The Metamorphosis of a Horse into a Zebra: A Case of Primary Eosinophilic Gastroenteritis

Chronic diarrhea is a common diagnostic entity faced by many primary care physicians. Primary eosinophilic gastroenteritis (PEG), a relatively rare but not uncommon cause of chronic nonbloody diarrhea, presents with nonspecific symptoms, making clinical consideration and diagnosis extremely challenging. In PEG, eosinophils selectively target the gastrointestinal tract, where they degranulate, causing inflammation and irritation. We report the case of a 46-year-old female with recurrent hospitalizations for nausea, vomiting, and diarrhea over a nine-month period. After an extensive workup ruling out secondary causes of eosinophilia, she was diagnosed with PEG.

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A Practical Approach to the Patient with Obesity

The Singapore Family Physician ◽

10.33591/sfp.47.5.u2 ◽

2021 ◽

Vol 47 (5) ◽

pp. 13-20

Author(s):

Yuan Ling Amanda Lim

Keyword(s):

Primary Care ◽

Weight Gain ◽

Goal Setting ◽

Primary Care Physicians ◽

Care Plan ◽

Weight History ◽

Prevalence Of Obesity ◽

Individualised Care ◽

Subsequent Patient ◽

Secondary Causes

The prevalence of obesity and obesity-related comorbidities is rising. Primary care physicians are the frontline of healthcare and play a central role in the management of obesity. In this article, we discuss the 5As framework (Ask, Assess, Advise, Agree, and Assist) as a practical framework for obesity counselling, focusing on initiating the conversation and assessing the person with obesity. The assessment includes taking a weight history, excluding secondary causes, understanding lifestyle factors contributing to weight gain and assessing for complications of obesity. This assessment then makes it possible for subsequent patient engagement, including advising, agreeing (goal setting), and assisting the patient on an individualised care plan.

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Performance of gastrointestinal tract endoscopy by primary care physicians. Lessons from the US Medicare database

Archives of Family Medicine ◽

10.1001/archfami.6.1.52 ◽

1997 ◽

Vol 6 (1) ◽

pp. 52-58 ◽

Cited By ~ 10

Author(s):

R. J. Ackermann

Keyword(s):

Primary Care ◽

Gastrointestinal Tract ◽

Primary Care Physicians ◽

The Us ◽

Medicare Database

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Eosinophilic Gastroenteritis with Appendix Involvement: Role of Intestinal Ultrasound

Applied Sciences ◽

10.3390/app9061037 ◽

2019 ◽

Vol 9 (6) ◽

pp. 1037

Author(s):

Roberto Bertè ◽

Pietro Soru ◽

Maurizio Vecchi ◽

Mirella Fraquelli

Keyword(s):

Case Report ◽

Gastrointestinal Tract ◽

Positive Response ◽

Rare Condition ◽

Eosinophilic Gastroenteritis ◽

Eosinophilic Inflammation ◽

Intestinal Involvement ◽

Gastrointestinal Ultrasound ◽

Secondary Causes

Eosinophilic gastroenteritis (EG) is a rare condition characterized by patchy eosinophilic inflammation of one or more layers of the gastrointestinal tract with no secondary causes of eosinophilia. EG is a treatable disease and, generally, patients show a positive response to steroid therapy. Sometimes the disease can present as acute abdomen, and appendicular involvement has seldom been described in the course of EG. In our case report we aimed to emphasize how useful gastrointestinal ultrasound is as a valuable tool for diagnosing and monitoring intestinal involvement during EG, avoiding invasive tests and unnecessary surgery.

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Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

American Journal of Law & Medicine ◽

10.1017/s0098858800002586 ◽

2003 ◽

Vol 29 (4) ◽

pp. 489-524

Author(s):

Brent Pollitt

Keyword(s):

Primary Care ◽

Mental Illness ◽

Nurse Practitioners ◽

Primary Care Physicians ◽

American Psychological Association ◽

The United States ◽

Psychotropic Medications ◽

American Psychological ◽

Training Requirements ◽

Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

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