Psychosocial Issues and Bereavement
Patients with serious illness and their family caregivers face numerous ongoing psychological and social concerns and stressors throughout the disease trajectory. Common challenges relate to the need to manage the disease by making complex and often difficult medical decisions. In addition, the presence of psychological and psychiatric distress, including depression and anxiety, may significantly add to the overall symptom burden for the patient and family caregivers. These challenges negatively impact mood, cognitive function, interpersonal relationships, and medical decision making. If not recognized and adequately addre...
Source: Primary Care: Clinics in Office Practice - June 28, 2019 Category: Primary Care Authors: E. Alessandra Strada Source Type: research

Palliative Care in the Management of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in the Primary Care Setting
This article reviews the epidemiology of HIV/A IDS, prognostic indicators, frailty, opportunistic infections, specific AIDS-defining malignancies and non–AIDS-defining malignancies, role of palliative care, advance care planning, and the role of HAART in patients dying of late-stage AIDS. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 28, 2019 Category: Primary Care Authors: Linda R. Mitchell, Nidhi Shah, Peter A. Selwyn Source Type: research

Preface
Our nation ’s population is aging, and the cultural and social diversity in our country is steadily increasing. More and more people are suffering with multiple chronic complex illnesses. In addition to this, we have increasing numbers of people who are suffering from functional decline, frailty, debility, a nd dementia. The complexities of caring for our elderly put an increasing strain on our health care system, and much of this burden is placed on our primary care providers. The need to educate our providers on the care of these individuals is paramount to ensuring the quality of care that our elderl y require and...
Source: Primary Care: Clinics in Office Practice - June 27, 2019 Category: Primary Care Authors: Alan R. Roth, Serife Eti, Peter A. Selwyn Source Type: research

Introduction to Hospice and Palliative Care
This article discusses the role of palliative care in the health care system. It reviews the importance of prognostication, disease trajectory, and communication. The role of the primary care physician as part of a multidisciplinary team member delivering primary palliative care is emphasized. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 24, 2019 Category: Primary Care Authors: Alan R. Roth, Angelo R. Canedo Source Type: research

Hospice for the Primary Care Physician
This article describes the history of hospice, palliative care versus hospice care, clinical appropriateness of the hospice patient, the regulatory guidelines of the Medicare Hospice Benefit, hospice reimbursement, primary care reimbursement, and employment opportunities in hospice. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 24, 2019 Category: Primary Care Authors: Joette Elise Greenstein, Joel S. Policzer, Eric S. Shaban Source Type: research

Assessment and Management of Chronic Pain in the Seriously Ill
The intent of this article is to help clinicians to have practical knowledge and skills related to both assessment and pharmacotherapy of chronic pain in the seriously ill patients. Treating patients with chronic pain and progressive disease should include assessment of “total pain” (physical, psychological, and spiritual suffering) and the care givers as part of treatment team. Effective management of chronic pain starts with thorough assessment and diagnosis of the pain syndrome. A worldwide consensus endorses use of multimodal approach and opioid pharmacothe rapy as the mainstay approach to moderate to sever...
Source: Primary Care: Clinics in Office Practice - June 24, 2019 Category: Primary Care Authors: Vanessa Lewis Ramos, Serife Eti Source Type: research

Communication Skills
This article focuses on communication skills to make difficult conversations easier, whether through assigning a health care proxy, breaking bad news, having conversations about serious illness, or leading a family meeting to discuss goals of care. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 24, 2019 Category: Primary Care Authors: Caitlin N. Baran, Justin J. Sanders Source Type: research

Cultural, Religious, and Spiritual Issues in Palliative Care
This article discusses why cultural, spiritual, and religious interplay with medical decision making is important and provide some strategies for addressing these aspects of care. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 24, 2019 Category: Primary Care Authors: Sally E. Mathew-Geevarughese, Oscar Corzo, Elizabeth Figuracion Source Type: research

Geriatric Palliative Care
In the geriatric age group, few studies demonstrate the efficacy of aggressive treatment. Often, a more palliative approach is wanted; such an approach can lead to better quality of life and even a longer life. The author discusses the limits of medical interventions in the elderly, the paucity of data, and the benefits of palliation in certain medical conditions, including dementia, Parkinson, depression, arthritis, congestive heart failure, and pneumonia. The role of frailty is addressed; specific goals of palliative care are delineated, such as reduction of polypharmacy, fall prevention, pain reduction, and the central ...
Source: Primary Care: Clinics in Office Practice - June 24, 2019 Category: Primary Care Authors: Andy Lazris Source Type: research

