Objectives: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with a lifetime prevalence of more than 80%. HPV is associated with cervical cancer, which affects thousands of US women each year. A vaccine was introduced in 2006 to mitigate the prevalence and mortality of…
Objectives: Primary care is an opportune setting to promote healthy behaviors for children and families. In 2007, an expert committee recommended that pediatric primary care clinicians assess nutrition and physical activity at wellness visits and offer recommendations; however, little is known about what pediatric primary care clinicians perceive their role…
The optimization of antithrombotic therapy for acute stroke treatment and secondary prevention is an evolving process based on an increasing array of studies that provide an evidence-based approach. Options have increased dramatically with the release of the non–vitamin K oral anticoagulants and with the results of recent randomized clinical trials…
Objectives: This study evaluated the effectiveness of the Center for Executive Medicine (CEM) concierge primary care practice on preventive colorectal cancer (CRC) screening rates relative to local and national comparator data. Methods: We performed an electronic medical record search encompassing our entire patient population who are between the ages of…
Objectives: To evaluate the rates and types of sexually transmitted infections (STIs) in patients infected with the human immunodeficiency virus (HIV) attending a public STI clinic in Miami, Florida as compared with HIV-uninfected patients attending the same clinic. Methods: This was a retrospective review of medical records of individuals attending…
Objectives: Although guidelines recommend hepatitis B virus (HBV) immunization for adults with diabetes mellitus (DM), vaccination rates remain low. Our aim was to evaluate knowledge and practice regarding HBV and to assess the effectiveness of a multifaceted educational program. Methods: Primary care residents (n = 244) at three academic institutions…
Objectives: Readmissions are an increasing area of focus for quality improvement initiatives. Widely variable estimates exist on preventability and impact of multipronged readmission interventions. Given the rotating nature of attending physicians in academic centers, physicians often are unaware of readmissions. We present a before-and-after (uncontrolled) trial evaluating timely feedback of…
Objectives: Studies have found that some health lines and physician’s offices have provided treatment advice other than “call 9-1-1 for an ambulance” to patients who present with a stroke scenario. We assessed the treatment advice given by selected pharmacies in the United States regarding stroke. Methods: The investigators called 73…
Osteoporosis, the most common human bone disease, affects 8 million American women and has significant morbidity and mortality. Screening is important in older women and younger postmenopausal women with additional risk factors for osteoporosis/fracture. Preventive measures include avoiding smoking, excessive alcohol/caffeine intake, and falls in addition to maintaining adequate calcium/vitamin…
Cardiovascular disease (CVD), the leading cause of death in the world, is largely preventable. An increasing amount of evidence suggests that annual vaccination with inactivated influenza vaccine reduces morbidity and mortality associated with CVD; however, immunization rates in patients with CVD fall consistently below the goals established by Healthy People…
Objective: Liver disease associated with hepatitis C virus (HCV) is a serious cause of mortality among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHA). Little is known about the HCV knowledge of PLWHA. Methods: One hundred seventy-nine patients at an infectious disease clinic were interviewed on HCV knowledge…
Objectives: Emergency physicians (EPs) and Juris Doctors (JDs) often disagree on the correct use of restraints for emergency department (ED) patients. The objective of the study was to compare EPs and JDs propensity to restrain patients given various scenarios. The study hypothesis was that EPs and JDs would agree on…
Objectives: The number and types of inpatients given inadequate prophylaxis for venous thromboembolism (VTE) are not known; patients receive less than appropriate prophylaxis with some frequency. Methods: Initially we evaluated VTE prophylaxis at a community hospital by comparing prophylaxis patterns in adult inpatients for whom some prophylaxis was indicated. Patients…
Background: Vitamin D deficiency is increasingly being recognized as a highly prevalent and undertreated problem. This study was conducted to determine the prevalence of vitamin D deficiency/insufficiency in hospitalized adults in northeast Tennessee. Methods: A prospective cohort study was conducted on 99 inpatients admitted to an internal medicine teaching service…
Objectives: Coronary heart disease (CHD) is the number one cause of death in adults in the industrialized world, and several large studies show that aspirin is helpful for the primary prevention of this disease. Unfortunately, few physicians are aware of its benefit, resulting in the underutilization of aspirin for the…
Smokeless tobacco (ST) use is common, especially in southern and rural areas. It is expected to become more popular with the recent move to sell more ST in areas where indoor smoking is banned. ST use usually starts in adolescence, which places this group at high risk. Nicotine dependence occurs…
Introduction:The United States Public Health Service (USPHS) recommends using all available patient encounters to provide preventive healthcare to patients. Many studies have demonstrated the importance of performing preventive care in the emergency department (ED). These studies have used the ED as a location for patient identification and treatment, rather than…
Patients taking low-dose glucocorticoids for 3 months or more are at risk for rapid bone loss. The loss may be as high as 15% in the first 3 to 6 months of treatment, and can lead to osteoporotic fractures, with an increase in morbidity and mortality. This article discusses an…
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