J Am Board Fam Med
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Review Case Reports
Spontaneous peripartum coronary artery dissection presentation and outcome.
The objective of this study was to determine whether spontaneous peripartum coronary artery dissection (SPCAD) is a cause of acute myocardial infarction in women. ⋯ SPCAD can occur weeks before or after delivery and should be considered in women presenting during the peripartum period with acute chest pain.
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To determine the prevalence of self-reported herpes zoster (HZ) disease and vaccination in a geriatric population and to characterize the deciding factors to receive the HZ vaccine. ⋯ There is a large difference in self-reported HZ and vaccination rates among races. The HZ vaccination rate was low overall, but most patients were interested in receiving the vaccine after the survey. More public awareness and education is needed to improve rates of HZ vaccination.
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Over the last decade, the use of medical marijuana has expanded dramatically; it is now permitted in 16 states and the District of Columbia. Our study of family physicians in Colorado is the first to gather information about physician attitudes toward this evolving practice. ⋯ Despite a high prevalence of use in Colorado, most family physicians are not convinced of marijuana's health benefits and believe its use carries risks. Nearly all agreed on the need for further medical education about medical marijuana.
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Randomized Controlled Trial
Association of speculum lubrication with pain and Papanicolaou test accuracy.
To determine the effects of lubrication of the vaginal speculum before insertion during a Papanicolaou test on perceived pain and quality of the cytology specimen. ⋯ During the collection of Papanicolaou test specimens, lubrication of the vaginal speculum with a small amount of K-Y Jelly (a water-soluble lubricant gel) decreases the pain associated with insertion of the vaginal speculum among postmenopausal women without obscuring the cytological interpretation of conventional or liquid-based cytology. In women of reproductive age, lubrication of the speculum with K-Y Jelly does not cause a meaningful effect with respect to perceived pain.
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Most physicians report routinely recommending colorectal cancer (CRC) screening, but many eligible patients are not screened. To better understand this finding, we explored the relationship between the content of hypothetical patient-physician CRC screening discussions and CRC screening rates in physicians' practices. ⋯ Encouraging providers to use risk-specific messaging about the consequences of CRC, offering screening option choices, and promoting a problem-solving approach to surmount barriers are potential strategies for increasing CRC screening rates.