Lung Transplantation
Lung transplantation is an appropriate therapeutic option for select patients with end-stage lung diseases and offers the possibility of improved quality of life and longer survival. Unfortunately, the transplant recipient is at risk for numerous immunologic, infectious, and medical complications that threaten both of these goals. Median survival after lung transplantation is approximately 6 years. Optimizing outcomes requires close partnership between the patient, transplant center, and primary medical team. Early referral to a transplant center should be considered for patients with idiopathic pulmonary fibrosis and rela...
Source: Medical Clinics of North America - March 13, 2019 Category: Primary Care Authors: Vivek N. Ahya, Joshua M. Diamond Source Type: research

Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is a leading cause of death nationally and worldwide. Cigarette smoking is the most common risk factor in the development of COPD. Disease course is variable with some patients having a high degree of obstruction and minimal symptoms, whereas others with better lung function have a greater symptoms burden. The goal of pharmacologic therapy is to minimize symptoms, improve exercise tolerance, and reduce exacerbation risk. No pharmacologic therapy has been shown to improve survival in COPD. Pulmonology referral is recommended for patients with COPD with symptoms despite first-line...
Source: Medical Clinics of North America - March 13, 2019 Category: Primary Care Authors: Sean P. Duffy, Gerard J. Criner Source Type: research

Pulmonary Disease
Amazing growth is evident in a number of different areas of pulmonary medicine, including the screening, diagnosis, and staging of lung cancer and the introduction of personalized treatments for chronic obstructive pulmonary disease, pulmonary hypertension, and asthma. Advances in interventional pulmonology have contributed significantly to changes in lung cancer management. This issue brings you up to speed with concise reviews that will enhance your knowledge and allow you to better serve your patients. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - March 13, 2019 Category: Primary Care Authors: Ali I. Musani Tags: Preface Source Type: research

Community-acquired Pneumonia and Hospital-acquired Pneumonia
Pneumonia is among the leading causes of morbidity and mortality worldwide. Although Streptococcus pneumoniae is the most likely cause in most cases, the variety of potential pathogens can make choosing a management strategy a complex endeavor. The setting in which pneumonia is acquired heavily influences diagnostic and therapeutic choices. Because the causative organism is typically unknown early on, timely administration of empiric antibiotics is a cornerstone of pneumonia management. Disease severity and rates of antibiotic resistance should be carefully considered when choosing an empiric regimen. When complications ar...
Source: Medical Clinics of North America - March 7, 2019 Category: Primary Care Authors: Charles W. Lanks, Ali I. Musani, David W. Hsia Source Type: research

Palliative Care in Chronic Obstructive Pulmonary Disease
Advanced chronic obstructive pulmonary disease (COPD), is characterized by high morbidity and mortality. Patients with COPD and their families experience a range of stresses and suffering from a variety of sources throughout the disease ’s progression. COPD is the fourth leading cause of death in the world. It exists as a significant contributor to global morbidity and mortality, and it results in substantial economic and social burden. This review provides some key facts regarding disease burden and encourages clinician to famil iarize themselves and use both conventional and palliative approach early in the disease...
Source: Medical Clinics of North America - March 7, 2019 Category: Primary Care Authors: Lubna Sorathia Source Type: research

Occupational Lung Disease
This article reviews the broad range of types of occupational lung diseases, including airways disease, pneumoconioses, and cancer. Common causes of occupational lung disease are reviewed with specific examples and clinical features. Emphasis on the importance of a detailed history to make an accurate diagnosis of an occupational lung disease is discussed. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - March 7, 2019 Category: Primary Care Authors: David M. Perlman, Lisa A. Maier Source Type: research

Tom Brady ’s Lungs
It ’s Super Bowl Sunday. I am watching the game, in awe of the athletic prowess and cardiopulmonary stamina of these men. Not only football players but all professional athletes amaze me with their ability to perform physical feats with ease and grace. Despite bursts of speed and agility, they seem t o rarely be out of breath. Although some athletes (eg, Jackee Joyner-Kersee, Emmett Smith) have noted lung disease (asthma), most athletes would not be able to do what they do if they had significant pulmonary disease. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - March 7, 2019 Category: Primary Care Authors: Bimal H. Ashar Tags: Foreword Source Type: research

