Appropriate use of endoscopy in the diagnosis and treatment of gastrointestinal diseases: up-to-date indications for primary care providers

Background: Vertigo is defined as an illusion of motion caused by a mismatch of information between the visual, vestibular and somatosensory systems. The most common diagnosis associated with whirling vertigo is benign paroxysmal positional vertigo (BPPV), which affects approximately 3.4% of patients older than 60 years of age. Objective: This paper aims to educate primary care providers on how to diagnose BPPV by performing canalith repositioning maneuvers at the initial point of care. Timely treatment of BPPV in the primary care office is believed to reduce healthcare costs by way of limiting unnecessary diagnostic testing and lowering referrals for specialty care. Immediate treatment is also believed to improve the quality of healthcare delivery for the vertigo patient by reducing morbidity and resolving the condition without the need for referrals or imaging. Population Health: A review of the literature finds that delayed diagnosis and treatment of BPPV is associated with a host of deleterious effects on patients. Population health impacts include increased rates of anxiety and depression; loss of work and/or change of career paths; inappropriate use of medications or emergency care resources; decreased access to healthcare services; increased healthcare costs; and reduced quality of care. Diagnosis: A history of positional vertigo and evidence of nystagmus with Dix-Hallpike positioning confirms the diagnosis. A detailed description of the performance of this test is elucidated. Treatment: The observed nystagmus is analyzed and classified based on directionality. Treatment can be initiated immediately with canalith repositioning maneuvers.

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Pediatric Appropriate Use Criteria for Outpatient Echocardiography: Practice Variations among Pediatric Cardiologists, Noncardiologist Subspecialists, and Primary Care Providers

Journal of the American Society of Echocardiography ◽

10.1016/j.echo.2017.08.014 ◽

2017 ◽

Vol 30 (12) ◽

pp. 1214-1224 ◽

Cited By ~ 4

Author(s):

Soultana Kourtidou ◽

Patrick D. Evers ◽

Neal W. Jorgensen ◽

Richard A. Kronmal ◽

Mark B. Lewin ◽

...

Keyword(s):

Primary Care ◽

Primary Care Providers ◽

Care Providers ◽

Appropriate Use Criteria ◽

Appropriate Use ◽

Practice Variations

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Hemophagocytic Lymphohistiocytosis for the Internist and Other Primary Care Providers

Journal of Primary Care & Community Health ◽

10.1177/21501327211053756 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110537

Author(s):

Tanmayi Srinivas Pai ◽

Fernando F. Stancampiano ◽

Candido Rivera

Keyword(s):

Primary Care ◽

Immune System ◽

Hemophagocytic Lymphohistiocytosis ◽

Immunosuppressive Treatment ◽

Primary Care Providers ◽

Outpatient Setting ◽

Adult Patients ◽

Diagnosis And Treatment ◽

Care Providers ◽

Life Threatening

Hemophagocytic lymphohistiocytosis (HLH) syndrome is a hyperinflammatory state that leads to life-threatening, disproportionate activation of the immune system and may be confused for and concomitantly exist with sepsis. However, its treatment differs from sepsis, requiring early initiation of immunosuppressive treatment. While HLH syndrome is more commonly diagnosed in children, internists and other primary care providers must be familiar with the diagnosis and treatment of adult patients with HLH in the hospital and outpatient setting. In this article, we review the essentials that an internist and other primary care providers managing adult HLH patients should know.

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The Influence of a Continuing Medical Education Campaign on New Strategies to Improve Appropriate Use of Antibiotics

Journal of Biomedical Education ◽

10.1155/2015/579726 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5

Author(s):

Brenda A. Bucklin ◽

Ronald S. Gibbs ◽

Carolyn Wieber ◽

Leslie Myers

Keyword(s):

Primary Care ◽

Medical Education ◽

Continuing Medical Education ◽

Antibiotic Use ◽

Primary Care Providers ◽

Dose Effect ◽

Drug Resistant ◽

Care Providers ◽

Appropriate Use ◽

Antibiotic Overuse

Introduction. Widespread use of antibiotics has led to drug-resistant bacteria and reports of drug-resistant infections. A continuing medical education (CME) campaign was used to improve antibiotic use among primary care providers. Methods. The Office of CME and Professional Development at the University of Colorado School of Medicine produces a semiannual, week-long course for primary care providers. A 2-year multifaceted CME campaign consisted of course content on antibiotic use, a practice audit, and two surveys to measure perceptions of the problem of antibiotic overuse, potential barriers to achieving appropriate use, and strategies to overcome barriers. Results. The overall response rate in the 2nd part of the campaign was 68.4%. Sixty-six percent of respondents had implemented at least one strategy to reduce antibiotic overuse. The rate was significantly higher among those who had attended previous reviews (81.0%) compared with those who had attended neither (54%, p=0.0002). However, there was no “dose effect” on the rate of implementing a new strategy. Conclusions. Overuse of antibiotic therapy has important public health implications. Results suggest that mixed interactive and didactic CME program was effective in increasing awareness of antibiotic overuse and strategies for reducing antibiotic administration.

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