Data from pivotal international phase III clinical trials showed superior efficacy, safety, and convenience for a new wave of direct-acting oral agents. The breakthrough will benefit physicians in all practice settings, including primary care.

Here: strategies for making the exam more comfortable and efficient, and tips for using topical anesthetics, removing earwax, extracting a plantar foreign body, and approaching the Dx of appendicitis.

The “take home” from this presentation: be cautious with inappropriate use of drugs with or without black box warnings, but maintain a healthy skepticism about some of these warnings. Cases in point: droperidol, antidepressants, clindamycin.

A presentation on October 14, 2013, at the American College of Gastroenterology Scientific Session by Joseph A. Murray, MD, FACG  (Mayo Clinic)Murray JA. Implications of gluten intolerance and celiac disease in IBS.  

Constipation is often treated as a simple functional disorder that responds well to improvements in diet, hydration, and exercise. That's not what happened to this young patient . . .

What accounts for the 129% increase in admissions for constipation over the past decade-and what can be done to avoid these expensive and often unnecessary admissions? Primary care clinicians take note.

This presentation at the ACG Scientific Meeting provided the requisite research-oriented material but an equal amount of practical information that will be useful for the general internist, family physician, DO, and primary care physician.

An IDWeek 2013 poster presentation quantified clinician fatigue with the finding that Boston-area primary care physicians were more likely to prescribe antibiotics for ARIs at the end of the day than when they were fresh on the job in the morning.

Broad-spectrum antibiotics offer no advantage over guideline-recommended agents, even against severe community-acquired pneumonia.

English- and Spanish-speaking parents cited widely differing reasons for avoiding vaccination for their eligible daughters or failing to ensure the 3 doses were received.

In hospitalized HIV patients, medication errors are common and can be mitigated by enlisting ID specialists.

The norovirus vaccine, while not preventive of all disease, does significantly reduce the severity of symptoms.

Clostridium difficile colitis can be cured by having patients swallow capsules brimming with other people’s concentrated stool. Inexpensive, effective, and readily available. This could be an enormous opportunity for primary care (if the FDA approves it).

This is an opportunity for primary care to help avert a public health catastrophe. Physicians need to take ownership over this issue and demand more time for URI patients-E&M criteria do not capture what is lost when these visits are viewed simply as “Level 2 Office Visit, CPT 99212.”

Most parents of boys aged 9 to 18 years do not know that an HPV vaccine is available for their sons. One major factor is a lack of information. This is where you play a vital role.

“STD organisms are all part of an ecological pool that simply share one thing in common: sex," says the author of a new study. Testing for all important STD pathogens is the only way to detect all agents that might be involved in both symptomatic and asymptomatic patients. Details here.

Fundic gland polyps are the most common form of gastric polyps. Giant FGPs, however, are extremely rare.

At the ASH meeting, one could get a pretty good sense of where the beta-blocker hypertension debate is headed.

The number of people who require 2 or more antihypertensives to reach target blood pressure is on the increase. So, simply stated, what goes best with what? The 2013 ASH meeting offered some good suggestions under the heading of “Within Class Differences.”

Recurrent C difficile requires pulse vancomycin therapy; fecal microbiota transplant shows promise.