Primary care
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Acute tonsillitis is a common illness that affects patients of all ages but the risk of complication increases with the young. Tonsillitis commonly presents with a sore throat and difficulty swallowing and will often have swelling of the tonsils with exudate on physical examination. Although acute tonsillitis secondary to group A beta-hemolytic Streptococcus should be considered so that antibiotic therapy can be initiated in a timely fashion to prevent complications such as a retropharyngeal abscess or acute rheumatic fever, the most common etiology of tonsillitis is viral. The treatment of viral tonsillitis is supportive with analgesia and hydration.
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Otitis media and otitis externa are common ear conditions affecting individuals of all ages. Symptoms can range from mild to severe ear pain. ⋯ Proper management requires use of up-to-date guidelines and advanced treatments to address the diagnosis, prevention, and therapy challenges. This article overviews current practices and recent developments in treating these common ear disorders.
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Rhinitis affects a significant portion of the world population and increases the cost of health care by billions of dollars in treatment costs and missed days of work. Allergic rhinitis is the most common cause. ⋯ Initial treatment includes using topical agents like intranasal corticosteroids and inhaled antihistamines as the first-line therapies for both allergic rhinitis and chronic rhinitis. Therapy can evolve in a stepwise manner depending on the primary symptom complaint prior to referral for advanced therapies such as allergen immunotherapy.
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Bell's palsy is acute weakness of the facial muscles associated with compression of cranial nerve VII. The annual incidence is 20 to 30 per 100,000. Diagnosis is based on a thorough history and physical examination, with careful attention to exclude other causes of facial weakness, such as stroke or Lyme disease. ⋯ Physical therapy and Botox injections can help patients with persistent symptoms. The roles of surgery and acupuncture remain unclear. Close follow-up is warranted and patients without improvement should be referred to a specialist.
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About 85% of US adults with hearing loss have unmet hearing needs, creating significant individual and population effects on chronic conditions, socioeconomics, and quality of life. This article reviews the diagnosis and management of hearing loss, overcoming systemic barriers, resources in limited primary care settings, and a multidisciplinary approach.