American family physician
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Cysticercosis (i.e., tapeworm infection) is an increasingly common medical problem in the United States, especially in the Southwest and other areas of heavy emigration from endemic areas or in populations with significant travel to these areas. The larval stage of the pork tape-worm, Taenia solium, causes the clinical syndrome of cysticercosis, with humans as dead-end hosts after ingestion of T solium eggs. Its clinical effects vary depending on site of larval lodging, larval burden, and host reaction. ⋯ Ocular and extraocular muscle cysticercosis generally requires surgical intervention. Skeletal muscle cysts are surgically removed only if painful. Because cysts can lodge in multiple locations, all patients with cysticercosis should have an ophthalmologic examination to rule out ocular involvement, and all patients with extraneurologic cysticercosis should have computed tomography or magnetic resonance imaging of the brain to rule out neurocysticercosis.
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American family physician · Jul 2007
Responses to medical students' frequently asked questions about family medicine.
This article provides answers to many questions medical students ask about the specialty of family medicine. It was developed through the collaborative efforts of several family medicine organizations, including the American Academy of Family Physicians, the Society of Teachers of Family Medicine, the Association of Family Medicine Residency Directors, and the Association of Departments of Family Medicine. The article discusses the benefits of primary care and family medicine, the education and training of family physicians, the scope of medical practice in the specialty, and issues related to lifestyle and medical student debt.
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The American Diabetes Association currently recommends an A1C goal of less than 7 percent. However, many patients are unable to achieve this goal by using oral drug combinations or diet and exercise, leaving insulin as the only treatment option. In most cases, insulin is initiated later in therapy because of its inconvenience and adverse effects (e.g., weight gain, hypoglycemia, possible role in atherogenesis). ⋯ Clinical trials have shown that both agents reduce, by a statistically significant degree, A1C levels (0.3 to 0.7 percent more than placebo), fasting plasma glucose levels, and body weight (3 to 5 lb [1.4 to 2.3 kg]). No studies have examined their effects on diabetic complications, cardiovascular disease, or overall mortality. Pramlintide and exenatide may help make glycemic goals more attainable.