Sarcoidosis
is a multisystemic granulomatous disease that affects individuals worldwide. The lungs are most commonly involved but any organ can be involved. It has variable manifestations and clinical course. Diagnosis of sarcoidosis is based on clinicopathologic findings and the exclusion of other causes of granulomatous disease. Its hallmark is the formation of granulomas in affected organs. Immunosuppressive therapy is the cornerstone of the management of sarcoidosis and is indicated when there is evidence of symptomatic or progressive disease or when critical organs (ocular, cardiac, nervous system) are involved. (Source: Medical...
Source: Medical Clinics of North America - February 20, 2019 Category: Primary Care Authors: Oscar Llanos, Nabeel Hamzeh Source Type: research

The Alzheimer ’s Disease Clinical Spectrum
Alzheimer ’s disease (AD) care requires timely diagnosis and multidisciplinary management. Evaluation involves structured patient and caregiver history and symptom-function reviews, examination, and testing (laboratory and neuroimaging) to delineate impairment level, determine the cognitive-behavioral syndr ome, and diagnose cause. Clinical biomarkers are available to aid high confidence in etiologic diagnosis. Management uses psychoeducation, shared goal setting, and patient-caregiver dyad decision making. When combined, pharmacologic and nonpharmacologic therapies mitigate symptoms and reduce clinica l progression ...
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Authors: Alireza Atri Source Type: research

Entrapment Neuropathies of the Upper Extremity
Upper extremity entrapment neuropathies are common and can cause pain, sensory loss, and muscle weakness that lead to functional disability. In this article, the authors review common entrapment neuropathies of the upper extremities, including median neuropathy at the wrist (carpal tunnel syndrome), ulnar neuropathy at the elbow, and radial neuropathy. The authors discuss the pathophysiology of nerve compression and typical etiologies, as well as strategies for differentiating between common mimics such as cervical radiculopathy and for selecting between various treatment modalities. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Authors: Christopher T. Doughty, Michael P. Bowley Source Type: research

Essential Tremor
Essential tremor is one of the most common movement disorders. It is characterized by a bilateral action tremor of the upper limbs. It may be accompanied by tremor of the head, voice, or lower limbs. Essential tremor is often present for years or decades before presentation and it progresses insidiously. It is often familial and transiently responsive to alcohol. For patients requiring treatment, the two first-line medications are propranolol and primidone, which are synergistic. Patients with disabling essential tremor that cannot be managed medically are candidates for either deep brain stimulation or focused ultrasound....
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Authors: Stephen G. Reich Source Type: research

Neurology for the Non-Neurologist
MEDICAL CLINICS OF NORTH AMERICA (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Authors: Tracey A. Milligan Source Type: research

Copyright
ELSEVIER (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Source Type: research

Forthcoming Issues
Pulmonary Disease (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Source Type: research

Contributors
BIMAL H. ASHAR, MD, MBA, FACP (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Source Type: research

Contents
Bimal H. Ashar (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Source Type: research

CME Accreditation Page
(Source: Medical Clinics of North America)
Source: Medical Clinics of North America - January 30, 2019 Category: Primary Care Source Type: research

The Importance of Neurology for the Non-Neurologist
Neurology is fascinating for neurologists and non-neurologists alike. Not only does our nervous system control all bodily functions but also our brain is the essence of who we are and how we think, perceive, feel, behave, and remember. Diseases of the nervous system are common, and all diseases of the nervous system have available treatment. Treatment is occasionally curative, often disease modifying, and there are always symptomatic treatments available. There has been remarkable progress in understanding diseases of the nervous system. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - December 20, 2018 Category: Primary Care Authors: Tracey A. Milligan Tags: Preface Source Type: research

Nonmigraine Headache and Facial Pain
The vast majority of headache patients encountered in the outpatient general medicine setting will be diagnosed with a primary headache disorder, mostly migraine or tension-type headache. Other less common primary headaches and secondary headaches, related to or caused by another condition, are the topic of this article. Nonmigraine primary headaches include trigeminal autonomic cephalalgias, primarily cluster headache; facial pain, primarily trigeminal neuralgia; and miscellaneous headache syndromes, such as hemicrania continua and new daily persistent headache. Selected secondary headaches related to vascular disease, ce...
Source: Medical Clinics of North America - December 20, 2018 Category: Primary Care Authors: Angeliki Vgontzas, Paul B. Rizzoli Source Type: research

Gait Disorders and Falls in the Elderly
Gait disorders in the elderly may be based on a neurologic deficit at multiples levels, or may be secondary to nonneurologic causes. The physiology and pathophysiology of gait problems are reviewed and bedside examination and investigative tools are discussed. The reader will have an excellent working knowledge of the subject and will know how to diagnose and treat gait disorders and falls. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - December 20, 2018 Category: Primary Care Authors: Michael Ronthal Source Type: research

