Family

A review of relatively common chronic venous abnormalities in the female pelvis that can cause LE varicosities and pelvic pain. James W. Mold, MD, MPH

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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.

Author/s:

Andrew D Brown

Practical Recommendations for Minimizing Pain and Anxiety with IUD Insertion

Erin Blanchette — Mon, 24 Mar 2025 16:11:24 +0000

Date Added:

March 24, 2025

Journal/Publication:

Journal of the American Board of Family Medicine

Publisher:

American Board of Family Medicine

Publication Date:

November 1, 2024

Issue:

Volume:

Pages:

1150-1155

URL:

Practical Recommendations for Minimizing Pain and Anxiety with IUD Insertion

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3122/jabfm.2024.240079R1

Keywords

PMID (1):

40118554

MeSH

Intrauterine Devices* / adverse effects

Intrauterine Devices

female

Contraceptive Agents, Female

Pain / prevention & control

pain management

Lidocaine

Prilocaine Drug Combination

An evidence-based review of methods for reducing pain during IUD insertion. Many of these would probably work as well for other painful procedures. James W. Mold, MD, MPH

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Background: Intrauterine devices (IUDs) are one of the most effective, long-lasting, and convenient contraceptive methods available in the United States. Unfortunately, the anticipated pain and anxiety associated with an IUD insertion procedure deter many people from using this contraceptive method.

Methods: A literature review was conducted on PubMed by searching the terms “IUD insertion”, “pain management”, “anxiety”, “gynecologic procedures”. The Cochrane database was also searched for reviews about pain management methods during IUD insertions. Findings were summarized using the American Academy of Family Physicians’ Strength of Recommendation Taxonomy (SORT) scale.

Results: Pharmacologic methods that can be used to reduce pain with IUD insertion include naproxen, tramadol, lidocaine paracervical blocks, 10% lidocaine spray, lidocaine-prilocaine cream, and EMLA cream. Non-pharmacologic methods for reducing pain or anxiety during gynecologic procedures include pre-insertion counseling, “verbal analgesia”, lavender aromatherapy, distraction with music or television, using Valsalva maneuver instead of tenaculum during IUD insertion, and use of heating pad during procedure.

Conclusion: Moderately effective pharmacologic and non-pharmacologic methods exist for reducing pain and anxiety with IUD insertion. These treatment methods should be offered to create a more comfortable experience for patients. Additional research is needed to determine the comparative efficacy of these methods.

Author/s:

Viktoriya Ovsepyan, Petra Kelsey, Ann E Evensen

Pets Are Associated with Fewer Peer Problems and Emotional Symptoms, and Better Prosocial Behavior: Findings from the Longitudinal Study of Australian Children

Brian Desmarais — Wed, 22 Apr 2020 23:44:31 +0000

Date Added:

April 22, 2020

Journal/Publication:

Journal of Pediatrics

Publication Date:

February 21, 2020

URL:

Pets Are Associated with Fewer Peer Problems and Emotional Symptoms, and Better Prosocial Behavior: Findings from the Longitudinal Study of Australian Children

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.jpeds.2020.01.012.

Keywords

MeSH

Family Characteristics

social change

Surveys and Questionnaires

This study supports pet ownership to support healthy childhood development. James W. Mold, MD, MPH

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Abstract

OBJECTIVE:

To investigate the longitudinal association between pet ownership and children's social-emotionaldevelopment.

STUDY DESIGN:

Two time-points of data from the Longitudinal Study of Australian Children were analyzed for children at ages 5 (n = 4242) and 7 (n = 4431) years. The Strengths and Difficulties Questionnaire (SDQ) measured children's social-emotional development. Pet ownership status and type (dog, cat, other) as well as sociodemographic and other potential confounders were collected. Longitudinal panel regression models were used.

RESULTS:

Overall, 27% of children had abnormal scores on 1 or more SDQ scales. By age 7, 75% of children had pets with ownership highest in single-child households. Owning any type of pet was associated with decreased odds of abnormal scores for emotional symptoms (OR, 0.81; 95% CI, 0.67-0.99), peer problems (OR, 0.71; 95% CI, 0.60-0.84), and prosocial behavior (OR, 0.70; 95% CI, 0.38-0.70), compared with non-pet owners. Dog ownership was associated with decreased odds of abnormal scores on any of the SDQ scales (OR, 0.81; 95% CI, 0.71-0.93). For children without any siblings, only the prosocial behavior scale was significantly associated with pet ownership (OR, 0.21; 95% CI, 0.07-0.66). In longitudinal models, cat-only and dog-only groups were associated with feweremotional symptoms and peer problems compared with non-pet owners.

CONCLUSIONS:

Early school age is an important period for family pet acquisition. Pets may protect children from developing social-emotional problems and should be taken into account when assessing child development and school readiness. Children without siblings may benefit most in terms of their prosocial behavior.

Author/s:

Christian, H., Mitrou, F., Cunneen, R., Zubrick, S.R.

Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2020

Brian Desmarais — Tue, 04 Feb 2020 15:43:52 +0000

Date Added:

February 4, 2020

Journal/Publication:

Centers for Disease Control and Prevention

Publication Date:

January 1, 2020

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Web Page

MeSH

Immunization Schedule

2020 child and adolescent immunization schedules. James W. Mold, MD, MPH

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None available

Author/s:

Centers for Disease Control and Prevention

Recommended Adult Immunization Schedule, United States, 2020

Brian Desmarais — Tue, 04 Feb 2020 15:28:01 +0000

Date Added:

February 4, 2020

Journal/Publication:

Annals of Internal Medicine

Publication Date:

February 4, 2020

Volume:

Online

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M20-0046

Keywords

guidelines

adult immunization

MeSH

Immunization Schedule

Centers for Disease Control and Prevention

Centers for Medicare and Medicaid Services (U.S.)

Adults

2020 guidelines for adult immunizations with printable charts. James W. Mold, MD, MPH

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In October 2019, the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Adult Immunization Schedule for Ages 19 Years or Older, United States, 2020. The 2020 adult immunization schedule, available at www.cdc.gov/vaccines/schedules/hcp/imz/adult.html, summarizes ACIP recommendations in 2 tables and accompanying notes (Figure). The full ACIP recommendations for each vaccine are available at www.cdc.gov/vaccines/hcp/acip-recs/index.html. The 2020 schedule has also been approved by the director of the Centers for Disease Control and Prevention (CDC) and by the American College of Physicians (www.acponline.org), American Academy of Family Physicians (www.aafp.org), American College of Obstetricians and Gynecologists (www.acog.org), and American College of Nurse-Midwives (www.midwife.org).

Author/s:

Freedman, M., Kroger, A., Hunter, P., Ault, K.A.