing through a 3-tiered algorithm can be an effective way to help make an early and differential diagnosis of the 8 most common rheumatic diseases. This may help speed evaluation for early diagnosis of autoimmune diseases and better patient outcomes.
The Ask the Expert webinar series from CHADD, the leading resource on ADHD, provides education for the 17 million children and adults in the United States living with ADHD, their families, healthcare professionals and educators. CHADD’s National Resource Center on ADHD (NRC) partners with leading experts in the field of ADHD with the Ask the Expert webinars to bring reliable, science-based information regarding current medical research and ADHD management to each of these audiences.
New survey data1 reveals the critical role of family practitioners in shaping patient statin knowledge. As family physicians, you’re on the front lines of treating common ailments ranging from fevers to fibromyalgia, cataracts to cancer, and everything in between, including America’s number one killer—heart disease. You may be familiar with this scenario: a patient with high cholesterol, at risk for heart disease, stops taking the statin that you prescribed, blaming muscle pain, forgetfulness, or cost of monthly prescription. It’s not just you. Data shows that at least 50% or more of people on a statin medication discontinue it within one year after treatment2, so many other doctors may be experiencing the same frustration that their patients are stopping this life-saving medication. To motivate patients to work with their doctors and “speak up before they stop their statin,” a new educational initiative—“Take Cholesterol to Heart”—recently launched in partnership with the AAFP Foundation and Kowa Pharmaceuticals America, Inc. The initiative was informed by the results of a new Harris Poll survey —commissioned by Kowa Pharmaceuticals America, Inc.—of more than 5,000 cholesterol patients, including polypharmacy patients and those with common comorbidities to heart disease. ACTION: The Statin Survey found that 82% of patients were first diagnosed by their family physician or internist, highlighting the pivotal role family doctors play in shaping patients’ knowledge and mindset towards statins. The survey also found that 59% of patients say it’s extremely important to them that their provider takes an individualized approach to selecting the right statin for them.
Asthma Today is a resource for asthma patients and their families created by the American Thoracic Society and supported by an educational grant from GlaxoSmithKline. The e-booklet discusses asthma symptoms, diagnosis, and treatments, and features the latest research on asthma presented at the ATS 2017 International Conference.
Though colonoscopy is the gold standard for diagnosing IBD, routine use is not warranted as it is costly, invasive, and associated with low-but-measurable morbidity. Calprotectin may be used as one of the initial tests in patients with suspected IBD. Calprotectin has three important clinical uses: 1) Diagnose inflammatory bowel disease (IBD) 2) Differentiate IBD from irritable bowel syndrome (IBS) 3) Monitor patients with IBD for treatment response and relapse Calprotectin is a small calcium-binding protein that makes up about 60% of neutrophil cytosol protein content. During inflammation, neutrophils migrate to the intestinal mucosa, and calprotectin is leaked into the bowel lumen. Numerous studies have shown that stool calprotectin concentration can help diagnose IBD, and distinguish it from IBS and other conditions with a similar presentation. In a 2010 meta-analysis, elevated stool calprotectin demonstrated a sensitivity of 93%, and a specificity of 96% for differentiating IBD from other causes of GI symptoms in adults. In children and teenagers, the sensitivity is 92% and the specificity is 76%. Calprotectin may be used as one of the initial tests in patients with suspected IBD; levels can help avoid unnecessary colonoscopy, as normal levels are not typically associated with active IBD. Conversely, levels above normal are consistent with organic diseases such as IBD and colorectal cancer, and warrant consideration of colonoscopy.
Heart disease is a major public health concern, and diet is believed to play an important role in mediating cardiovascular disease risk. As a family physician, you are in a unique position to educate Americans on the importance of diet and nutrition for better health. In the last several years, the evidence surrounding the role of lean beef in a heart-healthy diet has grown significantly. Lean beef, enjoyed daily as part of a healthy diet and active lifestyle, can promote heart health and keep healthy adults feeling strong. According to the latest research, lean red meat can be just as effective as other protein sources, such as chicken and fish, in lowering LDL cholesterol and reducing cardiovascular disease risk. (1) The 2015 Dietary Guidelines for Americans recommend a well-balanced diet focused on nutrient-dense foods—including lean beef—and smart portion control as part of a heart-healthy lifestyle. (1) Roussell et al. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr 2012;95:9-16.