The Journal of family practice
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Cirrhosis has become the focus of greater attention in recent years largely because of the increasing prevalence of 2 of its most common causes: chronic viral hepatitis and steatohepatitis (a subset of nonalcoholic fatty liver disease [NAFLD]). Cirrhosis is the result of progressive destruction and regeneration of the liver parenchyma due to chronic liver disease (CLD).
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The Vioxx Gastrointestinal Outcomes Research (VIGOR) trial, published in 2000, was the first to raise concerns that NSAIDs (specifically, the COX-2 selective inhibitor rofecoxib) might be associated with a higher risk for cardiovascular (CV) events. As discussed in this article, subsequent trials and meta-analyses have demonstrated a higher CV risk with use of not only COX-2 inhibitors (coxibs) but also certain tNSAIDs. These investigations have contributed to actions by the US Food and Drug Administration (FDA), most recently in July 2015, requiring strengthening of CV risk warnings on labels for all prescription and over-the-counter NSAIDs, despite evidence suggesting that differences in CV risk may exist among the NSAIDs.
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Research in other medical specialties has shown that the addition of medical scribes to the clinical team enhances physicians' practice experience and increases productivity. To date, literature on the implementation of scribes in primary care is limited. To determine the feasibility and benefits of implementing scribes in family medicine, we undertook a pilot mixed- method quality improvement (QI) study. ⋯ In an outpatient family medicine clinic, the use of scribes substantially improved physicians' efficiency, job satisfaction, and productivity without negatively impacting the patient experience.
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Case Reports Comparative Study
PURLs: When can exercise supplant surgery for degenerative meniscal tears?
Patients with a medial, degenerative meniscal tear and a minimal history of osteoarthritis make good candidates for physical therapy-- and there is an added benefit, too.