physicians

Approach to pelvic venous disorders

Author/s: 
Andrew D Brown

Objective: To provide a practical guide to help family physicians recognize, diagnose, and manage patients with pelvic venous disorders (PeVDs), often overlooked as causes of chronic pelvic pain and varicose veins.

Sources of information: This review is based on guidelines from the American Venous Forum, the Society for Vascular Surgery, the American Vein and Lymphatic Society, the Society of Interventional Radiology, and the European Society for Vascular Surgery.

Main message: PeVDs are common, though frequently misdiagnosed, causes of chronic pelvic pain and varicose veins predominantly in female patients. These conditions arise from venous reflux or obstruction, which can cause varicose veins and venous hypertension in the renal hilum, pelvis, perineum, and lower extremities. Family physicians should recognize the clinical signs of PeVDs and use appropriate imaging to confirm diagnoses. Interventional treatments, including embolization and stenting, are effective for symptom management and improving patient outcomes.

Conclusion: Early recognition of patients with PeVDs by family physicians is crucial for timely and effective treatment. By using appropriate diagnostic tools and making timely referrals, physicians can substantially improve patients' quality of life.

Antibody Response Following SARS-CoV-2 Infection and Implications for Immunity: A Rapid Living Review

Author/s: 
Mackey, K., Arkhipova-Jenkins, I., Armstrong, C., Gean, E., Anderson, J., Paynter, R. A., Helfand, M.

The aims of this rapid systematic review are to synthesize evidence on the prevalence, levels, and durability of the antibody response to SARS-CoV-2 infection among adults and how antibodies correlate with protective immunity. Given the rapidly evolving evidence within this field, the Agency for Healthcare Research and Quality’s Evidence-based Practice Center (AHRQ EPC) Program will maintain this report as a living review with planned ongoing literature surveillance and critical appraisal. We will provide regular report updates as additional evidence becomes available, modifying the scope of the review as new directions in SARS-CoV-2 immunity research emerge. This review was conducted in coordination with the American College of Physicians (ACP) as part of AHRQ’s standing work to provide health professional organizations and systems with evidence reviews to support the development of clinical guidance for their clinician members.

Preventing Firearm-Related Death and Injury

Author/s: 
Pallin, R., Spitzer, S.A., Ranney, M.L., Betz, M.E., Wintemute, G.J.

Deaths and injuries from firearms are significant public health problems, and clinicians are in a unique position to identify risk among their patients and discuss the importance of safe firearm practices. Although clinicians may be ill-prepared to engage in such discussions, an adequate body of evidence is available for support, and patients are generally receptive to this type of discussion with their physician. Here, we provide an overview of existing research and recommended strategies for counseling and intervention to reduce firearm-related death and injury.

Guide to Enhancing Referrals and Consultations Between Physicians

Access to care is a challenge for many of our patients. The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (Royal College) recognize that every possible measure must be taken to help ensure access to timely and quality medical and other health care service.
As part of ongoing efforts, the CFPC and the Royal College released a conjoint paper in 2006, to address the issue of intra-professional relationships between physiciansi. This paper identifies a number of issues and recommendations to improve patient care and professional satisfaction. The referral-consultation process is chief among the areas addressed in follow up to this conjoint paper.
There is growing knowledge and many new approaches developing in various regions of the country to improve the referral-consultation processes of care between referring and consulting physicians.
This guide on enhancing referrals and consultations between physicians is not intended to replace instruments already in place. It is complementary and may also help fill gaps where there are few or no tools in place to support good referrals and consultations, both within as well as between community and hospital settings. It is hoped that physicians will find this reference to be a valuable addition to practice.

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