Primary care
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This article reviews the commonly encountered agents causing acute inflammation of the pharynx and tonsils, with special attention to a practical approach for identifying and dealing with the group A beta-hemolytic streptococcus. Ubiquitous viral agents such as Epstein-Barr virus, rhinovirus, and adenovirus are reviewed. Some agents such as group A beta-hemolytic streptococcus and Epstein-Barr virus are susceptible to treatment. Additionally, unusual infectious agents and noninfectious causes of pharyngitis are enumerated.
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Persistent or chronic cough is defined as a cough lasting more than 3 weeks. A systematic approach to the diagnosis and treatment of chronic cough involves a detailed history. ⋯ When further investigation is necessary, a complete blood count, chest radiograph, and PPD are indicated. Additional testing is guided by findings in the history and physical examination to rule out the less common but more serious causes.
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The ankle, knee, hip, and shoulder are sites of frequent injuries for which clients will seek care from their physician, and this article briefly reviews the normal functions of these sites. Range-of-motion exercises for rehabilitation of these joints are introduced. An understanding of basic exercises for rehabilitation of common injuries occurring at the ankle, knee, hip, and shoulder will enhance the management of occurring problems.
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The role of humor in medicine is becoming increasingly apparent. Humor helps individuals narrow interpersonal and cultural gaps, communicate difficult messages, express frustration and anger, and cope with anxiety. Primary care providers need to be able to interpret humor used by patients and can learn to use humor to create a healing environment. This article reviews the roles played by humor in the doctor-patient relationship and provides a brief guide to using one's sense of humor to improve and enrich patient care.
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Cost-effectiveness and cost containment are becoming increasingly more important in medicine as health care costs continue to rise and as public attention continues to focus on these costs. This article examines the major issues and terminology of cost-effectiveness and cost containment in the context of primary care. A review of basic terminology and a quick reference glossary are included; relevant literature is reviewed. The goal of this article is to provide a beginning step for physicians to become more knowledgeable and enthusiastic participants in cost-effectiveness and cost-containment efforts.