American family physician
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Complex regional pain syndrome (CRPS) is a rare, chronic pain disorder. It is challenging for patients and physicians because it leads to significant morbidity due to chronic pain that may last for years. CRPS typically develops four to six weeks after direct trauma, such as an injury or surgery, and causes pain that is out of proportion to the inciting injury. ⋯ There is no single proven treatment modality for CRPS, and there have been no large randomized controlled studies of CRPS treatments. Most treatments are based on studies of their use for other types of neuropathic pain. The mainstay of treatment is to improve function of the affected body part and to decrease pain; therefore, treatment requires multiple modalities, including medications, behavioral health interventions, and referral to a pain specialist.
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American family physician · Jul 2021
Review Case ReportsAddressing Loneliness and Social Isolation in Older Adults.
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This article summarizes the top 20 research studies of 2020 identified as POEMs (patient-oriented evidence that matters), including the two most highly rated guidelines of the year on gout and chronic obstructive pulmonary disease (COPD). Regarding COVID-19, handwashing and social distancing through stay-at-home orders or quarantine measures are effective at slowing the spread of illness. Use of proper face masks (not gaiters or bandanas) is also effective at preventing trans- mission. ⋯ Low-value screening tests in asymptomatic, low-risk patients often lead to further testing, diagnostic procedures, or referrals. A new tool helps determine the amount of change needed to signify a real difference between two laboratory values in the same person over time. Finally, a pillar of our specialty, continuity of care, is associated with decreased all-cause mortality.