The Importance of Neurology for the Nonneurologist
Neurology is fascinating for neurologists and nonneurologists alike. Not only does our nervous system control all bodily functions but also our brain is the essence of who we are and how we think, perceive, feel, behave, and remember. Diseases of the nervous system are common, and all diseases of the nervous system have available treatment. Treatment is occasionally curative, often disease modifying, and there are always symptomatic treatments available. There has been remarkable progress in understanding diseases of the nervous system. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - December 20, 2018 Category: Primary Care Authors: Tracey A. Milligan Tags: Preface Source Type: research

Peripheral Neuropathy
This article provides a diagnostic framework for neuropathies and summarizes treatment options. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - December 17, 2018 Category: Primary Care Authors: Kelsey Barrell, A. Gordon Smith Source Type: research

Diagnosis in Neurologic Disease
The diagnosis of neurologic disease is relevant to the non-neurologist because neurologic symptoms are a common reason patients present to their health care provider and most of these patients are never referred to a neurologist. The diagnosis of a neurologic disease is a rewarding endeavor because it requires intellectual rigor, skill, and is of paramount importance to patient care. A tailored history and examination lead to localization and differential diagnosis. Diagnostic testing often involves neuroimaging and serum testing and also may involve lumbar puncture, electroencephalogram, nerve conduction studies, and elec...
Source: Medical Clinics of North America - December 17, 2018 Category: Primary Care Authors: Tracey A. Milligan Source Type: research

Dads and Moms
My father grew up in India. At the age of 22, he excitedly accepted an opportunity to continue his education at the University of Michigan. With $20 in his pocket, he traveled to the United States on a cargo ship, suffering from severe motion sickness throughout his journey. Through hard work, perseverance, and an adventurous spirit, he and my mother ultimately immigrated to America and were able to provide my brother and me with a middle class upbringing. At the time (1970s), I had little understanding of what it must have been like for them to raise two sons in a culture in which they had limited familiarity. (Source: Me...
Source: Medical Clinics of North America - December 17, 2018 Category: Primary Care Authors: Bimal H. Ashar Tags: Foreword Source Type: research

Parkinson ’s Disease
The diagnosis of Parkinson disease (PD) is based on the presence of bradykinesia and either resting tremor or rigidity and there should be no features from the history or examination to suggest an alternative cause of parkinsonism. In addition to the motor manifestations of PD, there is a long list of nonmotor symptoms, several of which occur before motor signs and are considered “prodromal” PD. These are classified as neuropsychiatric, autonomic, sleep, and sensory. There are many medical options for the treatment of PD but levodopa remains the mainstay. Deep brain stimulation and other advanced therapies are ...
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: Stephen G. Reich, Joseph M. Savitt Source Type: research

Seizures and Epilepsy
Epilepsy affects 65 million people worldwide, and is a leading neurologic cause of loss of quality-adjusted life years. The diagnosis of seizures and epilepsy often depends on a careful history, and is supported with electroencephalogram and imaging. First-line treatment of epilepsy includes medical management. Antiepileptic drugs must be chosen with the patient ’s particular comorbidities in mind. Drug-resistant epilepsy cases should be referred to an epilepsy specialist and may be evaluated for additional medications, epilepsy surgery, neurostimulation, or dietary therapy. When caring for women, providers must take...
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: Emily L. Johnson Source Type: research

Migraine and Tension-Type Headache
Migraine and tension-type headache are highly prevalent. Migraine is associated with significant work- and family-related disability. Migraine is underdiagnosed; it reasonable to err on the side of migraine when choosing between primary headaches. Barriers to appropriate treatment of migraine include lack of access to providers, misdiagnosis, and acute and preventive therapies not being prescribed. Acute, rescue, and preventive treatment options are extensive, and new classes of treatments are either available or in development. This review addresses diagnostic challenges including recognizing migraine with aura. It also s...
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: Rebecca Burch Source Type: research

Multiple Sclerosis and Autoimmune Neurology of the Central Nervous System
Autoimmune disorders of the central nervous system are common and often affect people in the most productive years of their lives. Among primary autoimmune diseases of the central nervous system, multiple sclerosis is most prevalent in the United States. Many other autoantibody-mediated neurologic syndromes have been identified within the past 2 to 3 decades, including neuromyelitis optica and anti-N-methyl-D aspartate receptor encephalitis. Finally, the central nervous system can also be affected by systemic autoimmune diseases such as sarcoidosis. Many of these diseases are treatable when detected early. (Source: Medical...
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: Kristin M. Galetta, Shamik Bhattacharyya Source Type: research

