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Spring 2026
An Osteopathic Perspective on the Mastitis Spectrum
Mastitis spectrum disorders include a variety of presentations, including engorgement, plugged ducts, mastitis, and abscess formation. Lactational mastitis is a common occurrence in lactation, affecting up to 10% of patients. Common risk factors include oversupply, nipple trauma, and ineffective la...
Preoperative Optimization in Surgical Patients
Preoperative optimization is a critical component in enhancing surgical outcomes and reducing postoperative complications. This review provides a comprehensive approach to managing preoperative care in a primary care setting, emphasizing the importance of risk assessment, patient education, and mul...
Managing Pediatric Asthma in Primary Care
Asthma is the most common chronic lung disease of childhood, affecting approximately 6 million children in the United States. Its pathophysiology involves airway hyperresponsiveness and inflammation, which can lead to intermittent or persistent respiratory symptoms such as coughing, wheezing, shortn...
Altitude Sickness
Altitude sickness encompasses conditions such as acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE), affecting individuals ascending to high altitudes without proper acclimatization....
Multidisciplinary Care Models for Managing Fibromyalgia
Fibromyalgia (FM) is a prevalent syndrome characterized by widespread chronic pain, fatigue, sleep disturbances, and cognitive difficulties. Diagnosis is primarily clinical, often involving exclusion of other conditions. Effective management of FM requires a multidisciplinary approach that utilizes ...
Febrile Seizures
Febrile seizures are a common age-dependent phenomenon that affects up to 5% of children in the United States, typically between 6 months and 5 years of age. These seizures are triggered by a rapid increase in body temperature, most often due to an underlying viral illness. Febrile seizures typ...
From Previous IssuesView all issues
Why Family Medicine Matters Now More Than Ever
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What Is Sjögren's Syndrome?
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Vitamin C, Topical Retinoids, and Sunscreen in Clinical Practice
The field of skincare has been rapidly evolving, making it harder to navigate the plethora of products and trends. Vitamin C, topical retinoids, and sunscreen effectively prevent and combat the effects of photoaging with sunscreen being the most crucial product for daily use. Daily application of a ...
Vegetarian Education in Type 2 Diabetes Prevention
Past iterations of the Diabetes Prevention Program (DPP) have demonstrated success in reducing the risk of developing type 2 diabetes in high-risk individuals, including studies that focused on low-carbohydrate or ketogenic approaches. The program emphasizes dietary modifications, phy...
Vaccines and Knowledge: Silent Guardians Against HPV
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Understanding Childhood Cancers
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Understanding Carpal Tunnel Syndrome
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The Galbreath Osteopathic Manipulative Treatment and Prompt Recovery from a Case of Acute Otitis Media
A 5-year-old presented to urgent care with a 3-day history of fever with a tympanic Tmax of 102°F. Laboratory studies revealed positive results for Influenza B and negative for COVID. Physical examination revealed a left erythematous tympanic membrane with bulging and decreased motion. The patient w...
Support and Dedication: Our Professional Family Values
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Sunscreen Utilization and Protection
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Seasonal Affective Disorder
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Rotator Cuff Injuries
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Resolution of Chronic Coccydynia After Osteopathic Manipulative Treatment
Coccydynia is characterized by pain or discomfort in the coccyx region, most frequently caused by direct trauma. This condition, exacerbated by sitting on flat or hard surfaces, may cause immobility and adversely impact activities of daily living. Standard treatment options include ergonom...
Renal Cell Carcinoma from Screening to Surveillance
Renal cell carcinoma (RCC) is the most common type of renal cancer, and it is usually found incidentally in asymptomatic individuals. Despite an increase in prevalence, RCC mortality has improved. Advancements have been made over the years in diagnostic and treatment modalities and screeni...
Relationship Between Vitamin K Refusal and Refusal of Other Newborn Interventions
Infants are born with low levels of vitamin K, placing them at risk for vitamin K deficiency bleeding (VKDB). To prevent this, the American Academy of Pediatrics recommends intramuscular (IM) vitamin K for all newborns. However, parental refusal of this and other standard newborn interventions is in...
