Enhancing primary healthcare in under-resourced communities with mobile health clinics.

Mobile health clinics (MHCs) have the potential to enhance primary care in low-resource communities. This article describes an initiative spearheaded by public health nurses that utilized MHCs to provide affordable, equitable, and culturally appropriate primary healthcare services to a rural community in Haiti.

Mitigating Homicide Risk During Pregnancy.

This leading cause of maternal death often involves intimate partners and firearms.

Disease screening and prevention for transgender and gender-diverse adults.

Primary care clinicians have an important role in the health and wellness of transgender and gender-diverse (TGD) adults and need to know best practices of health maintenance and disease prevention interventions. This article focuses on how exogenous use of sex steroids provided as hormone therapy and gender-affirming procedures affect screening and prevention. Hormone therapy can affect the heart, liver, lipids, bones, brain, skin, and reproductive organs; likewise, behaviors and gender-affirming procedures may alter the risks, prevalence, and screening techniques of sexually transmitted infections.

Necrotizing enterocolitis: Current concepts in practice.

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants and continues to be a major cause of morbidity and mortality. The incidence of NEC as well as mortality from the disease has persisted at unacceptably high levels for decades as current understanding of the cause remains incomplete. Identifying infants at risk and preventing NEC are mainstays of care.

Surgical management for Hirschsprung disease: A review for primary care providers.

Primary care providers may encounter infants and children with Hirschsprung disease, a congenital colonic defect. Although primarily a surgical problem, the disease requires extensive supportive care and a multidisciplinary approach that often extends beyond surgical correction. This article reviews the management of Hirschsprung disease.

Botulinum toxin as a treatment for refractory overactive bladder.

Detrusor overactivity is the most common cause of overactive bladder (OAB) and refers to demonstrable involuntary detrusor contractions during urodynamic studies. The number of adults age 40 years or older suffering from idiopathic urge incontinence ranges from 13% in men to 30% in women. For patients whose symptoms are refractory to conventional therapy, intradetrusor botulinum toxin injection offers a safe and effective outpatient treatment with high rates of improvement of OAB symptoms.

Evaluating scrotal masses.

Scrotal complaints can be challenging to diagnose because of overlapping signs and symptoms among various presentations. Failure to properly identify and manage testicular malfunctions such as testicular torsion, testicular cancer, varicocele, and hydrocele may lead to patient infertility, testicle loss, or death. This article describes proper assessment of scrotal masses, recognition of potentially life-threatening testicular conditions, and appropriate diagnostic evaluations for each pathology.

Emergency management of high-energy pelvic trauma.

A fractured pelvis can be a significant cause of patient morbidity and mortality. Injuries to the pelvis that result from high-energy trauma can be devastating, and patients often have other associated injuries. This article reviews the pathophysiology of pelvic fractures and how to classify and manage them in the emergency setting in order to improve patient outcomes.

Gout: a comprehensive review.

The prevalence of gout in the US population is steadily increasing. Genome-wide research has found several variants of DNA sequences that predispose patients to irregular uric acid metabolism. Comorbidities linked to gout include obesity and cardiovascular disease.

Pancreatic cancer: practical strategies for early diagnosis and management.

Pancreatic cancer often is diagnosed too late for effective treatment. Knowing the risk factors, best diagnostic tests, and management options may help clinicians recognize pancreatic adenocarcinoma earlier, improving patient outcomes.