Vasomotor Symptoms During Menopause: A Practical Guide on Current Treatments and Future Perspectives.

Vasomotor symptoms affect as many as 80% of midlife women, but only about one in four women receive treatment due to many factors. Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms, and current professional guidelines conclude that the benefits of treatment typically outweigh the risks for healthy, symptomatic women under age 60 years and those within 10 years from their final menstrual period. For women with medical comorbidities, an individualized approach to treatment is recommended. For women who cannot use or choose not to use menopausal hormone therapy, there are many evidence-based non-hormonal options available including pharmacologic therapies. This review aims to summarize treatment options for bothersome vasomotor symptoms to guide clinicians caring for midlife women.

Outpatient Primary Care Practitioner Access: Gender-Based Preferences.

Background: Primary care practices are evolving under the pressure of modern-day challenges, with some clinics now introducing the choice of new nontraditional care models designed to maximize patients' needs with practitioner efficiency. These changes include team models consisting of advanced practitioners and physicians, as well as new care delivery formats such as virtual care. With a growing number of options for care, it is unclear whether patients' gender affects their visit preferences; therefore, we surveyed patients presenting to an outpatient internal medicine clinic in Arizona to understand how practice variations impact patient satisfaction of their primary care. Methods: Patients seen in an outpatient internal medicine clinic were surveyed. Multivariable models adjusting for age, marital status, education level, and income were used to evaluate gender-based care preferences. Results: Of 796 total participants (446 women, 350 men), women were more likely to prefer continuity of care with the same health care practitioner (90.2% women vs. 85.0% men, p = 0.028) and allied health staff (AHS) (36.3% women vs. 28.0% men, p = 0.0031) over convenience of appointment or quicker response time than men. However, after multivariable analysis, no statistically significant relationships remained. Discussion: Women favored both continuity of care with the same health care provider and AHS over faster access to primary care. A large majority of men had similar preferences for continuity of care. To provide the highest level of care with greatest patient satisfaction, understanding individual preferences for care delivery will be important.

A Rare Case of Adult Onset Intussusception Complicated By Narcotic Dependence.

This report describes a rare case of adult intussusception in a patient with a history of a Roux-en-Y gastric bypass procedure; complicated by a history of narcotic abuse, methadone dependence, and methamphetamine abuse. Adult patients who have undergone a Roux-en-Y gastric bypass procedure may be at an increased risk of developing intussusception, and clinicians involved in their care should be aware of this potential complication.