Rare and Recurrent Tendon Ruptures in the Context of Long-term Statin Therapy
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Preparing for the Challenges and Opportunities Ahead
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Preparing for the Challenges and Opportunities Ahead
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Patient Engagement in Type 2 Diabetes: Are We There Yet?
Objective: Provide clinical recommendations to help patients engage in type 2 diabetes mellitus (T2DM) self-careMethods: Review current literature to understand patient engagement (PE) and utilize case examples to demonstrate PE in common scenarios regarding diabetes self-care.Results: T2DM is ...
Past Presidents Spotlight: Winter 2024
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Osteopathic Manipulative Treatment of Chronic Pain and Emotional Trauma
Depression and anxiety symptoms have a profound impact on a person’s life, affecting their emotional well-being, relationships, and overall quality of life long-term. This case study presents a patient who suffered from persistent neck pain, depression, and anxiety for 9 months following a traumatic...
Osteopathic Consideration of Pelvic Girdle Pain in the Postpartum Patient: A Case Study
Pelvic girdle pain (PGP) during and after pregnancy can present diagnostic and therapeutic challenges. In our case, a 31-year-old Asian American woman developed PGP and lower back pain that was not relieved 3 months’ postpartum. She was treated with over-the-counter analgesics and physical therapy f...
Orthopedic Hip Injuries Encountered in the Primary Care Setting
Hip pain and disorders are commonly seen in adults and children in the primary care setting. Primary care physicians can manage many of these disorders through physical examinations and basic radiographs, but some may pose a challenge requiring advanced imaging and specialist interventio...
Opioid Use in the Elderly
Chronic noncancer pain presents a significant challenge worldwide, particularly among the elderly population, where concerns of polypharmacy and additional morbidity and mortality risks exist. When nonopioid treatment approaches are deemed ineffective, the decision to use opioids requires a careful ...
Obesity Management in Primary Care
Background: This collaboration from the Obesity Medicine Association (OMA) and ACOFP examines obesity management from a primary care perspective.Methods: This joint perspective is based on scientific evidence, clinical experience of the authors, and peer review by OMA and ACOFP leadership. The goal ...
Newborn Rash: Distinguishing Benign vs Pathological Skin Lesions
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Nephrolithiasis, or Kidney Stones
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Masculinizing Gender-Affirming Hormone Treatment (GAHT) in Adults
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Managing Common Gynecologic Disorders
Polycystic ovary syndrome (PCOS), endometriosis, and uterine fibroids are highly prevalent gynecologic conditions that often lead to pelvic pain, menstrual irregularities, and infertility. While standard treatment relies on hormonal therapy and surgery, there is growing interest in integrative, nonp...
Management of Chronic Respiratory Diseases
Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) are common throughout the world and cause a great deal of morbidity and mortality. Acute exacerbations can result in missed work, hospitalizations, and sometimes death. This review will discuss the epidemiol...
Management of Binge Eating Disorder
Binge eating disorder (BED) is a mental health condition characterized by recurrent episodes of consuming large amounts of food, in the absence of the compensatory behaviors seen in bulimia nervosa. Patients with BED often first present to primary care physicians (PCPs), who play a pivotal role in d...
Long-term Mucosal Scarring in Non-IBD Colitis Mimicking IBD
Colitis is an inflammatory condition of the colon commonly associated with inflammatory bowel disease (IBD). However, non-IBD colitis can also present similarly, often resulting from medications or ischemia leading to chronic symptoms as well as diagnostic challenges. The literature on non-IBD colit...
Ketogenic Diet and Its Applications in Ehlers-Danlos Syndrome
Ehlers-Danlos syndrome (EDS) encompasses a group of hereditary connective tissue disorders characterized by abnormal collagen structure and function. Common comorbid conditions include mast cell activation syndrome, dysautonomia, and cardiovascular abnormalities. This paper examines potential benefi...
Integrating Behavioral Health and Primary Care
Osteopathic family physicians embody the philosophy of whole-person care, including using a biopsychosocial approach to incorporate mental health into patient care. The creation of the Behavioral Health Integration Collaborative increased support for a system-level adoption of whole-pers...
Injection Options for the Treatment of Trigger Finger: A Review of Current Literature
Introduction: Stenosing tenosynovitis of the flexor tendon, more commonly known as trigger finger (TF), is an ailment characterized by inflammation of the A1 pulley. This inflammation can eventually lead to pain and the inability to manipulate the digit. While surgical release is considered the gold...
