The Journal of family practice
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Being fluent in new guidelines helps you meet the challenges of changing disease prevalence, rising antibiotic resistance, and evolving social patterns.
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New updates in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report include major changes to initial disease assessment and pharmacologic therapy, highlighting the clinical relevance of exacerbations. The updated GOLD 2023 algorithms offer a shorter path to consideration of triple therapy, including both initial and follow-up treatment. Most mild- or moderate-severity chronic obstructive pulmonary disease (COPD) exacerbations can be successfully managed in outpatient settings; primary care clinicians have many opportunities to identify, diagnose, and treat patients with COPD earlier to reduce lung damage and disease progression. COPD and cardiovascular disease share common mechanisms and risk factors that influence COPD management.
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Randomized Controlled Trial
Does use of continuous or flash glucose monitors decrease hypoglycemia episodes in T2D?
NO. In adults with insulin-treated type 2 diabetes (T2D), continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) do not decrease symptomatic hypoglycemia episodes (strength of recommendation [SOR], B) but do lower time in hypoglycemia (SOR, C; disease-oriented evidence). ⋯ FGM, in which glucose levels are sent on demand to a device, did not significantly reduce hypoglycemic episodes (SOR, B; 1 small RCT and 1 prospective study). Hypoglycemia duration was reduced significantly with FGM in a 6-month RCT (SOR, B) but not in a 1-year prospective study (SOR, B).
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The developmental origins of health and disease (DOHaD) hypothesis suggests prenatal nutrition sets the stage for the developing brain, with effects that last into adulthood. Macronutrient and micronutrient requirements increase in pregnancy and deficiencies can influence fetal neurodevelopment and cognition. Foods such as eggs, meat, and seafood contain many of the nutrients needed for healthy neurodevelopment and intake should be encouraged among women of reproductive age. Family practice clinicians play an important role in providing nutrition recommendations surrounding food and prenatal supplements to consume before, during, and after pregnancy.
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Was this an infectious abscess, or something less common?