The Journal of family practice
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Firearm injuries are the eighth leading cause of death in the United States. Evidence suggests that availability of guns in the home is associated with an increased risk of homicide, suicide, and unintentional injuries and fatalities. Our study examined five demographically diverse primary care practices in Oregon to determine the extent to which patients and members of their households might be at risk for firearm injuries. ⋯ Our data indicate that a substantial number of patients cared for by primary care physicians are at risk for firearm injuries.
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Review Case Reports
A case report of disseminated blastomycosis and adult respiratory distress syndrome.
Blastomycosis is a fungal disease endemic to the midwestern and southeastern United States. This is a case report of a 29-year-old woman who presented with weight loss, fever, fatigue, and pneumonia. ⋯ Blastomycosis is endemic to a large portion of the United States. Family physicians should consider fungal infection in the differential diagnosis of an unresolving pneumonia.
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Race has been shown to be a significant predictive factor in a number of treatment decisions and outcomes, including survival following out-of-hospital cardiopulmonary resuscitation (CPR). The goal of this study was to determine whether race is associated with the rate of survival to discharge following in-hospital CPR. ⋯ Black race is significantly associated with a lower rate of survival to discharge following in-hospital CPR. Further work is needed to explore this association in other settings; to examine the effect of other possible confounding variables, such as tobacco use, socioeconomic status, and marital status; and to further study the determinants of physician decision-making about resuscitation.
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Multicenter Study Comparative Study
Practice variations between family physicians and obstetricians in the management of low-risk pregnancies.
Studies suggest that family physicians and other generalist physicians practice differently than specialists. This study was performed to determine whether practice patterns and outcomes differ for women with low-risk pregnancies who obtain maternity care from family physicians as compared with those who are cared for by obstetricians. ⋯ Women obtaining maternity care from family physicians were less likely to receive epidural anesthesia during labor or an episiotomy after vaginal births, and had a lower rate of cesarean section delivery rates, primarily because of a decreased frequency in the diagnosis of cephalopelvic disproportion. Differences between outcomes persisted after adjustment for potential confounders such as parity, previous cesarean delivery, and use of epidural anesthesia during labor. No differences between the two physician groups with respect to neonatal outcomes were found.