Ingested Foreign Body in a 2-Year-Old Boy
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Human Parechovirus Meningoencephalitis In an Eight-Day-Old Infant
Human parechovirus (HPeV) infections have been increasing in the United States since May 2022, according to the Centers for Disease Control and Prevention. HPeVs are a member of the Picornaviridae family and share similarities with enteroviruses, though they differ in genomic structure. ...
Human Papillomavirus
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How to Use Your Inhaler
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Histiocytic Sarcoma
Histiocytic sarcoma is a rare and frequently missed diagnosis. With unusual and varied presentations, it typically indicates a rapid patient decline and poor outcomes. The diagnosis requires a high degree of clinical suspicion. In this case, we explore the progression of illness in a 56-...
High Blood Pressure and Screening
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Grounded in Science, United in Osteopathic Spirit
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Food Insecurity
Introduction: Food and nutrition insecurity, characterized by limited or uncertain access to sufficient and affordable nutritious foods, is an economic and social condition at the individual, household, and neighborhood levels that poses a significant public health issue. Health impacts of food inse...
Evaluating Guidelines for Tobacco Cessation in Pregnancy
Background: Smoking is the most important preventable cause of adverse outcomes in pregnancy;however, most smokers who become pregnant continue to smoke and/or relapse following delivery.The identification of patients at risk can be challenging, and the treatment options available can benebulous, in...
Cultivating Connection to Combat Isolation and Burnout
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Considerations for the Guidelines of Chronic Venous Insufficiency in Older Individuals
Chronic venous insufficiency is a common condition categorized by ever-increasing incidence, prevalence, and recurrence, despite treatment. Older individuals (adults 65 years of age and older) are most affected in terms of diagnosis and severity. Guidelines discussed include disease characterization...
Considerations for an Osteopathic Approach to Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic autoimmune disorder that primarily affects the joints. The condition causes inflammation, pain, stiffness, and sometimes deformity in the affected joints. RA can also affect other parts of the body, including the lungs, heart, and eyes, and it can lead to long-...
Common Orthopedic Hand and Wrist Diagnoses Encountered in the Primary Care Setting
Primary care physicians are crucial in diagnosing and managing hand and wrist pain. As the first point of contact for patients, primary care physicians develop individualized treatment plans, which may involve prescribing medications, recommending physical therapy, providing joint inject...
Common Childhood Sleep Disorders and the Role of Osteopathic Manipulative Treatment
Sleep is crucial for normal, healthy development in childhood. Consistent, high-quality sleep regimens lead to better overall health outcomes, such as enhanced focus, behavior, learning, memory, emotional control, and overall mental and physical well-being. In contrast, poor, minimal, and irregular ...
Colorectal Cancer Screening Recommendations
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Colorectal Cancer Guide for Family Physicians
Colorectal cancer is a leading cause of morbidity and mortality in the United States. Family physicians play an integral role in educating patients about the current screening recommendations and modalities of available screening to improve early detection and allow treatment at its earl...
Chronic Pelvic Pain in Females
Chronic pelvic pain (CPP) is a debilitating condition that significantly impacts the quality of life of females. It is defined as pelvic pain lasting at least 6 months or longer, and stems from multiple etiologies, including gynecologic, gastrointestinal, urologic, musculoskeletal, neurologic, and p...
Chronic Limb-Threatening Ischemia
Chronic limb-threatening ischemia (CLTI) is an advanced form of peripheral vascular disease with high rates of morbidity and mortality. Patients often present with claudication, impaired walking, and ischemic pain. Screening for CLTI and peripheral arterial disease is recommended with an...
Childhood Obesity: Updates on Current Treatments
Rates of obesity among adults and children in the United States have been on the rise for decades and continue to increase based on recent studies. This is due to a combination of individual, environmental, and socioeconomic factors. Most recent studies indicate that 19.7%, or approximately 14.7 mil...
Charting the Future Together
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Cervical Cancer Screening
The annual rate of cervical cancer death has been in slow decline in part due to the broad implementation of screening technology. This annual death rate is also affected by risk factor exposure and discovery of new treatments. While the current rate, 2.2 deaths in 100,000 women, is the lowest recor...
