J Am Board Fam Med
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Wound botulism (WB) is an uncommon but severe neuromuscular illness caused by the bacterium Clostridium botulinum in an infected wound. There has been a dramatic increase in WB associated with black tar heroin injection in California. ⋯ Progressive cranial nerve palsy with symmetric descending paralysis with heroin abuse should raise the suspicion of WB and require prompt diagnosis and treatment. This case highlights raising awareness of the disease could help lead to early diagnosis and treatment.
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During the Coronavirus disease 2019 (COVID-19) pandemic, wearing facemasks became obligatory worldwide. ⋯ While important to prevent viral spread, wearing facemasks during brisk 5-minute walks might be associated with mild hypercarbia and desaturation. The clinical significance of these minor gas exchange abnormalities is unclear and should be further investigated.
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Eliminating health and health care inequities is a longstanding goal of multiple United States health agencies, but overwhelming scientific evidence suggests that health and health care inequities persist in the United States, despite decades of research and initiatives to alleviate them. Because of its comprehensiveness, studying health inequities in the context of primary care allows for the use of multiple paradigms and methodologic approaches to understanding almost any state of health, disease, social challenge, or societal circumstance a patient or group of patients might face. We argue in this special communication that the many features/advantages of primary care research have valuable contributions to make in reducing health inequity, and scientists, journals, and funders should increase the incorporation of primary care approaches and findings into their portfolios to better understand and end health inequity.
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Randomized Controlled Trial Multicenter Study
The Relationship Between Social Determinants of Health and Functional Capacity in Adult Primary Care Patients With Multiple Chronic Conditions.
Social determinants of health (SDoH) including insecure access to food, housing, and financial resources are critical threats to overall health. We sought to examine this relationship among adult primary care patients with multiple chronic conditions. ⋯ Among primary care patients with chronic conditions, SDoH are associated with poorer functional capacity, independent of other social and demographic factors. Primary care offers a promising, if underused, opportunity to intervene in SDoH. There is a need for future studies to explore the role of screening and intervention by primary care providers to mitigate or prevent SDoH.