J Am Board Fam Med
-
Adults with intellectual disabilities need thoughtful, well-coordinated primary care from family physicians. However, evidence-based screening recommendations are lacking. We examined screening recommendations for common preventable conditions using the US Preventative Service Task Force guidelines. ⋯ Obesity, osteoporosis, and smoking are more prevalent in adults with intellectual disabilities, and enhanced screening for these conditions is recommended. Abnormal Papanicolaou smears and cervical cancer are less common in adults with intellectual disabilities and screening recommendations should be individualized. We also discussed strategies to make screening procedures less stressful for these patients.
-
Children and firearms in the home: a Southwestern Ohio Ambulatory Research Network (SOAR-Net) study.
To ascertain the prevalence of gun ownership, gun safety education, and parental attitudes on gun counseling in a Midwestern sample. ⋯ Despite the morbidity and mortality associated with guns, physicians in this study do not seem to be addressing this risk with families. A majority of gun owners do not agree that physicians should counsel the removal of guns from the home but agree that they should discuss safe gun storage information.
-
Review
Postpartum depression screening: importance, methods, barriers, and recommendations for practice.
Postpartum depression occurs in 10% to 20% of women who have recently given birth, but fewer than half of cases are recognized. The purpose of this review is to discuss the potential benefit of mass screening for improving postpartum depression recognition and outcomes. ⋯ Postpartum depression screening improves recognition of the disorder, but improvement in clinical outcomes requires enhanced care that ensures adequate treatment and follow-up.
-
The aim of this study was to learn about community members' definitions and types of harm from medical mistakes. ⋯ CBPR methodology is an important strategy to design and implement a community-based survey. Community members reported experiencing medical mistakes, most with harmful outcomes. The response they received by the medical community may have influenced their perception of mistake and harm.
-
Case Reports
Delay in diagnosis of diabetes mellitus due to inaccurate use of hemoglobin A1C levels.
Testing of hemoglobin A(1C) (HbA(1C)) levels has become widespread in the management of patients with diabetes mellitus. Since the 1980s, it has proven to be an invaluable tool correlating with a patient's average blood glucose levels as well as with their disease morbidity. Clinicians often base treatment decisions and make adjustments depending on a patient's HbA(1C) level. ⋯ When one of these conditions is present, it is important to recognize the inaccuracy of the HbA(1C) test to prevent a delay or error in the diagnosis or care of patients with diabetes mellitus. It is also important to be aware of alternative methods of monitoring a patient's diabetes such as a fructosamine assay or home and office blood glucose measurements. Presented is the case of a patient with diabetes mellitus and hereditary spherocytosis, a condition that interfered with her HbA(1C) value and resulted in a delay in her care.