Browse Primary Care/Hospitalist Articles by Topic

Weighing the Harms and Benefits of E-cigarettes

So far, studies evaluating whether e-cigarettes are less harmful than traditional cigarettes remain mostly inconclusive.

Hypoglycemia Increases Cardiovascular Risk in Patients With Type 1 and Type 2 Diabetes

This is a retrospective analysis of data from the UK Clinical Practice Research Datalink which includes 265,868 insulin-treated patients age > 30 years diagnosed with diabetes between 2001 and 2007. 3260 were diagnosed with T1DM and 10,422 had T2DM. During a median follow-up of 5 years for type 1 diabetes patients and 4.8 years for those with type 2 diabetes, hypoglycemia was experienced by 573 (18%) and 1463 (14%) of patients, respectively. Compared with patients who did not experience hypoglycemia, the hazard ratio (HR) for CV events among T1DM patients who experienced hypoglycemia was 1.51 (not significant) and 1.61 for those with and without a history of CVD. For T2DM patients, the respective HRs were 1.60 and 1.49. The median time interval between the first hypoglycemia event and the first CV event was 1.5 years for all diabetes patients. Thus, hypoglycemia increases the risk of both CV and all-cause mortality in patients with diabetes.

Influenza, 2014-2015 — Something Old, Something New, and a Mismatch

By early January, influenza activity had reached epidemic proportions in large parts of the United States, despite prior vaccination.

The Devalued Body: Symptoms of BPD in Mental Health and Medical Settings

Borderline personality disorder is a complex dysfunction often caused by childhood trauma and it may result in your patients harming themselves.

Quality Family Planning (QFP) — Put it into practice

“Providing Quality Family Planning Services — Recommendations of CDC and the U.S. Office of Population Affairs” is the newest member in the “suite” of family planning recommendations from the Centers for Disease Control and Prevention.

Where should teens access condoms?

On the most recent Youth Risk Behavior Survey (YRBS), 40% of sexually active U.S. high school students reported that they did not use a condom at last intercourse. This percentage has significantly declined since 1991 when the survey began but has increased since a low of 37% in 2003.¹ Additionally, in 2013 less than 10% of students reported dual use of condoms plus a hormonal method.

Despite new options, oral contraceptive pills are still in birth control mix, survey respondents say

How are oral contraceptives being used in today’s family planning practices? The Affordable Care Act (ACA) might be making a difference when it comes to use of the Pill. Between 2012 and 2013, the number of women who filled prescriptions for the Pill with no co-pay more than quadrupled from 1.2 million to 5.1 million, according to data from the IMS Institute for Healthcare Informatics in Parsippany, NJ, an information and technology service.

Oral contraceptives — Should they be OTC?

When it comes to moving oral contraceptives over the counter (OTC), almost 50% of participants in the Contraceptive Technology Update Contraception Survey say they support such a move. Support for OTC access is growing; 62% of American women support the pill being available without a prescription.

With unsurpassed efficacy and rapid reversibility, contraceptive implant can be put into practice

While use of long-acting reversible contraceptive (LARC) methods is growing, the contraceptive implant (Nexplanon, Merck & Co., Whitehouse Station, NJ) is still underused, say family planning experts. Look at the most recent national figures: In 2009, 8.5% of women using contraceptives relied on LARC methods, rising from 5.5% in 2007 and 2.4% in 2002. However, most of these women (nearly 8%) use intrauterine devices (IUDs), compared to less than 1% who use the implant.

Ortho Evra patch discontinued — What next?

Rewind to 2002: The first transdermal contraceptive, the Ortho Evra patch, hit U.S. pharmacy shelves. Fast forward to the present: The manufacturer has production of the device “due to a business decision,” according to information on the Food and Drug Administration (FDA) website.