RESUMO
Plastic surgery is a broad field, including maxillofacial surgery, reconstruction after injuries, hand surgery, and skin flaps and grafts, but the most common procedures for women are liposuction and body contouring, breast surgery, and facial cosmetic procedures. Techniques of face and brow lifts, blepharoplasty, and rhinoplasty are discussed as well as botulinum toxin and filler injections, and laser and pulsed light techniques that may delay or eliminate the need for surgery. Comparison of the surgeries for breast reconstruction, reduction, augmentation, and mastopexy is discussed. New surgeries for enhancement of female genitalia are also examined.
Assuntos
Técnicas Cosméticas/estatística & dados numéricos , Atenção Primária à Saúde , Saúde da Mulher , Fatores Etários , Toxinas Botulínicas Tipo A/administração & dosagem , Preenchedores Dérmicos/administração & dosagem , Feminino , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/estatística & dados numéricosRESUMO
Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic chest pain, fever, fatigue, and loss of appetite. Children and the elderly have different presenting features of pneumonia, which include headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms. Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia.
Assuntos
Pneumonia Bacteriana/diagnóstico , Guias de Prática Clínica como Assunto , Antibacterianos/uso terapêutico , Humanos , Pneumonia Bacteriana/tratamento farmacológico , Pneumonia Bacteriana/prevenção & controle , Pneumonia Associada à Ventilação Mecânica/diagnóstico , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , ViagemRESUMO
Food allergies are common and seem to be increasing in prevalence. Preventive measures have become far more evident in the public arena (schools, camps, sports venues, and so forth). Evaluation and management of food allergies has evolved such that primary care practitioners may choose to provide initial diagnostic and treatment care or refer to allergists for similar care. Food allergies, once considered incurable, are now being diminished in intensity by new strategies.
Assuntos
Hipersensibilidade Alimentar/diagnóstico , Adolescente , Fatores Etários , Anafilaxia/prevenção & controle , Aleitamento Materno , Criança , Pré-Escolar , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/terapia , Humanos , Lactente , Hipersensibilidade a Leite/epidemiologia , Hipersensibilidade a Amendoim/epidemiologia , Prevalência , Atenção Primária à Saúde , Fatores de Risco , Índice de Gravidade de Doença , Fatores SexuaisRESUMO
OBJECTIVE: The objective of this study was to examine the impact of the transition from International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), to Interactional Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), on family medicine and to identify areas where additional training might be required. METHODS: Family medicine ICD-9-CM codes were obtained from an Illinois Medicaid data set (113,000 patient visits and $5.5 million in claims). Using the science of networks, we evaluated each ICD-9-CM code used by family medicine physicians to determine whether the transition was simple or convoluted. A simple transition is defined as 1 ICD-9-CM code mapping to 1 ICD-10-CM code, or 1 ICD-9-CM code mapping to multiple ICD-10-CM codes. A convoluted transition is where the transitions between coding systems is nonreciprocal and complex, with multiple codes for which definitions become intertwined. Three family medicine physicians evaluated the most frequently encountered complex mappings for clinical accuracy. RESULTS: Of the 1635 diagnosis codes used by family medicine physicians, 70% of the codes were categorized as simple, 27% of codes were convoluted, and 3% had no mapping. For the visits, 75%, 24%, and 1% corresponded with simple, convoluted, and no mapping, respectively. Payment for submitted claims was similarly aligned. Of the frequently encountered convoluted codes, 3 diagnosis codes were clinically incorrect, but they represent only <0.1% of the overall diagnosis codes. CONCLUSIONS: The transition to ICD-10-CM is simple for 70% or more of diagnosis codes, visits, and reimbursement for a family medicine physician. However, some frequently used codes for disease management are convoluted and incorrect, and for which additional resources need to be invested to ensure a successful transition to ICD-10-CM.
Assuntos
Codificação Clínica/classificação , Registros Eletrônicos de Saúde/normas , Medicina de Família e Comunidade/classificação , Classificação Internacional de Doenças/normas , Aplicações da Informática Médica , Codificação Clínica/economia , Simulação por Computador , Custos e Análise de Custo , Registros Eletrônicos de Saúde/economia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Medicina de Família e Comunidade/economia , Humanos , Illinois , Revisão da Utilização de Seguros/economia , Revisão da Utilização de Seguros/estatística & dados numéricos , Classificação Internacional de Doenças/economia , Classificação Internacional de Doenças/estatística & dados numéricos , Medicaid/economia , Medicaid/estatística & dados numéricos , Mecanismo de Reembolso/economia , Mecanismo de Reembolso/normas , Estados UnidosRESUMO
Upper respiratory infections (URIs) are infections of the mouth, nose, throat, larynx (voice box), and trachea (windpipe). This article outlines the epidemiology, etiology, diagnosis, and management of URIs, including nasopharyngitis (common cold), sinusitis, pharyngitis, laryngitis, and laryngotracheitis.
