Health of asylum-seeking immigrants: Providing medical care from a volunteer's perspective No abstract available

Using pharmacogenetics in primary care Pharmacogenetics offers a way to personalize medication prescribing for patients. Through the use of genetic tests that identify variations in enzymes important to drug metabolism, PAs can have patients' genetic information before prescribing a medication. This may reduce the risks of adverse reactions and lost treatment time when patients are given drugs to which they are unlikely to respond. Laboratory testing can identify common genetic variants that alter how the body metabolizes drugs. PAs with knowledge of these variants can choose medications that are more personalized and effective for each patient. Clinical pharmacogenetic guidelines are under development and will help providers identify which drugs are most likely to be affected by genetic variations so they can prescribe for patients based on their specific genetic phenotypes.

Recognizing autism spectrum disorder Autism spectrum disorder (ASD), previously called autism, is a developmental condition that can cause significant social, communication, and behavioral challenges. Early symptoms of ASD can easily be overlooked. Clinicians who can recognize the symptoms of ASD can help children get prompt referral to specialists and early intervention, which is key to improving developmental outcomes for children with ASD.

CME POST-TEST No abstract available

Negative-pressure pulmonary edema after laparoscopic appendectomy Negative-pressure pulmonary edema (NPPE) is acute-onset bilateral pulmonary interstitial edema. This condition can be caused by significant negative intrathoracic pressure generated by large inspiratory effort against acute upper airway obstruction. Postoperative NPPE is rare but potentially life-threatening if not recognized and treated promptly. This article describes a patient who developed postoperative NPPE following a laparoscopic appendectomy.

Evaluating and managing acetabular dysplasia in adolescents and young adults Hip dysplasia is a developmental deformity in which abnormal acetabular or proximal femoral growth causes structural instability of the hip joint due to inadequate bony coverage of the acetabulum over the femoral head. Skeletally mature adolescents or young adults with underlying acetabular dysplasia may present with activity-related groin or lateral hip pain and a limp. This article reviews the current understanding of the disease and better treatment options for correcting acetabular dysplasia in symptomatic adolescents and young adults before secondary osteoarthritis develops.

A simple guidewire and angiocatheter technique for urinary catheter placement Objective: To report on a simple technique of inserting any difficult urinary catheter using a hydrophilic guidewire and an angiocatheter. Materials and methods: A total of 764 requests were made to the urology team for assistance with a difficult urinary catheter placement. For all patients, either a regular or bent-tip catheter was attempted first. If the initial placement attempt failed, our technique using an angiocatheter, a hydrophilic guidewire, and a urinary catheter of choice was then employed. Results: We were able to successfully insert 526 regular or bent-tip indwelling urinary catheters on first attempt (68.8%). Two hundred and four (26.7%) placements required the use of our described technique. No complication was encountered from the bedside maneuver. Conclusions: Our method is safe, easily learned, and performed. The technique saves time, effort, and resources, as it averts the necessity of rare use of expensive equipment, bedside flexible cystoscopy, and cystotomy.

Using point-of-care ultrasound: Shock No abstract available

Lumbar spinal stenosis No abstract available

Updated management for patients with cardiovascular disease and diabetes Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality for patients with diabetes. The latest guidelines from the American Diabetes Association include new information on hypertension, lipid management, heart failure, and coronary heart disease. This year, for the first time, the cardiovascular disease and risk management section was endorsed by the American College of Cardiology. Primary and secondary prevention of ASCVD is a critical element of the primary care visit for patients with diabetes. This article provides key highlights that are important for busy clinicians.