Articles related to Family Medicine/General Practice

This woman’s headache started suddenly three months ago. It begins as a dull, localized pain at the top of the head, starting within 30 minutes of rising, and increases in intensity, becoming a global headache as the day progresses. Bedrest alleviates the symptoms. Review the MRI and choose an appropriate therapy.

Shift work has previously been linked to an increased risk of developing MS, presumably due to the resulting sleep deprivation and circadian desynchrony. The current study compared sleeping 7–9 hours/night during adolescence, with less than 7 hours/night and found a 40% increase in risk for developing MS in the short-sleep cohort. The authors conclude that “insufficient sleep and low sleep quality during adolescence seem to increase the risk of subsequently developing MS.”

The authors speculate that pharmacogenomic testing can identify patients at higher risk for adverse events related to drug-drug and drug-gene interactions based on the 29-year-old man’s prescription list and gene testing results. Potential drug-drug interactions should also be investigated, and patients should be appropriately monitored for adverse reactions. Before performing pharmacogenomic testing, consider the severity of potential reactions, cost, and the possibility of using an alternative regimen that avoids the interaction of concern entirely. As more is learned about pharmacogenomics and the potential personalization of therapeutic regimens, clinical considerations that warrant testing should be evaluated on a regular basis to facilitate both resource stewardship and optimal patient care.

The modified Mifepristone Risk Evaluation and Mitigation Strategy (REMS) Program eliminates the requirement for in-person dispensing and replaces it with a requirement that pharmacies dispense the drug be certified. Mifepristone, a progestin antagonist, may now be dispensed by or under the supervision of a certified prescriber, or by a certified pharmacy on a prescription issued by a certified prescriber, for medical termination of pregnancy up to 10 weeks gestation (70 days or less since the first day of the last menstrual period).

Guideline Central offers a complete summary of the ADA’s latest guideline — Standards of Care for 2023. The update and summary cover topics from delaying the onset of T2DM to supporting positive behaviors, glycemic targets, weigh management, technology, pharmacology, and preventing and managing complications and concomitant diseases.

Clinical trials of abaloparatide, a human parathyroid hormone related peptide analog, showed significantly increased bone mineral density at 12 months in the lumbar spine and femoral neck in men with osteoporosis.