Assuntos
Atenção Primária à Saúde , Infecções Respiratórias/tratamento farmacológico , Analgésicos/uso terapêutico , Antibacterianos/uso terapêutico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Laringite/tratamento farmacológico , Descongestionantes Nasais/uso terapêutico , Faringite/tratamento farmacológico , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle , Fatores de Risco , Sinusite/tratamento farmacológico , Estados Unidos/epidemiologiaRESUMO
Nicotine dependence is a significant addiction with many health consequences. Consistent attempts and efforts at addressing this condition, guiding and advising afflicted patients using motivational techniques and the 5-A stepwise strategies, and instituting appropriate therapies will result in better health outcomes and less incidence of diseases. In pharmacotherapy, Nicotine replacement therapy and oral medications can be used alone or in combination with varying degrees of success.
Assuntos
Nicotina/efeitos adversos , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Administração Cutânea , Benzazepinas/uso terapêutico , Bupropiona/uso terapêutico , Inibidores da Captação de Dopamina/uso terapêutico , Cardiopatias/prevenção & controle , Humanos , Neoplasias/etiologia , Nicotina/administração & dosagem , Agonistas Nicotínicos/uso terapêutico , Quinoxalinas/uso terapêutico , Fumar/efeitos adversos , VareniclinaRESUMO
Successful long-term weight loss maintenance can be achieved by various means. A combination of dietary and physical activity interventions, along with one or more behavioral approaches, has proven successful in some persons, as documented by the National Weight Control Registry, but is limited by adherence to a consistent weight loss regimen. Successful approaches to weight loss maintenance include consulting with a physician, nutritionist, or another support source; adhering to a stable diet with a limited variety of food; monitoring weight; eating breakfast; and exercising regularly. Long-term pharmacologic treatments for weight loss maintenance have been studied and were found to have modest success, with some weight regain typically reported. Sibutramine and orlistat are the two medications approved by the U.S. Food and Drug Administration with the potential to help patients achieve long-term weight loss maintenance. Bariatric surgery is another modality for accomplishing successful long-term weight loss maintenance in patients with morbid or complicated obesity. Its success is due in large part to better weight loss outcomes, more successful long-term weight loss maintenance, and remission of comorbid medical conditions.
Assuntos
Fármacos Antiobesidade/uso terapêutico , Dieta Redutora , Exercício Físico , Derivação Gástrica , Obesidade/terapia , Ciclobutanos/uso terapêutico , Humanos , Lactonas/uso terapêutico , Obesidade/prevenção & controle , Orlistate , Redução de PesoRESUMO
Complementary and alternative medicine (CAM) therapies have become increasingly popular for the treatment of a variety of conditions. The World Health Organization has recognized the value of traditional healing techniques, which are classified as CAM, for 30 years. In the United States nearly 50% of women use CAM for common medical conditions, significantly more than men. This pattern is frequently seen in the treatment of women's health conditions such as infertility, premenstrual syndrome, and menopause. This article provides an integrative approach for conditions commonly encountered in the primary care setting among women, discusses alternative therapies used to treat these health conditions, and provides an evidence-based summary of recommendations based on a review of the literature.
Assuntos
Terapias Complementares , Doenças dos Genitais Femininos/terapia , Suplementos Nutricionais , Feminino , Humanos , Hiperêmese Gravídica/terapia , Infertilidade Feminina/terapia , Menopausa , Distúrbios Menstruais/terapia , Osteoporose Pós-Menopausa/terapia , Fitoterapia , Preparações de Plantas/uso terapêutico , Gravidez , Síndrome Pré-Menstrual/terapiaRESUMO
This article outlines steps on how to move the treatment of obesity to a new paradigm of prevention in the primary care setting. Almost all Americans visit their primary care physician or health care provider for routine health maintenance or some unexpected illness or sickness at one point or another. The primary care office is the most likely entry point to the health care system for most of the population and should be the preferred venue for addressing chronic disease prevention. Prevention in the primary care setting is the short- and long-term solution to obesity.