Primary care
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This article reviews elbow injuries that occur at the medial, lateral, anterior, and posterior aspects, including pediatric elbow injuries. A description, imaging, anatomy (where appropriate), mechanism of injury, physical examination, diagnostics, differential diagnosis, management, cause for referral to an orthopedic surgeon, controversies, and advancements in management for each type of injury are included.
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Sports-related brain injuries are increasing in incidence and may affect athletes from many different sports. Concussion is the most common form of sports-related head injury and is a form of mild traumatic brain injury. ⋯ Return to play should not begin until all symptoms resolve, and then this should be done in a graduated fashion that avoids recreating symptoms. Research is ongoing concerning the maximum safe number of concussive injuries and any possible long-term sequelae.
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Evaluation of the hand and wrist requires a thorough understanding of the anatomic alignment of various bones, tendons, and ligaments along with the physiologic function in order to make an accurate diagnosis that portends appropriate healing and function while minimizing future disability. This article provides the latest research-based evidence of important trends in the treatment and rehabilitation of hand and wrist injuries.
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Elevated levels of blood lipids are well-documented risk factors for cardiovascular disease. Current classification schemes and treatment levels for hyperlipidemia are based on the National Cholesterol Education Panel's Adult Treatment Program-3 (ATP-III) guidelines. Extensive research over the past decade has raised the question whether or not ATP-III guidelines are sufficiently aggressive. New guidelines from ATP-IV are expected to be released in the near future, but in the meantime physicians are faced with uncertainty about how low to target low-density lipoprotein cholesterol, whether to pharmacologically treat high-density lipoprotein cholesterol and triglyceride levels, and how best to achieve target goals.
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Heart failure (HF) often presents as dyspnea either with exertion and/or recumbency. Patients also experience dependent swelling and fatigue. ⋯ Cardiac defibrillators and biventricular pacemakers can also improve outcomes in selected patients with a decreased LVEF. The authors provide a guide for therapeutic decisions based on the inclusion criteria of the major clinical trials.