Showing papers in "Medical Clinics of North America in 2018"

TL;DR: Current understanding of the biological, behavioral, and environmental factors driving this near-ubiquitous body weight trajectory are described and the implications for long-term weight management are described.

TL;DR: The mechanisms of obesity and its related comorbidities are reviewed, with a focus on overweight men and women.

TL;DR: Because TC typically occurs in younger men, considerations of the treatment impact on fertility, quality of life, and long-term toxicity are paramount; an individualized approach must be taken with patients based on their clinical and pathologic findings.

TL;DR: During the prostate-specific antigen-based prostate cancer screening era there has been a 53% decrease in the US PCa mortality rate, and further consideration is needed for more intensive screening in men with high-risk factors.

TL;DR: The insufficient evidence related to pharmacotherapy as well as providing an overview of using physiologic rather than chronologic age for identifying suitable candidates for bariatric surgery are discussed.

TL;DR: Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry and the practices of medicine at a distance.

TL;DR: Findings and recommendations are reviewed and recommendations across these guidelines are compared, areas of controversy and concordance are identified, and how primary care practices may make use of the most appropriate recommendations for their circumstances are suggested.

TL;DR: The authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality.

TL;DR: The flexibility of energy density gives patients options to tailor and personalize their dietary pattern to reduce energy intake for sustainable weight loss.

TL;DR: Inpatient addiction consult services are an important intervention to use the reachable moment of hospitalization to engage patients and initiate addiction treatment.

TL;DR: Antimicrobial stewardship programs have been shown to improve patient outcomes, reduce antimicrobial adverse events, and decrease AR, when implemented alongside infection control measures, especially hand-hygiene interventions, were more effective than implementation of AS alone.

TL;DR: A perception and treatment gap continues to exist between health care providers and patients regarding the provision of obesity care.

TL;DR: An overview of technology-based interventions that are extending the reach of effective addiction treatments both in substance use treatment and primary care settings is provided.

TL;DR: Eye protection is of paramount importance to prevent vision loss in patients with impaired eye closure and patients should be assessed for signs of depression and treated appropriately.

TL;DR: Weight and medical comorbidities should be optimized both before and during pregnancy and in the postpartum period, breastfeeding and weight loss should be promoted.

TL;DR: Sleep and substance use disorders commonly co-occur and insomnia that is brief or occurs in the context of active substance use is best treated by promoting abstinence.

TL;DR: The various antimicrobial stewardship metrics that have been described in the literature, evidence to support these metrics, controversies surrounding metrics, and areas in which future research is necessary are reviewed.

TL;DR: Recent meta-analyses or systematic reviews of stewardship programs offer encouragement that some interventions reduce overall antimicrobial selective pressure and, where associated with infection control interventions, impact resistance rates in individual institutions.

TL;DR: The authors offer an integrative therapeutic approach to manage this complex clinical scenario with pain at multiple sites, psychosocial dysfunctions, medical and psychiatric disorders, polypharmacy, and polysubstance use, all interacting with each other in complex ways.

TL;DR: Several novel psychoactive substances have emerged in recent years and general treatment includes benzodiazepines for agitation and supportive therapy.

TL;DR: As antimicrobial stewardship continues to expand across the patient care continuum, pharmacists will serve a vital role in preserving the armamentarium of antimicrobials and improving quality of patient care.

TL;DR: The best evidence indicates that educational interventions to reduce diagnostic error should give physicians feedback about clinical outcomes and enhance their ability to recognize signs and symptoms of specific diseases at the bedside.

TL;DR: This article outlines some of the behavioral, pharmacologic, and surgical interventions available to primary care physicians to help their patients with weight management.

TL;DR: An effective hospital-wide antimicrobial stewardship program (ASP) should be led by an infectious disease physician who should have special expertise in various aspects of antimicrobial therapy, that is, pharmacokinetics, resistance, pharmacoeconomics, and C difficile.

TL;DR: Following the Centers for Disease Control and Prevention Core Elements and using the strategies suggested in this article should be able to design, develop, participate in, or improve antibiotic stewardship programs within community hospitals.

TL;DR: Clinicians should avoid overcovering and overtreating colonizing organisms in respiratory secretions and urinary catheters and take into account the prevalence of multidrug-resistant organisms in the hospital setting.

TL;DR: Understanding ritual in medicine, including the placebo effects of such rituals, reaffirms the centrality of the physical examination to the process of building strong physician-patient relationships.

TL;DR: Key differences in the neurobiologic, epidemiologic, and relational aspects of substance use found in AYA are highlighted and how prevention and intervention can be adapted for optimal effectiveness for this distinct and high-risk population is discussed.

TL;DR: Primary care-based treatment of opioid and alcohol use disorders can be effective; more data is needed to better understand the benefits of these models and identify means of treating other substance use disorders in primary care.

TL;DR: Several endoscopic bariatric therapies' safety and efficacy for primary care providers in the era of evolving obesity treatment are reviewed.