Palliative Care Approach to Chronic Diseases
Management of chronic diseases is often palliative by definition. Empowering primary care providers to manage symptoms and effectively prognosticate is necessary for this challenging population. In this article, the authors focus specifically on end-stage congestive heart failure, chronic obstructive pulmonary disease, end-stage kidney disease, and end-stage liver disease and how palliative principles can guide decision making and symptom management in these disease states. Special considerations in advanced care planning, initiation and cessation of advanced therapies, and discussions on when to initiate hospice are inclu...
Source: Primary Care: Clinics in Office Practice - June 24, 2019 Category: Primary Care Authors: Kathleen Mechler, John Liantonio Source Type: research

Cystitis and Pyelonephritis
Urinary tract infections, including cystitis and pyelonephritis, are the most common bacterial infection primary care clinicians encounter in office practice. Dysuria and frequency in the absence of vaginal discharge and vaginal irritation are highly predictive of cystitis. Urine culture is recommended for the diagnosis and management of pyelonephritis, recurrent urinary tract infection, and complicated urinary tract infections. Antibiotics targeted toward Escherichia coli, Proteus, Klebsiella, and Staphylococcus saprophyticus are the recommended treatment. The duration of treatment varies by specific drug and type of infe...
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Authors: Karyn B. Kolman Source Type: research

Nephrolithiasis
Incidence of nephrolithiasis has increased dramatically over the past 30  years, likely due to environmental changes such as dietary habits. Nephrolithiasis presents as acute flank or abdominal pain with nausea and vomiting. Hematuria is present in 90% of cases, but its absence does not rule out nephrolithiasis. Most cases can be managed expectantly as an outpatient wit h hydration, analgesia, and possibly medications to aide in passage. A metabolic evaluation may be indicated after a second episode of nephrolithiasis in adults or after a first episode in children or those with a family history of nephrolithiasis. (So...
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Authors: Laura Mayans Source Type: research

Nocturnal Enuresis
Nocturnal enuresis is a common problem that children may present with in a primary care setting. It is important to take a detailed history to rule out secondary causes; however, most cases are primary in nature. It is essential to demystify the problem and reassure parents by educating them that the episodes are nonvolitional and most children outgrow the problem over time. Behavioral interventions are considered first line and are most successful when the child is invested in succeeding. Interventions should be initiated with specific goals in mind. Medications are effective and should be used in conjunction with behavio...
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Authors: Robin A. Walker Source Type: research

Urologic Commonalities and Challenges
From enuresis to incontinence, urologic symptoms can impact individuals of all genders throughout the lifespan. Urologic conditions may cause physical pain or psychological discomfort that can have tremendous negative impact on an individual ’s well-being. Urologic symptoms, such as dysuria, hematuria, erectile dysfunction, and bladder pain, are common and yet are all too often underreported to primary care physicians. Some patients are embarrassed to discuss symptoms, while others may mistakenly believe that there is no treatment ava ilable that can be helpful. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Authors: Gretchen M. Irwin, Laura Mayans Tags: Preface Source Type: research

Urology
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Authors: Gretchen M. Irwin, Laura Mayans Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Source Type: research

Forthcoming Issues
Palliative Care (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2019 Category: Primary Care Source Type: research

Urinary Incontinence
Urinary incontinence is a common, often undertreated, condition that impacts millions of Americans. Primary care physicians are well equipped to diagnose and treat urinary incontinence. Key to successful treatment is accurately determining the type of incontinence that ails the patient and using patient-reported quality-of-life indicators to guide stepwise treatment. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 5, 2019 Category: Primary Care Authors: Gretchen M. Irwin Source Type: research

Bladder Pain Syndrome
Bladder pain syndrome (BPS) is a common cause of chronic pelvic pain with associated lower urinary symptoms. BPS is incurable; management requires an interdisciplinary team (nutritionist, physical therapist, behavioral health specialist) focusing on maximizing patient function. For patients, dietary changes (avoiding acidic, spicy, and caffeinated foods) are effective at relieving symptoms. Medications may be considered in patients who do not respond to these treatments. Referral to urology or urogynecology should be considered if bladder cancer is suspected (especially in patients who smoke or have environmental exposures...
Source: Primary Care: Clinics in Office Practice - April 1, 2019 Category: Primary Care Authors: Miranda M. Huffman, Aniesa Slack, Maris Hoke Source Type: research

Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) is a common condition in aging men that is frequently associated with troublesome lower urinary tract symptoms (LUTS). The American Urologic Association Symptom Index is a validated, self-administered tool that is used to diagnose LUTS, guide initial treatment, and assess treatment response. Watchful waiting is an option for men with mild symptoms. Pharmacologic treatment includes alpha-adrenergic blockers and 5-alpha reductase inhibitors. There is no evidence to support the use of herbal supplements in the treatment of LUTS. Surgical therapy is effective and indicated for men with compli...
Source: Primary Care: Clinics in Office Practice - April 1, 2019 Category: Primary Care Authors: Robert C. Langan Source Type: research

Erectile Dysfunction
Erectile dysfunction is a common condition. Many men do not self-report erectile dysfunction symptoms; thus, physicians must ask about sexual health and function to elicit concerns. Although the impact of untreated erectile dysfunction on quality of life should prompt physicians to ask about symptoms, so should the presence of cardiac and metabolic disease. Diagnosis of erectile dysfunction is made in the primary care office, and patients may be treated with oral, intraurethral, or intracavernosal medications; vacuum devices; or penile prosthesis. Treatment should be guided by patient preference with a goal of improving qu...
Source: Primary Care: Clinics in Office Practice - April 1, 2019 Category: Primary Care Authors: Gretchen M. Irwin Source Type: research

Prostate Cancer Screening
Whether to screen for prostate cancer in aging men is a topic that is fairly well researched, but recommendations are controversial, because the evidence supporting any recommendation is equivocal. The evidence clearly does not support routine screening of all average-risk men, but for men aged 55 to 69  years, either not routinely screening, or engaging each man in shared decision making for his individual preference on screening, is reasonable and consistent with the evidence. Many organizations, including the American Cancer Society, have not yet reassessed their guidelines, in response to the US Preventative Servi...
Source: Primary Care: Clinics in Office Practice - April 1, 2019 Category: Primary Care Authors: James D. Holt, Fereshteh Gerayli Source Type: research

Hematuria
is common in the primary care setting. It is classified as either gross or microscopic. Hematuria warrants a thorough history and physical to determine potential causes and assess risk factors for malignancy. Risk of malignancy with gross hematuria is greater than 10%, and prompt urologic referral is recommended. Microscopic hematuria most commonly has benign causes, such as urinary tract infection, benign prostatic hyperplasia, and urinary calculi. If no benign cause for microscopic hematuria is found, the work-up includes laboratory tests to rule out intrinsic renal disease, imaging of the urinary tract, and referral to...
Source: Primary Care: Clinics in Office Practice - April 1, 2019 Category: Primary Care Authors: Leah M. Peterson, Henry S. Reed Source Type: research

Urologic Malignancies
The primary care physician should be familiar with renal and bladder cancer risk factors, symptoms, and workup. Bladder cancer generally presents with painless hematuria, which primary care providers may identify. Bladder cancer is treated more successfully when caught early. Patients need support and follow-up through treatment. Renal cell carcinoma is generally asymptomatic and commonly is an incidental finding on abdominal imaging. The workup of incidental renal masses is important and ensure appropriate follow-up and treatment are received. Renal cancer is easier to successfully treat when identified at an early stage,...
Source: Primary Care: Clinics in Office Practice - April 1, 2019 Category: Primary Care Authors: Jennifer E. Thuener Source Type: research

To Own the Truth, Own the Data
Urologic conditions continue to challenge primary care providers with regard to accurate diagnosis and treatment. A middle-aged woman who suffers from “chronic urinary tract infections” and “pyelonephritis” was recently referred to my clinic for evaluation. She stated that she was “tired of always being prescribed antibiotics,” many of which she had an adverse reaction to. She admitted that she had been to many doctors and urgent care practices over the last few years in search of answers for her symptoms and was recently told that she must have “stones or some kind of blockage&quo...
Source: Primary Care: Clinics in Office Practice - April 1, 2019 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Prescription of Aspirin and Statins in Primary Prevention
This article reviews randomized evidence to provide guidance to primary care providers regarding the use of adjunctive drug therapies. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Authors: Charles H. Hennekens, Nicole Schuttenberg, Marc A. Pfeffer Source Type: research

