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Articles for May 25, 2021

Selected articles for Primary Care Providers
Collected By Dr. Bruce Peyser
ENDOCRINOLOGY
Hypothyroidism: Diagnosis and Treatment
American Family Physician

Lots of fun facts within the article to know and tell.  For instance, did you know that people who ingest walnuts, supplemental fiber, and or grapefruit juice might need to take higher doses of levothyroxine due to drug-food interactions? And we all know that for folks older than 60 if you are going to initiate treatment, start with a low dose such as 12.5-50 mcg per day.


                                                                                                       
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PSYCHIATRY
Depression
Annals of Internal Medicine - In the Clinic Series

Lots of valuable information.  Note with mirtazapine, we should be careful when we use this in a patient with renal disease.  Also, concurrent use of alcohol and or benzodiazepines can contribute to sedation.  Risk factors for depression: chronic medical conditions, being female, older age, lower socioeconomic status, recent childbirth, and recent stressful events.

       
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CARDIOLOGY
CABG: When, why, and how?
Cleveland Clinic Journal of Medicine

In general, CABG recommended when there is an extensive disease and the patient has dm.  Dual antiplatelet therapy recommended for 6 months in patients who present with the acute coronary syndrome who undergo CABG.



                   
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PHARMACOLOGY

Intranasal Naloxone Administration
NEJM

Check out this video in the clinical medicine series.


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GYNECOLOGY
Dyspareunia in Women
American Family Physician

This is a helpful review of a variety of conditions that can lead to this problem.  Check out table 1 which identifies a number of causes, what the findings are on the exam, and then various treatment options.


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COVID - 19
Post-acute sequelae of SARS-CoV2 infection: Caring for the "long-haulers"
Cleveland Clini Journal of Medicine

A range of symptoms can occur.  A care pathway for patients is proposed.
 


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