J Am Board Fam Med
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Case Reports
Staphylococcus epidermidis in urine is not always benign: a case report of pyelonephritis in a child.
Staphylococcus epidermidis in urine cultures from previously healthy children is usually considered to be a contaminant. The goal of this study was to identify cases in which S. epidermidis was an infectious cause of urinary tract infection (UTI) in children. ⋯ UTIs caused by S. epidermidis in a previously healthy child should not be disregarded as a contaminant and further workup for urinary tract abnormality is indicated.
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Case Reports
A rare case of neck pain: acute longus colli calcific tendinitis in a possibly immunocompromised individual.
We present a rare case of severe neck pain in a 45-year-old man with severe hidradenitis suppurativa who was participating in a study involving adalimumab. The neck pain was associated with acute longus colli calcific tendinitis, which is a noninfectious inflammatory response in the longus colli tendons secondary to deposition of calcium hydroxyapatite crystal. The diagnosis was made by computed tomography, which showed calcifications and deposits, and magnetic resonance imaging, which showed a retropharyngeal effusion. ⋯ In acute longus colli tendinitis, differentiating retropharyngeal aseptic effusion from infection is important. Of note, the confounding factor in this case was that the patient was blinded to whether he was receiving the placebo or adalimumab, so whether the patient was immunosuppressed and at risk for infection was unknown. Clinician familiarity and education concerning acute calcific longus colli tendinitis may lead to decreased costs stemming from incorrect diagnosis and unnecessary treatment.
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Little is known about patient factors associated with the provision of hypertension care as recommended by JNC 7. ⋯ Hypertension care in 2013 at an academic family medicine center was, for the most part, in agreement with guidelines; however, provision of some items varied based on sex, marital status, and insurance. Awareness of these predictors may help improve the implementation of guidelines, particularly relevant given the recent release of JNC 8.
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Over the past 20 years there has been a statistically significant trend toward fewer family physicians identifying as being in solo practice. Further study to determine the reasons for this decline and its impact on access to care will be critical because rural areas are more dependent on solo practitioners.