Colorectal Cancer Screening
This article focuses on programmatic and opportunistic colorectal cancer screening. The pathogenesis and risk factors for colon cancer are discussed. Specific screening tests, screening in high-risk groups, and surveillance recommendations are reviewed. Important considerations for office practice, including improving screening implementation and cost issues, are addressed. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Authors: Nikerson Geneve, Daniel Kairys, Bralin Bean, Tyler Provost, Ron Mathew, Nergess Taheri Source Type: research

Perspectives on Prevention and Screening
Each year in the United States, millions of premature deaths result from potentially preventable diseases. These deaths occur from preventable chronic diseases, such as heart disease, cancer, and diabetes, leading to 7 of every 10 deaths and accounting for 75% of our nation ’s health spending. Preventive care includes health services, such as screenings, physical examinations, and patient counseling, with the goal of preventing illness and disease, or detecting conditions at an early stage when treatment is likely to work best. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Authors: Joanna L. Drowos Tags: Preface Source Type: research

Prevention into Practice, Practicing Prevention
Primary care practices are tasked with centering the health care of adults and children, women and men, on the prevention of disease and cancer. Guidelines change, quality metrics loom, and patients continue to occupy a spectrum of interest and engagement relative to prevention and screening. With increasingly complicated agendas during patient encounters coupled with limited time per office visit, meeting the appropriate needs of our patients in teaching disease prevention and in discussing current guidelines while offering unbiased shared decision making remains a formidable challenge. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Prevention and Screening
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Authors: Joanna L. Drowos Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Source Type: research

Forthcoming Issues
Urology (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Source Type: research

Prostate Cancer Screening
This article evaluates issues in current prostate cancer pathologic patterns, epidemiology, and screening. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 24, 2018 Category: Primary Care Authors: Russ Blackwelder, Alexander Chessman Source Type: research

Screening for Sexually Transmitted Diseases
This article discusses sexually transmitted infections (STI) screening and focuses on reportable STIs. This includes gonorrhea, chlamydia, syphilis, and human immunodeficiency virus. Hepatitis B and C, trichomonas, and herpes are covered as well. Recommendations are summarized from the various organizations that produce screening recommendations. These screening recommendations only apply to asymptomatic individuals. Once an individual has symptoms, testing becomes diagnostic. It is important to know the prevalence of STIs within your population. If you work in a population with a high prevalence of a specific disease, you...
Source: Primary Care: Clinics in Office Practice - December 24, 2018 Category: Primary Care Authors: Shoshana B. Levy, Jyothi Gunta, Peter Edemekong Source Type: research

Update on Osteoporosis
Osteoporosis is often a silent disease that reveals itself at the time of a fracture. Assessing risk factors and applying appropriate screening guidelines in the population at risk can potentially decrease the looming high disease burden in the United States. FRAX is a validated tool that can be used to determine 10-year fracture risk to assist in medical decision making. Bone mineral density testing of the hip or spine using DEXA can be used alone or in combination with FRAX to determine patients ’ risk for fracture and determine if patients are candidates for treatment of osteoporosis. (Source: Primary Care: Clinic...
Source: Primary Care: Clinics in Office Practice - December 24, 2018 Category: Primary Care Authors: Srikala Yedavally-Yellayi, Andrew Manyin Ho, Erwin Matthew Patalinghug Source Type: research

Lifestyle Changes for Disease Prevention
In primary care, physicians have the opportunity to address preventative causes of morbidity and mortality. Primary care physicians have a distinct opportunity to provide counseling regarding lifestyle changes and disease prevention in a variety of settings, both during the treatment of acute illnesses and with wellness examinations. Questions from patients regarding specific recommendations and interventions are common. In this article, we address barriers to and tools to encourage lifestyle changes in the areas of smoking cessation, weight loss, physical activity, mental health, and substance abuse/misuse. (Source: Prima...
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Joanna Petrides, Philip Collins, Alexander Kowalski, Jennifer Sepede, Meagan Vermeulen Source Type: research

Prevention of Hypertension Related to Cardiovascular Disease
Hypertension, among the common conditions encountered in primary care, is known to have a causal link with cardiovascular disease. With new thresholds for diagnosing hypertension, its prevalence is expected to increase. Currently, a high percentage of patients have suboptimal or inadequately controlled blood pressure, thus placing them at risk for cardiovascular disease. Among the best strategies for improved outcomes are inclusion of the patient in decision-making as well as provision of individualized treatment plans. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Parvathi Perumareddi Source Type: research

