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Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2023 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, 2023 Category: Primary Care Source Type: research

Forthcoming Issues
Gastroenterology (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 26, 2023 Category: Primary Care Source Type: research

Gastroesophageal Reflux Disease
Symptoms potentially attributable to gastroesophageal reflux disease are among those most commonly reported to primary care providers in the outpatient setting. In this review, we discuss clinical approaches to the evaluation and management of these symptoms, including proton pump inhibitor trials as well as specific indications or clinical settings that warrant referral to Gastroenterology specialists. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 20, 2023 Category: Primary Care Authors: Janaki Patel, Natalie Wong, Kurren Mehta, Amit Patel Source Type: research

Diseases of the Gallbladder and Biliary Tree
Diseases of the gallbladder include a spectrum of gallstone diseases (cholelithiasis, cholecystitis, choledocholithiasis, and cholangitis), cysts, polyps, and malignancy. In this review, we present the incidence, risk factors, clinical presentation, diagnosis, and treatment of these various conditions. Importantly, we report when more urgent referral is indicated, as well as red flags that warrant further intervention and/or management. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 18, 2023 Category: Primary Care Authors: Seth Anthony Politano, Nida Hamiduzzaman, Dalal Alhaqqan Source Type: research

Biologics, Single Maintenance and Reliever Therapy, Oral Immunotherapy, and More: Updates from the World of Allergy, Asthma, and Immunology
Atopic conditions are common complaints in a primary care office. From atopic dermatitis to severe asthma and complicated food allergy, primary care physicians are the first stop for most allergic conditions. In the years since the first Primary Care: Clinics in Office Practice issue devoted to allergy-related disorders, there have been significant advancements in the treatment of atopic conditions with the development of biologics and the evolution of different types of immunotherapies, with a particular nod to advancements in oral immunotherapy for treatment of food allergy. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - March 27, 2023 Category: Primary Care Authors: Andrew Lutzkanin, Kristen M. Lutzkanin Tags: Preface Source Type: research

Food Allergy
Food allergy is a growing health problem affecting both pediatric and adult patients. Food allergies are often immunoglobulin E (IgE) mediated but other food-induced non –IgE-mediated diseases exist. Diagnosis of food allergy relies on the combination of clinical and reaction history, skin and IgE testing as well as oral food challenges. Although oral immunotherapy has been able to achieve sustained unresponsiveness in some patients, no cure for food allergies has been found to date. Avoidance of the inciting food as well as availability of epinephrine autoinjectors remains the mainstay of treatment. (Source: Primary Car...
Source: Primary Care: Clinics in Office Practice - March 27, 2023 Category: Primary Care Authors: Chelsea Elizabeth Mendonca, Doerthe A. Andreae Source Type: research

Biologics, Single Maintenanec and Reliever Therapy, Oral Immunotherapy, and More: Updates from the World of Allergy, Asthma, and Immunology
Atopic conditions are common complaints in a primary care office. From atopic dermatitis to severe asthma and complicated food allergy, primary care physicians are the first stop for most allergic conditions. In the years since the first Primary Care: Clinics in Office Practice issue devoted to allergy-related disorders, there have been significant advancements in the treatment of atopic conditions with the development of biologics and the evolution of different types of immunotherapies, with a particular nod to advancements in oral immunotherapy for treatment of food allergy. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - March 27, 2023 Category: Primary Care Authors: Andrew Lutzkanin, Kristen M. Lutzkanin Tags: Preface Source Type: research

Management of Chronic Asthma in Adults
Asthma is characterized by chronic inflammation and respiratory symptoms such as wheezing and coughing. In the United States, it affects 25 million people annually. Chronic smokers, poor adherence to medications, incorrect use of inhalers, and overall poor asthma control are known risk factors that lead to poorly controlled chronic asthmatics. Although asthma is traditionally categorized by severity, treatment by primary care providers is guided by the Global Initiative for Asthma or the National Asthma Education and Prevention Program. As more research is available, shared decision-making between health care providers and...
Source: Primary Care: Clinics in Office Practice - March 26, 2023 Category: Primary Care Authors: Huong Nguyen, Munima Nasir Source Type: research

