Canadian family physician Médecin de famille canadien
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To assess counseling practices for gestational weight gain (GWG) among primary care providers (PCPs) at 2 clinics to identify barriers and potential health interventions for patients from diverse cultural backgrounds. ⋯ Healthy lifestyle in pregnancy is an important but underemphasized topic in antenatal care owing to barriers faced by patients and physicians, with unique socioeconomic considerations. This gap provides an opportunity to increase education of patients and providers and to develop patient-centred weight management interventions. By contrasting patient groups, our study reflected the importance of addressing social determinants of health in comprehensive care.
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A 2-year-old boy presented to my clinic after a caregiver witnessed him swallow a foreign body. The caregiver recalls seeing a small metallic object but is unsure exactly what was ingested. The child was asymptomatic upon examination. How should I identify and localize the foreign body? Do metal foreign bodies need to be removed endoscopically? ⋯ Foreign body ingestion is very common in children. Considerations must be made for the type of foreign body and site of impaction. A clear patient history and radiographs should be used to localize and identify the object. Handheld metal detectors can also be used to localize known metallic foreign bodies. Most metallic objects that pass the esophagus and reach the stomach will continue to pass without complication. Bowel perforation, sepsis, and even death have been documented in extremely rare cases of multiple magnets, button batteries, and long, angular, or 2-pointed sharp objects. These objects must be removed. Other metallic foreign bodies including coins and single magnets can be managed conservatively with stool monitoring.