The Screening and Prevention of Diabetes Mellitus
This article reviews the screening guidelines and prevention strategies for type 2 diabetes mellitus and discusses the risks and benefits of screening. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Lisa C. Martinez, Dawn Sherling, Allison Holley Source Type: research

Immunizations
Vaccination is one of the most effective preventative health measures in modern times. It has positively affected the incidence and prevalence of a myriad of diseases, as well as improved both their morbidity and mortality. It is essential that health care providers understand the value of this intervention, promote comprehensive immunization coverage within their community, and recognize the underlying principles that guide decisions regarding vaccination. Factors important to consider before immunization administration include the type of vaccination, its recommended timing and intervals, and the presence of contraindica...
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Benjamin B. Wilde, David J. Park Source Type: research

Pediatric Screening
Screening and prevention are important components of general pediatric health care. Infants and young children should be screened for iron deficiency anemia, lead poisoning, and developmental disorders as essential parts of the well-child visit. Developmental and behavioral screening early in childhood is necessary to identify developmental delays and facilitate timely treatment. Lead screening is recommended for at-risk pediatric patients to treat children with elevated lead levels. Infants and children are also at risk for iron deficiency anemia and must be screened appropriately. Familiarization with pediatric screening...
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Sarah K. Wood, Randi Sperling Source Type: research

Geriatrics Screening and Assessment
Geriatric screening and assessment allows clinicians to care for older patients in an efficient, patient-centered manner. This framework includes standard screening questions that may trigger the use of standard geriatric assessment tools and/or other interventions. Additionally, it serves to complement the history and physical examination, and is critical for maximizing the health, function, safety, and quality of life of older patients. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Mandi Sehgal, Elizabeth Hidlebaugh, Matthew G. Checketts, Bernardo Reyes Source Type: research

Breast Cancer Screening
Screening mammography and evolving treatments have improved mortality over the last 25  years. However, breast cancer remains the second leading cause of cancer-related mortality for women in the United States. There are several contradictory recommendations regarding breast cancer screening. Familiarity with these recommendations will allow physicians to counsel their patients and e nsure well-informed shared decision making. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Veronica Jordan, Muneeza Khan, Donna Prill Source Type: research

Cervical Cancer and Its Precursors
Cervical cancer affects the cells lining the cervix, most commonly occurring in the cells of the transformation zone. Screening for cervical cancer looks to detect preinvasive disease, allowing for intervention before invasive disease develops. an assessment of individual risk factors, Selection of screening method depends on patient age, her screening history and results, and resources available. Screening has resulted in well-documented declines in cervical cancer incidence and mortality in the United States. Guidelines continue to evolve as new data emerge. Although cervical cancer prevention strategies include interven...
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Sarah E. Stumbar, Maria Stevens, Zoe Feld Source Type: research

Cancer Survivor Health Needs for Women
As a result of better diagnostics and treatment of cancer, the number of survivors is on the rise. Health care needs for female cancer survivors encompass several domains that include surveillance, prevention, management of short/long-term side effects of cancer, and cancer therapy. Primary care health providers (PCHPs) can play an important role in their health care. There is a need for PCHPs to acquire knowledge and understand the complexity involved in caring for this population. They also should be familiar with the guidelines for following cancer survivor patients. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 4, 2018 Category: Primary Care Authors: Jamal Islam, George D. Harris Source Type: research

Plastic Surgery for Women
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 femal...
Source: Primary Care: Clinics in Office Practice - November 4, 2018 Category: Primary Care Authors: Michelle M. De Souza, Andrea D. Jewell, Samuel N. Grief, Belinda A. Vail Source Type: research

Providing Abortion Services in the Primary Care Setting
Patients commonly present with unintended pregnancy in the primary care setting, and 1 in 4 women has an abortion in her lifetime. Early abortion services can be safely provided in the primary care setting. Abortion options provided in primary care settings include both medication abortion and early uterine aspiration abortion. Medication abortion, provided up to 10  weeks’ gestational age, includes mifepristone (a progestin antagonist) and misoprostol (a prostaglandin). Uterine aspiration can be provided via manual or electronic vacuum in the first trimester. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 4, 2018 Category: Primary Care Authors: Jennifer R. Amico, Terri L. Cheng, Emily M. Godfrey Source Type: research