Osteopathic Family Physician 2018-01-05T07:58:34-08:00 Belinda Bombei Open Journal Systems <p><em>Osteopathic Family Physician&nbsp;</em>is the ACOFP’s official peer-reviewed journal. The bi-monthly publication features original research, case reports and articles about&nbsp;preventive medicine, managed care, osteopathic principles and practices, pain management, public health, medical education and practice management.</p> Winter is a Great Time for CME 2018-01-05T07:58:31-08:00 Amy J. Keenum ##submission.copyrightStatement## Leaning Into the Winds of Change Swirling Around Osteopathic Medicine 2018-01-05T07:58:31-08:00 Rodney M. Wiseman, DO, FACOFP dist. _ ##submission.copyrightStatement## Aortic Aneurysms: Clinical Guidelines for Primary Care Physicians 2018-01-05T07:58:31-08:00 Jordan E. Wong, BS, OMS I Peter Zajac, DO, FACOFP <p class="p1">Aortic aneurysms (AA) are permanent, localized abnormal dilation of the wall of the aorta, the largest artery in the body, occurring as a result of medial degeneration of the arterial wall, generally, as a result of increased aortic hypertension or genetic predisposition. Risk factors for AAs are similar to those of other cardiovascular diseases. Tobacco use is strongly associated with aneurysm formation and dilation, and patients diagnosed with AA should be advised to stop smoking. An abdominal aorta with a diameter greater than 3.00 cm is generally considered aneurysmal. By convention, a thoracic aorta with a diameter greater than 4.50 cm is generally considered aneurysmal. No specific laboratory tests exist to diagnose an AA, and testing should be ordered supplementary to imaging studies. Dedicated imaging studies offer definitive identification or exclusion of potential AAs, but the imaging modality used is largely dependent upon patient-related factors. Patients with small aneurysms may be candidates for medical management, however, any patient with an aortic diameter greater than 5.00 - 5.50 cm should be referred for immediate surgical consultation. With the majority of AAs asymptomatic prior to rupture, it is important that primary care physicians understand how to properly evaluate and diagnose patients at risk for developing an AA as well as the short and long-term management of patients diagnosed with an AA.</p> ##submission.copyrightStatement## Giant Cell Arteritis 2018-01-05T07:58:32-08:00 Leonid Skorin, Jr., DO, OD, MS, FAAO, FAOCO Rebecca Lange, OD <p class="p1">Giant cell arteritis, also known as temporal arteritis, is a condition that can present in patients with a headache, scalp tenderness, anemia, jaw claudication, diplopia or sudden severe vision loss. The main differential diagnosis is non-arteritic anterior ischemic optic neuropathy. Upon suspected diagnosis of giant cell arteritis, laboratory workup for erythrocyte sedimentation rate, C-reactive protein, and complete blood count are performed. A temporal artery biopsy serves as confirmatory evidence of the disease. The immediate treatment for suspected giant cell arteritis is systemic steroids. This article will review giant cell arteritis, its pathophysiology, patient symptomatology, differential diagnosis, and treatment. Included in this review will be a video of a temporal artery biopsy.</p> ##submission.copyrightStatement## Paronychia 2018-01-05T07:58:32-08:00 Korinn Vandervall, OMS III Mary Ann Yehl, DO Lindsay Tjiattas-Saleski, DO, MBA, FACOEP <p class="p1">A 73-year-old female with past a medical history of diabetes mellitus type II, hypertension and thyroid disease presented to the Urgent Care Center with right distal thumb pain and swelling (Figure 1). She had been seen two days prior, diagnosed with paronychia and prescribed cephalexin 500mg three times daily. She reported no improvement in the antibiotics and warm soaks. She did not report any associated fevers or chills. On her second visit, incision and drainage were performed. She discontinued cephalexin, and trimethoprim/sulfamethoxazole was started.</p> ##submission.copyrightStatement## Traumatic Eye Injury in a 14-Year-Old Male 2018-01-05T07:58:32-08:00 Lisa J. Hrushka, OMS IV Eric S. Wernsman, DO, FACOEP <p class="p1">A 14-year-old caucasian male presents to the emergency department after being struck by a baseball to the left side of his face. The patient reports that while playing the outfield, he was hit by a line drive to the eye after losing the ball in the sun. He denies wearing glasses or contacts at the time of the injury. He complains of left eye pain and blurry vision but denies loss of consciousness or loss of vision after the accident. He also denies any nausea or vomiting. The patient describes his pain as throbbing which is made worse by eye-opening and bright lights. The patient has no other reported medical history<span class="s1">.</span></p> ##submission.copyrightStatement## Patients & Doctors - Facebook Friends? 2018-01-05T07:58:33-08:00 Bernadette Riley, DO, FACOFP, FILM _ ##submission.copyrightStatement## AORTIC ANEURYSMS 2018-01-05T07:58:33-08:00 Malathi Amarnath, DO Sandra Carnahan, DO Gabrielle Koczab, DO <p class="p1">The aorta is the main blood vessel that carries blood from the heart to all the arteries in the body. It travels down the back of the chest and abdomen and then branches into two large arteries by the hips. An aneurysm is a stretch or bulge in the vessel that is caused by long-term vessel wall damage. There are multiple ways to damage vessels including smoking, elevated blood pressure, and elevated cholesterol. An aortic aneurysm usually does not have symptoms, but it can tear and cause severe chest and back pain, significant internal bleeding and even death. Fortunately, there are ways to prevent this from happening. Stopping smoking, controlling your blood pressure and cholesterol will help reduce risks. Your physician may get a screening ultrasound to check on the blood vessels.</p> ##submission.copyrightStatement## SPORTS RELATED EYE INJURIES 2018-01-05T07:58:33-08:00 Ante T. Pletikosic, DO Louis Leone, DO, FAOASM <p class="p1">Many people experience sports and recreation-related eye injuries each year. In fact, the number is estimated to be around 100,000 with approximately 42,000 going to the ER for treatment. Sports-related injuries cause over 13,000 people to go blind yearly and is the leading cause of blindness in children in the United States. Sports can have a low, high, and very high risk of eye injury. Low-risk sports do not use a ball, puck, bat, stick, and do not involve body contact. Some include swimming, gymnastics, and cycling. High-risk sports involve what low-risk sports do not and include sports such as baseball, basketball, hockey, football, lacrosse, tennis, and water polo. Very high risk does not use eye protectors and involve full body contact such as boxing, wrestling, and contact martial arts. Protective eyewear includes goggles and safety glasses, safety shields and eye guards designed for a particular sport. Most frequent injuries involve baseball, basketball and racquet sports. The good news is that about 90% of serious eye injuries are preventable by using appropriate protective eyewear.</p> ##submission.copyrightStatement## TREATMENT OF PARONYCHIA (NAIL INFECTIONS) 2018-01-05T07:58:33-08:00 Michael Majetich, DO Louis Leone, DO, FAOASM <p class="p1">Paronychia is a skin infection that occurs around a fingernail or toenail. It can be acute lasting less than six weeks or can be chronic and persist for more than six weeks. It is most likely to occur following a break in the skin, such as with trauma, nail-biting, and ingrown nails. It can also be more common in patients with diabetes, bad immune systems, poor circulation, or those who work with their hands in water a lot. Symptoms include pain, redness, swelling, and sometimes the development of a pus-filled blister. Your physician may get cultures to look for a specific bacterial infection. Treatments may include soaks in warm water, antibiotic use, cutting the pus pocket open, and sometimes even removal of the nail to help the pus drain. Depending on the extent of your infection, acute paronychia should clear within a few days to a few weeks.</p> ##submission.copyrightStatement##