Musculoskeletal Medicine and Pain
John J. Dougherty, DO, MBA, FACOFP, FAOASM, FAODME; Anthony C. Medina, ATC; John J. Dougherty, BS; and Caleb J. Hoover, DO, MEd
Gitelman syndrome is an inherited renal salt wasting tubulopathy caused by variants in SLC12A3 and classically associated with hypokalemic metabolic alkalosis, hypomagnesemia, and hypocalciuria. This report describes an 18-year-old professional baseball player with an approximately 6-month history of recurrent, exertional muscle cramping, fatigue, and profuse sweating that persisted despite hydration and commercial electrolyte supplementation.
Public Health and Primary Care
Rebecca Delp, BS; and Erik Langenau, DO, MS, MAPP
Firearm-related injury and suicide represent a critical public health challenge in the United States, with older adults experiencing the highest rates of firearm suicide. Despite high household firearm access and unsecured storage, standardized screening and counseling in primary care remain underutilized. Primary care physicians are uniquely positioned to identify clinically vulnerable patients and evaluate lethal means safety through longitudinal relationships during routine encounters. This Clinical Practice report presents an evidence-based framework for firearm suicide risk assessment, clinical communication, and safe storage counseling tailored to older adults.
Public Health and Primary Care
Vijay Joshi, MD; Shreepriya Mangalgi, MD; Kunal Chaudhary, MD; and Adam Whaley-Connell, DO
Rates of treatment-resistant hypertension in the United States are increasing despite our better understanding of underlying mechanisms, lifestyle and pharmacologic approaches, and with refinement of treatment goals. This article reviews current definitions of treatment resistance, pseudo-resistance, and refractory hypertension, and discusses patient- and provider-related factors that influence resistance, facilitating a more holistic approach to care.
