Journal of general internal medicine
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Patients with chronic obstructive pulmonary disease (COPD) are included in several national pneumococcal vaccination recommendations whereas asthma patients are not. The objective of this study was to evaluate pneumonia-related hospitalization risk in patients with COPD or asthma and vaccination impact. ⋯ This study supports the value of vaccinating COPD patients; however, the value of vaccination for asthma patients is less certain.
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Early initiation of colorectal cancer screening in individuals with affected first-degree relatives.
Several guidelines recommend initiating colorectal cancer screening at age 40 for individuals with affected first-degree relatives, yet little evidence exists describing how often these individuals receive screening procedures. ⋯ White participants with a family history are more likely to have endoscopic procedures beginning before age 50 than African Americans.
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Despite the high prevalence rates of HIV infection in the African-American community, African Americans remain underrepresented in HIV treatment trials. ⋯ Having never been asked to participate in research is a major barrier to the participation of HIV-infected African Americans in HIV treatment trials. African Americans who seek medical care for HIV infection should be asked to participate in HIV treatment trials.
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We describe a 59-year-old patient who developed acute renal failure because of rhabdomyolysis after extensive red fire ant bites. This case illustrates a serious systemic reaction that may occur from fire ant bites. ⋯ While local allergic reactions to fire ant bites are described in the literature, serious systemic complications with rhabdomyolysis and renal failure have not been previously reported. It is our effort to alert the medical community of the possibility of such a complication that can occur in the victims of fire ant bites.
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For patients to experience the benefits of total joint arthroplasty (TJA), primary care physicians (PCPs) ought to know when to refer a patient for TJA and/or optimize nonsurgical treatment options for osteoarthritis (OA). ⋯ PCP knowledge with respect to guideline-concordant care for OA could be improved, specifically in deciding when to consider TJA versus optimizing nonsurgical options. Moreover, the perception of the success rate of TJA may influence a clinician's decision making.