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Waldenström macroglobulinemia is a rare disorder affecting about 1400 people annually in the United States. This case report reviews from a primary care provider's perspective the initial presentation of a patient who complained of fatigue and dizziness that ultimately led to hospital admission with a diagnosis of Waldenström macroglobulinemia. The referral to hematology/oncology prompting the bone marrow biopsy that led to the diagnosis highlights the important role of the primary care provider in the initial workup, coordination among specialists, and overall management of patients with rare disorders. [ABSTRACT FROM AUTHOR]

The authors examined the responses of 63 primary care physicians to diabetes clinical protocols (DCPs) for the management of type II diabetes (T2DM). We measured physician demographics, current diabetes patient loads, and responses to DCPs (physician attitudes, physician familiarity, and physician recommendation of DCPs) using a 20-question electronic survey. Results of the survey indicate that primary care physicians may be unfamiliar with the benefits of diabetes clinical protocols for the self-management of T2DM. Given the importance of diabetes self-management education in controlling T2DM, those interested in implementing DCPs should address the beliefs and attitudes of primary care physicians. [ABSTRACT FROM AUTHOR]

A previously healthy 3-month-old girl was admitted to the hospital after 1 day of fever, decreased oral intake, irritability, lethargy, and decreased activity. Examination disclosed a bulging anterior fontanelle, tachycardia (heart rate of 160 beats/minute), and urate crystals in her diaper. Lumbar puncture revealed meningitis. She was treated with broad-spectrum antibiotics and fluids. A urine culture was negative, but blood and cerebrospinal fluid cultures came back positive for Salmonella species, nontyphoid. During her hospitalization, she developed seizures but quickly improved with treatment and made a complete recovery with no sequela. Additional inquiry disclosed that the baby spent several days a week at her grandparents' house, where they raised chickens and ate fresh chicken eggs, which are well-known carriers for Salmonella. [ABSTRACT FROM AUTHOR]

Dabigatran, a new oral anticoagulant, is a direct thrombin inhibitor used as an alternative to warfarin to reduce the risk of stroke and systemic embolism with nonvalvular atrial fibrillation. We report a case of a man who resumed dabigatran after 6 weeks of prior therapy and began experiencing hematuria with worsening kidney function. Renal biopsy with immunofluorescence and electron microscopy showed mesangial deposits consistent with immunoglobulin A nephropathy. With discontinuation of dabigatran and addition of methylprednisolone, the gross hematuria cleared and urine output improved. [ABSTRACT FROM AUTHOR]

Choledocholithiasis has been found in about 5% to 20% of the approximately 20 million Americans with cholelithiasis who have undergone cholecystectomy. We report a case of a 64-year-old woman who developed gallstones after undergoing a cholecystectomy >40 years earlier. The potential of retained gallstones, incomplete gallbladder removal, or regeneration of gallstones in the gallbladder remnant or cystic duct remnant after a long time following cholecystectomy is discussed. [ABSTRACT FROM AUTHOR]

A 72-year-old woman with a prior history of stage IIIa lung adenocarcinoma was seen with complaints of knee pain, swelling, and difficulty sleeping at night for 1 month. Although mimicking osteoarthritis, patellofemoral syndrome, and iliotibial band syndrome, radiographs showed a lytic lesion suspicious for metastatic disease. The right tibial lesion was excised, saphenous neurolysis was performed, and radiation treatment and four cycles of chemotherapy were administered. This case shows the importance of early imaging in patients with knee pain of prolonged duration seen in the primary care setting. [ABSTRACT FROM AUTHOR]

Steroid-induced psychosis is a well-documented phenomenon. It usually occurs with oral systemic steroid treatment and is more common at higher doses, although there are case reports of occurrence with local steroid injections. We report a case of a 35-year-old man with no previous history of psychosis who was seen for follow-up after a brief psychotic episode following an injection of 5 mg of dexamethasone into his scrotum the previous day. The injection was given to treat chronic pain from a combat injury. [ABSTRACT FROM AUTHOR]

The article offers information on the safety injury interventions devices such as using of seat belt. Topics discussed observational survey of seat belt use by vehicle occupants; findings of the prevalence of homes with inadequate smoke alarm protection from residential fires; and information on the helmet use as successful safety device.

An editorial is presented on the dangers associated with the use of mobile phones while walking or driving which can result in injuries. It talks about the use of mobiles on the road can be dangerous for the passers-by and also for the motorists. It tells about the use of social media while crossing the road, watching videos or clicking pictures.

An introduction is presented in which the editor discusses articles in the issue on topics including geographical information systems; analytical methods to inform injury control; and the joinpoint regression analytical method to evaluate traffic public health policies in Chile.

An introduction is presented in which the editor discusses various reports within the issue on topics including epidemiology of drowning to safety education around bodies of water; drowning burden in lakeside districts of Uganda; and drowning preventive efforts on other age groups.

An introduction to the journal is presented in which the editor discusses the report on the knowledge, attitudes, and practices of healthcare professionals on childhood unintentional injuries in Cairo, Egypt.

The author reflects on how the various methods available for the estimation of injury rates and risks from existing databases are limited by methodological and data quality issue. He references an article by R. Alexandrescu, SJ O'Brien and FE Lecky where they took a critical examination of the methodological approaches in the measurement of injury incident rates and recommended for the development of new methodological approaches to constructing or estimating injury rates.

The author reflects on the impact of improvement in poison prevention in reducing the rates of childhood unintentional poisoning. He mentions the systematic reviews of primary studies about the occurrence of childhood poisoning in home. It says that potential increase on risk of childhood poisoning happens at the age of one to three years old. The author provides suggestions on how to prevent poisoning.

The article offers information on the Safety 2016 World Injury Conference which will be held in Tampere, Finland.

An introduction is presented in which the editor discusses various reports within the issue on topics including children's injuries sustained from outdoor activities, the epidemiology of unintentional child injuries in the South East Asia Region, and paediatric head injuries.

An introduction is presented in which the editor discusses reports within the issue on topics including identification of child abuse in emergency department (ED) in Australia, substance use in ED in South Africa, and snowboarders injured in a terrain park and presented to an ED in Alberta, Canada.