J Am Board Fam Med
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This paper reviews current indications for otolaryngology consultation for tonsillectomy and adenoidectomy (T&A). Despite often being performed concurrently, these procedures should be considered separate surgeries done for different indications. The American Academy of Otolaryngology - Head and Neck Surgery published tonsillectomy guidelines for children in 2019. ⋯ T&A should be recommended for pediatric obstructive sleep apnea. Specific frequencies of tonsillitis have been identified that indicate benefit from tonsillectomy in normal children; certain modifying health factors warrant consideration of surgery with fewer infections. The guidelines include consideration of tonsillectomy for poorly validated indications such as halitosis, febrile seizure, dental malocclusion, dysphagia, dysphonia, and psoriasis.
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To assess the reliability of peer review of abstracts submitted to academic family medicine meetings in North America. ⋯ For abstracts submitted to North American academic family medicine meetings, inter-reviewer agreement is often low, compromising initial review reliability. For many submission categories, program committees should supplement initial review with independent postreview assessments.
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To describe demographic factors and calculate prevalence of heart disease-related conditions among the adult Down syndrome (DS) sample population and to compare demographic and heart disease-related conditions between the DS sample population (n = 2342) and the general population. ⋯ Adults with DS generally experience less heart disease and associated risk conditions commonly seen in the general population. Prevention and treatment guidelines for heart disease for the DS population should be adjusted after more research is conducted.
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To provide a potential biological, mechanistic link for the well-established association between primary care access and reduced mortality, this study sought to measure the impact of having a usual source of health care on leukocyte telomere length (LTL). ⋯ Having a usual source of health care is associated with longer LTL among older adults. This study provides a potential biologic link for the noted association between primary care access and reduced mortality that has been observed at the individual and population level.
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Using data from 2014 to 2018, we found that the proportion of family physicians caring for children under age 5 years and between ages 5 and 18 years has significantly declined. This has implications for the pediatric primary care workforce and may exacerbate inequities in access to care for pediatric patients in all geographies, particularly those in areas with a shortage of pediatricians.