The Journal of the American Board of Family Practice / American Board of Family Practice
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J Am Board Fam Pract · Mar 1998
Case ReportsPolypharmacy: a case report and new protocol for management.
Polypharmacy is an important issue in primary care, yet few data are available concerning its prevalence, complications, and management in clinical medicine. The following case illustrates the clinical perils of polypharmacy and serves as a point for critical discussion. ⋯ Polypharmacy is associated with morbidity and iatrogenic complications. The SAIL protocol can be a useful tool in the management of this entity. More research needs to be done on the prevalence, complications, and management of polypharmacy.
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J Am Board Fam Pract · Sep 1997
Microanatomy of the structures contributing to abdominal cutaneous nerve entrapment syndrome.
Family physicians commonly see patients who complain of abdominal pain, the cause of which cannot be readily diagnosed. Often this pain results from abdominal cutaneous nerve entrapment syndrome. ⋯ Three pictures presented here show the relevant microstructures involved in abdominal cutaneous nerve entrapment syndrome. The photomicrographs confirm the existence of a fibrous ring within which the neurovascular bundle can move freely. If this bundle is pushed or pulled too far from behind or in front, however, compression of the bundle against the ring causes nerve ischemia and symptoms of abdominal cutaneous nerve entrapment. Family physicians can save their patients unnecessary pain and expense by being aware of this syndrome.
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J Am Board Fam Pract · Jul 1997
The National Health Service Corps: rural physician service and retention.
The National Health Service Corps (NHSC) scholarship program is the most ambitious program in the United States designed to supply physicians to medically underserved areas. In addition to providing medical service to underserved populations, the NHSC promotes long-term retention of physicians in the areas to which they were initially assigned. This study uses existing secondary data to explore some of the issues involved in retention in rural areas. ⋯ Although most NHSC physicians did not remain in their initial rural practice locations, a substantial minority are still rural practitioners; those remaining account for a considerable proportion of all physicians in the most rural US counties. This study suggests that rural retention can be enhanced by selecting more assignees who were committed to and then completed family medicine residencies before assignment.
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J Am Board Fam Pract · Mar 1997
Review Case ReportsPenetrating BB shot head wound in an asymptomatic 9-year-old girl: the ultimate teaching moment.
Air rifle BB injuries represent a common type of childhood accident. The purpose of this case report is to encourage all providers of pediatric care to include nonpowder firearm safety education with standard well-child anticipatory guidance. ⋯ Firearm education is not a standard part of every well-child encounter. Injuries by all types of firearms are increasing at epidemic rates. Questioning about the accessibility of both powder- and non-powder-based weapons (ie, air rifle) and providing routine safety education should become the standard of care at all well-child encounters.