Food allergy knowledge, attitudes, and beliefs of primary care physicians.
Pediatrics. 2010 Jan;125(1):126-32
Authors: Gupta RS, Springston EE, Kim JS, Smith B, Pongracic JA, Wang X, Holl J
OBJECTIVE: To provide insight into food allergy knowledge and perceptions among pediatricians and family physicians in the United States. METHODS: A national sample of pediatricians and family physicians was recruited between April and July 2008 to complete the validated, Web-based Chicago Food Allergy Research Survey for Primary Care Physicians. Findings were analyzed to provide composite/itemized knowledge scores, describe attitudes and beliefs, and examine the effects of participant characteristics on response. RESULTS: The sample included 407 primary care physicians; 99% of the respondents reported providing care for food-allergic patients. Participants answered 61% of knowledge-based items correctly. Strengths and weaknesses were identified in each content domain evaluated by the survey. For example, 80% of physicians surveyed knew that the flu vaccine is unsafe for egg-allergic children, 90% recognized that the number of food-allergic children is increasing in the United States, and 80% were aware that there is no cure for food allergy. However, only 24% knew that oral food challenges may be used in the diagnosis of food allergy, 12% correctly rejected that chronic nasal problems are not symptom of food allergy, and 23% recognized that yogurts/cheeses from milk are unsafe for children with immunoglobulin E-mediated milk allergies. Fewer than 30% of the participants felt comfortable interpreting laboratory tests to diagnose food allergy or felt adequately prepared by their medical training to care for food-allergic children. CONCLUSIONS: Knowledge of food allergy among primary care physicians was fair. Opportunities for improvement exist, as acknowledged by participants’ own perceptions of their clinical abilities in the management of food allergy.
PMID: 19969619 [PubMed - indexed for MEDLINE]
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Large vestibular aqueduct syndrome and endolymphatic hydrops: two presentations of a common primary inner-ear dysfunction?
J Laryngol Otol. 2009 Aug;123(8):919-21
Authors: Spiegel JH, Lalwani AK
OBJECTIVE: To present the theory that large vestibular aqueduct syndrome (i.e. the recognised existence of an enlarged vestibular aqueduct with progressive sensorineural hearing loss) and endolymphatic hydrops are due to a common primary dysfunction of inner-ear fluid homeostasis. METHOD: Case report and review of the world literature concerning large vestibular aqueduct syndrome and endolymphatic hydrops. RESULTS: We report a family in which one sibling suffered from large vestibular aqueduct syndrome while the other had classic Méničre’s disease. This suggests that large vestibular aqueduct syndrome and endolymphatic hydrops, in some cases, may be due to a common primary dysfunction of inner-ear fluid homeostasis. CONCLUSION: To our knowledge, this is the first report in the world literature to postulate that variation in the relative compliance of inner-ear membranes could be the factor that determines the manifestation of the disorder as either endolymphatic hydrops or large vestibular aqueduct syndrome.
PMID: 19000343 [PubMed - indexed for MEDLINE]
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An urgent matter-identifying your patients’ cardiovascular risk and improving their outcomes. Atherosclerosis: the underlying disease.
J Fam Pract. 2009 Nov;58(11 Suppl Urgent):S19-25
Authors: Tóth PP
Despite our longstanding awareness of atherosclerosis and its association with myocardial infarction and sudden cardiac death, only recently have we been able to study the pathology and progression of atherosclerotic plaque formation. Novel methods of imaging the arterial wall have enabled the identification of preclinical disease and plaque progression, as well as better evaluation of therapeutic interventions. Thanks in large part to advances in imaging technology, this deeper understanding of the stages of atherosclerosis progression underscores the importance of primary and secondary preventive efforts. Patients are becoming increasingly sophisticated in their knowledge of health issues and often want to know more about their own illnesses. Unfortunately, a plethora of inaccurate, biased, or incomplete information is readily available through the Internet, television, and print media. So-called advocacy groups claiming to protect the populace against dangerous drugs also amplify the risks of many drug therapies and downplay their benefits, to the detriment of public health. Family physicians play an important role in educating patients about risk factor identification and management and treatment of coronary artery disease. In particular, family physicians can help patients understand the implications and clinical utility of new research findings related to atherosclerosis. The text and figures that follow will review new developments in our understanding of the pathogenesis of atherosclerosis and new ways that changes in atherosclerotic plaque size and volume can be measured.
PMID: 19891944 [PubMed - in process]
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