Cervical Cancer Screening
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Celebrating Success: Osteopathic Physicians’ Journey From Match Day to Healthcare Leadership
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Causes, Symptoms, and Management of Sleep Apnea
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Caring For Your Health: Understanding Ovarian Cancer and Its Early Signs
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Caring for Transgender Persons
Individuals who identify as transgender (TGD) who are taking gender-affirming hormone therapies (GAHT) may experience physiologic changes that impact the interpretation of laboratory results, diagnostic tools, and risk calculations. This review provides guidance for healthcare practitioners on navig...
Care Guide for Hygiene of Uncircumcised Boys
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Brief Review of Fibromyalgia
Fibromyalgia (FM) is a prevalent condition characterized by widespread musculoskeletal pain, often accompanied by fatigue, cognitive difficulties, mental health symptoms, sleep problems, and various other physical complaints. Current research refers to FM as dysfunction of pain processing in the cen...
Breast Cancer Screening Guidelines
Correction: Updated Breast Cancer Screening Guidelines Patient Education HandoutWe thank our readers for identifying that the previously published Patient Education Handout (PEH) for Breast Cancer Screening Guidelines contained outdated standards of care.The relevant guidelines were updated after th...
Breast Cancer Screening Guidelines
Correction: Updated Breast Cancer Screening Guidelines Patient Education HandoutWe thank our readers for identifying that this Patient Education Handout (PEH) for Breast Cancer Screening Guidelines contained outdated standards of care. The relevant guidelines were updated after the PEH’s accept...
Breast Abscess After Reoccurring Lactation-Associated Mastitis
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Atypical Case of Acute Kidney Injury Due to Clindamycin Use in a Child
Acute kidney injury (AKI) is commonly caused by medications including, but not limited to, aminoglycosides, cephalosporins, penicillins, trimethoprim-sulfamethoxazole, and amphotericin. Among pediatric patients, clindamycin has been widely used to treat skin and soft-tissue infections, abscesses, os...
Approaches to Diagnosing and Treating Common Hair Loss Conditions
Hair loss impacts both physical appearance and psychosocial well-being. It necessitates a compassionate and comprehensive approach to diagnosis and treatment. This narrative review presents current evidence on the most common nonscarring alopecias, i.e. androgenetic alopecia (AGA), alopecia areata (...
Application Of Osteopathic Treatment for Non-Pain–Related Discomforts of Pregnancy
Many osteopathic textbooks include treatment modalities and techniques that could improve frequently experienced ailments of pregnancy, such as nausea, vomiting, gastroesophageal reflux disease, constipation, and edema. However, there is little scientific evidence to support the use of o...
Apathetic Hyperthyroidism as an Adverse Effect of Amiodarone for the Treatment of New-Onset Atrial Fibrillation for the Primary Care Physician
Amiodarone is the most used anti-arrhythmic drug worldwide.1 Its effectiveness for the treatment of multiple arrhythmias including atrial fibrillation, supraventricular tachycardia, and ventricular tachycardia is well documented.2 Older adults, however, are especially prone to adverse drug effects; ...
ADHD in the Family Medicine Setting
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental phenomenon commonly presented to the primary care physician for diagnosis and treatment. The primary care physician has the capability to diagnose ADHD and should remain well-informed in the current body of literature regarding ...
Addressing Infertility and Other Reproductive Outcomes Among Female Physicians
Infertility affects one in four female physicians in the United States, yet the topic of fertility among female physicians is understudied and warrants focused strategies to implement change. Factors that exacerbate the rates of infertility in female physicians include intentional delays...
Abuse of Older People
Abuse of older people, also known as elder abuse, occurs when there is harm or distress to older adults from an action or lack of action by an individual expected to be trusted. Abuse of older people comes in different forms including physical abuse, psychological or emotional abuse, sexual abuse, f...
Abdominal Pain and Splenomegaly
This is a case study regarding a 37-year-old male with no significant medical history who presented with progressive, nonradiating, bilateral abdominal discomfort. The patient noted a tender hot spot in his left lower quadrant. Review of symptoms revealed unintentional weight loss of 20 pounds and g...
A Year of Legacy Milestones
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2023: A Memorable Year, an Artistic Outlook
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