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Articles for February 23, 2021

Selected articles for Primary Care Providers
Collected By Dr. Bruce Peyser
OB-GYN
Postpartum Care: An Approach to the Fourth Trimester 
American Family Physician
Importance of a thorough assessment within 12 weeks after delivery, covering a variety of areas such as bp check, a glucose tolerance test if gestational dm was present, and all women should be screened for depression and intimate partner violence.
 
PERSPECTIVE
Learning how to die
NEJM
I love this quote from the article: “the Irish did get something right: sharing the dying process can help heal those left behind.”

 

ENDOCRINOLOGY
How should you assess glycemic control if the hemoglobin A1c is inaccurate or uninterpretable?
Cleveland Clinic Journal of Medicine
There are a LOT of conditions that can affect hemA1c such as chronic kidney or liver disease, hemolytic anemia, iron deficiency, pregnancy, as well as b12 and folate deficiencies.  There are several ways around this including more frequent glucose monitoring, serum fructosamine, and there is work now looking at the value of glycated albumin.
ADOLESCENT HEALTH
There is a great website run by Columbia University entitled Go Ask Alice.  It is designed as a safe place for students and others to ask questions about a variety of topics, many of which are related to sexuality.  Sign up for the newsletter and you will get a very interesting email twice a month that you will want to read.
 
Here is the web site
https://goaskalice.columbia.edu/
 
PSYCHIATRY
Bipolar Disorders: Evaluation and Treatment
American Family Physician
We probably underdiagnose this problem.  From the article, 25% of patients presenting with depression or anxiety in a primary care setting have been diagnosed with bipolar disorder.
 

 

GERIATRICS
Frailty: Evaluation and Management
American Family Physician
Remember that symptoms of this can include generalized weakness, exhaustion, slow gait, poor balance, decreased activities, cognitive impairment, and weight loss.
 

 

COVID
Should Remdesivir be used for the treatment of patients with Covid 19?
Annals of Internal Medicine
The evidence seems to support a net benefit for rRemdesivir in patients with moderate Covid 19, with a 5 day treatment period as effective as 10 days.
 
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