Concussion Evaluation and Management
Concussion is a public health crisis affecting vulnerable populations including youth athletes. As awareness increases, more patients with acute concussion are seeking medical evaluations. Internists are frontline medical providers and thus should be able to identify, diagnose, manage, and know when to refer patients with concussion. Management of concussion includes rapid removal from play, symptomatic treatment, and return to learn/play recommendations. Inappropriate management may lead to recurrent concussions, prolonged recovery, and potential long-term consequences. Understanding the key features of diagnosis, postinj...
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: William T. Jackson, Amaal J. Starling Source Type: research

Examination of the Patient with Dizziness or Imbalance
Dizziness and imbalance are common and challenging chief complaints carrying high morbidity, due to their association with falls, injuries, and loss of quality of life. The physical examination represents an opportunity to collect objective clinical data that facilitate an understanding of symptoms that might otherwise be enigmatic and ineffable. This review focuses on the examination techniques used routinely by physicians who provide specialized care for patients with dizziness and imbalance. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: Gregory T. Whitman Source Type: research

Entrapment Neuropathies of the Lower Extremity
Entrapment neuropathies in the lower limbs are a common neurologic problem and may present in any medical setting. Accurate identification and management of these nerve palsies can prevent pain, sensory loss, incoordination, and muscle weakness that may significantly affect a patient ’s functional mobility. In this article, the authors focus on the cause, signs and symptoms, diagnosis, and treatment of select entrapment neuropathies of the lower extremity, including palsies of the common peroneal, lateral femoral cutaneous, femoral, and posterior tibial nerves. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: Michael P. Bowley, Christopher T. Doughty Source Type: research

Parkinson Disease
The diagnosis of Parkinson disease (PD) is based on the presence of bradykinesia and either resting tremor or rigidity and there should be no features from the history or examination to suggest an alternative cause of parkinsonism. In addition to the motor manifestations of PD, there is a long list of nonmotor symptoms, several of which occur before motor signs and are considered “prodromal” PD. These are classified as neuropsychiatric, autonomic, sleep, and sensory. There are many medical options for the treatment of PD but levodopa remains the mainstay. Deep brain stimulation and other advanced therapies are ...
Source: Medical Clinics of North America - December 3, 2018 Category: Primary Care Authors: Stephen G. Reich, Joseph M. Savitt Source Type: research

Cerebrovascular Disease
Despite advances in earlier diagnosis and available aggressive treatments for vascular risk factors, stroke remains a leading cause of death and long-term disability worldwide. Disparities exist in stroke risk, rates of stroke, and treatment. Stroke is a heterogeneous disease with multiple additive risk factors and causes. Primary prevention of stroke focusing on risk factor modification plays an important role in reducing the burden of stroke in an aging population. Secondary prevention of recurrent strokes relies on the workup and a tailored treatment targeted at the mechanisms responsible for the incident stroke or tran...
Source: Medical Clinics of North America - November 27, 2018 Category: Primary Care Authors: Fan Z. Caprio, Farzaneh A. Sorond Source Type: research

Pancreatic Cysts
Pancreatic cysts are common and are incidentally detected in up to 13.5% of individuals. Intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN) are precursors to pancreatic adenocarcinoma. Most will never develop into pancreatic cancer. Several types of pancreatic cysts have no malignant potential. Solid tumors can present as a pancreatic cysts. Guidelines recommend surveillance. Management includes differentiating IPMNs and MCNs from other types, identifying those at highest risk of harboring pancreatic cancer or high-grade dysplasia, and referral to a multidisciplinary group for evaluation and ...
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Olaya I. Brewer Gutierrez, Anne Marie Lennon Source Type: research

Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is present in patients with symptoms of chronic abdominal pain and altered bowel habits but no identifiable organic etiology. Rome IV classification groups patients based on predominant stool pattern. Low-FODMAP diets have been helpful in providing symptom relief, as have cognitive behavioral and mind-body techniques that help patients manage symptoms. Targeted symptomatic relief for the patient ’s predominant symptoms provides relief in addition to effective older medications that are inexpensive and reliable. Newer treatments for IBS-D, such as eluxadoline, and IBS-C, with linaclotide...
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Nuha Alammar, Ellen Stein Source Type: research

The Revolution in Treatment of Hepatitis C
This article focuses on hepatitis C epidemiology; the clinical impact and consequences; discussion of past hepatitis C treatments; and a review of current recommendations for screening, diagnosis, and treatment of this ubiquitous virus. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Jordan Mayberry, William M. Lee Source Type: research