Venom Hypersensitivity
Stinging insects are a frequent cause of local and systemic hypersensitivity reactions, including anaphylaxis. For those with a history of life-threatening anaphylaxis, venom immunotherapy is effective, safe, and can be life-saving. Arachnids are a much less common source of envenomation through bites or stings and are less likely to cause a hypersensitivity reaction. However, recognizing the clinical manifestations when they do present is important for accurate diagnosis and treatment, and, when indicated, consideration of other diagnoses. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - March 10, 2023 Category: Primary Care Authors: J. Lane Wilson, Bridgid Wilson Source Type: research

Atopic Dermatitis
Atopic dermatitis (AD) is a common, chronic relapsing, and remitting inflammatory skin disease that is characterized by erythematous, scaly, and pruritic lesions often located over the flexural surfaces. Treatment goals of AD include the reduction of itching and burning, as well as the reduction of skin changes. Treatment of AD includes emollients and skin care, topical therapies including topical corticosteroids and steroid-sparing therapies, systemic therapies, and phototherapy. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - March 8, 2023 Category: Primary Care Authors: Karl T. Clebak, Leesha Helm, Prabhdeep Uppal, Christopher R. Davis, Matthew F. Helm Source Type: research

Allergic Rhinitis
Allergic rhinitis is a common ailment in primary and acute care settings. Diagnosis is clinical, by means of history and physical examination. Referral to an allergist is considered when symptoms are difficult to manage and/or confirmation by means of further testing is desired. Management of allergic rhinitis should not be considered trivial, as multiple secondary effects can present as the course progresses. Several treatment modalities exist but should begin with glucocorticoid nasal sprays and systemic second- or third-generation antihistamines. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - March 8, 2023 Category: Primary Care Authors: Eric J. Czech, Andrew Overholser, Paul Schultz Source Type: research

Eosinophilic Esophagitis
This chapter presents an overview of eosinophilic esophagitis (EoE) for the Primary Care Practitioner (PCP). The focus is on helping PCPs keep it in their differential diagnosis by discussing the spectrum of clinical presentations, how to screen for EoE in at-risk populations and subsequently manage the patient with this condition. The authors review epidemiology, risk factors and associated conditions, pathology, clinical presentation, diagnosis, and management options. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - March 3, 2023 Category: Primary Care Authors: Alexandra Horwitz, Samina Yunus Source Type: research

Urticaria and Angioedema
Urticaria and angioedema are caused by immunoglobulin E- and non-immunoglobulin E-mediated release of histamine and other inflammatory mediators from mast cells and basophils. Diagnosis is made clinically, and anaphylaxis must be ruled out if urticaria or angioedema is present. A limited nonspecific laboratory workup should be considered unless elements of the history or physical examination suggest specific underlying conditions. The mainstay of treatment is avoidance of triggers when and if triggers are identified. The first-line pharmacotherapy is second-generation H1 antihistamines, which can be titrated to greater tha...
Source: Primary Care: Clinics in Office Practice - March 2, 2023 Category: Primary Care Authors: Kate Szymanski, Paul Schaefer Source Type: research

Penicillin Allergy
Allergy to penicillin can occur via any of the 4 types of Gel-Coombs hypersensitivity reactions, producing distinct clinical histories and physical examination findings. Treatments include penicillin discontinuation, and depending on the type of reaction, epinephrine, antihistamines, and/or glucocorticoids. Most beta-lactams may be safely used in penicillin-allergic patients, with the possible exception of first-generation and second-generation cephalosporins. Penicillin testing includes skin testing, patch testing, and graded challenge. The selection of the type of testing depends on the clinical setting, equipment availa...
Source: Primary Care: Clinics in Office Practice - February 26, 2023 Category: Primary Care Authors: Estelle A. Green, Kelan Fogarty, Faoud T. Ishmael Source Type: research