Articles related to Family Medicine/General Practice

Fewer than half of patients with celiac disease have characteristic GI symptoms. The diagnosis is often complicated by atypical symptoms such as constipation. How can clinicians improve their diagnostic abilities? This review and summary provides practical tips for identifying, diagnosing, and treating patients.

This 23-year-old woman is being seen for a chronic cough. She had repeat episodes of chronic bronchitis as a child and has a persistent, productive cough with thick, purulent sputum. She also has chronic nasal congestion and chronic diarrhea. What’s your suspicion?

The results of these trials show that vitamin D reduced the risk of diabetes progression by 3% to 18% after three years, with serum 25-hydroxy D levels of at least 125 nmol/L showing the greatest benefit. Vitamin D was also associated with a 30% increase in the likelihood of returning to normal glucose regulation.

In the US, chronic pain is widespread and continues to be a burden for people, families, and society as a whole. Extreme caution should be exercised when choosing to take an opioid to treat pain. The organizations do not advocate the regular use of opiate analgesics to treat chronic pain, as the hazards to the patient outweigh the minimal benefits that opioids may offer. Buprenorphine should be taken into consideration if it is decided to employ long-term opioid therapy for a patient due to its lower risk profile. By checking for underlying mental problems and a history of traumatic brain injury, clinicians can further lower the risk. Although risk mitigation strategies have been used to reduce risk in opioid patients, the guideline development group was surprised to find little evidence in this area.

4,500 people were tracked using 24-hour monitors for 7 days. Activity levels were studied to determine the effect on short-term memory, problem-solving, and processing skills. As little as six to nine minutes of moderate-to-vigorous activity when compared to sitting, sleeping, or gentle activities yielded higher cognition scores. Cognitive improvement was modest, but increasing time spent in energetic activity increased the measured benefits.

The SGLT2 inhibitor bexagliflozin is now available under the brand name Brenzavvy. Approval was based on monotherapy trials versus glimepiride, where the new drug was non-inferior, and in combination with metformin.