Diet and the Role of Food in Common Gastrointestinal Diseases
This article focuses particularly on the role of food in common gastrointestinal and liver diseases, and discusses the current evidence that either supports or debunks common dietary recommendations. Nutrition topics discussed include the use of artificial sweetener for weight loss, avoidance of all dairy products in the setting of lactose intolerance, dietary recommendations for diverticular disease, and dietary management in cirrhotic patients with hepatic encephalopathy. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Michelle Pearlman, Oviea Akpotaire Source Type: research

The Management of Chronic Pancreatitis
Chronic pancreatitis (CP) may remain undiagnosed for years until patients exhibit manifestations, such as pain and exocrine or endocrine insufficiency. Some patients with CP develop serious complications, such as malignancy or peripancreatic fluid collections. Considering CP in at-risk patients such as those with a long-standing history of alcohol or tobacco use is key to establishing the diagnosis. Management involves reducing and eliminating exposures, dietary modification, treatment of pancreatic insufficiency, assessing for complications, and surveillance for neoplasia. The management of CP is often multidisciplinary i...
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Vaishali Patel, Field Willingham Source Type: research

Helping Patients with Gastroparesis
Gastroparesis is an increasing concern and options remain limited. Diagnosis hinges on recognition of delayed gastric emptying in the absence of mechanical obstruction. Nontransit studies evaluating gastric motility serve a complementary role and may help guide therapy. Treatment consists of a combination of lifestyle and dietary medication, medications (antiemetics, prokinetics, neuromodulators, and accommodation-enhancers), alternative and complementary therapy, endoscopic therapy (pyloric-directed therapy, temporary stimulation, jejunostomy, or venting gastrostomy) and surgical therapy (pyloroplasty, gastric electrical ...
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Frances U. Onyimba, John O. Clarke Source Type: research

Gastroenterology for the Internist
Gastroenterology disorders such as gastroesophageal reflux disease (GERD) and irritable bowel syndrome are a common indication for primary care office visits. Patients with chronic gastroenterology and hepatology disorders are often followed closely by both internists and gastroenterologists. This issue of Medical Clinics of North America is dedicated to advances in the management of common gastroenterology and hepatology disorders managed by both internists and gastroenterologists and the new developments and challenges related to these disorders. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Kerry B. Dunbar Tags: Preface Source Type: research

CME Accreditation Page
(Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Source Type: research

Gastroenterology for the Internist
MEDICAL CLINICS OF NORTH AMERICA (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Kerry B. Dunbar Source Type: research

Copyright
ELSEVIER (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Source Type: research

Forthcoming Issues
Neurology for the Non-Neurologist (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Source Type: research

Contributors
BIMAL H. ASHAR, MD, MBA, FACP (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Source Type: research

Contents
Bimal H. Ashar (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Source Type: research

Proton Pump Inhibitor –Refractory Gastroesophageal Reflux Disease
This article reviews the definition, mechanisms, and management options for PPI-refractory GERD. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 1, 2018 Category: Primary Care Authors: Rena Yadlapati, Kelli DeLay Source Type: research

Colonoscopy, Polypectomy, and the Risk of Bleeding
This article discusses the risks of colonoscopy and polypectomy and reviews the most recent data for managing antiplatelet agents and anticoagulants in the periendoscopic period. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 1, 2018 Category: Primary Care Authors: Linda Anne Feagins Source Type: research

The Future of Nonalcoholic Fatty Liver Disease Treatment
Nonalcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease in the United States. The NAFLD subtype, nonalcoholic steatohepatitis, represents a progressive form of the disease that can lead to cirrhosis, portal hypertension, and hepatocellular carcinoma. NAFLD is a diagnosis of exclusion and is strongly related to obesity and the metabolic syndrome. Although there has been an explosion of exciting therapeutic avenues for NAFLD in recent years, the bedrock of management continues to be lifestyle modification, weight loss, and optimization of metabolic risk factors. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 1, 2018 Category: Primary Care Authors: Khurram Mazhar Source Type: research

Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is a chronic disorder characterized by symptoms of esophageal dysfunction and esophageal inflammation with intraepithelial eosinophils. EoE represents an important cause of upper gastrointestinal morbidity. Primary care providers are pivotal for timely and accurate recognition of symptoms of eosinophilic esophagitis, for facilitating diagnoses through specialist referrals, and for understanding management strategies. This process begins with a thorough understanding of the clinical features of EoE, its associated atopic conditions, and its evolving epidemiology. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 1, 2018 Category: Primary Care Authors: Craig C. Reed, Evan S. Dellon Source Type: research