Ecler Ercole Jaqua

Loma Linda University · Department of Family Medicine

Dementia and cognitive decline pose significant global public health challenges, with prevalence expected to rise in the coming decades. Lifestyle medicine offers a promising approach to mitigating cognitive issues through six key interventions: diet, physical activity, restorative sleep, social connections, stress management, and avoiding risky su...

Alzheimer disease is a progressive, neurodegenerative disorder characterized by the accumulation of amyloid beta plaques and hyperphosphorylated tau proteins. Alzheimer disease affects cognitive function, leading to memory loss and impairment in activities of daily living. Approximately 6.9 million people in the United States 65 years and older liv...

Background The escalating use of complementary and alternative medicine (CAM) raises concerns, particularly among geriatric patients taking multiple medications. Notably, the doubled chance of major drug interactions between prescription and over-the-counter (OTC) drugs in older adults underscores the need for further research. This study aimed to...

Lifestyle medicine, characterized by its evidence-based approach, recognizes the profound impact of lifestyle choices on overall health. The six pillars of lifestyle medicine encompass nutrition, physical activity, stress management, sleep, avoidance of risky substances, and social connections. While their significance in promoting general health i...

Introduction: COVID-19 vaccination hesitancy is prevalent in underserved communities, and family medicine clinics can combat hesitancy with vaccine education. However, due to general misinformation, physicians hesitate to educate patients because doing so can create conflict. Methods: A series of resident-run, team-based quality improvement proj...

Poor sleep negatively effects hormones that govern the food reward system and can interfere with weight-loss programs. Obesity in turn restricts sleep. Which treatments have shown promise?

Cryptorchidism refers to an undescended testicle, the most common genitourinary malformation in male children. It is diagnosed with history and physical examination findings, and primary care physicians play a key role in the early identification of the condition. Early surgical intervention reduces the risk of testicular cancer and preserves ferti...

Delirium is an acute disturbance in attention, cognition, and awareness that fluctuates over time. Delirium is characterized by three subtypes: hyperactive, hypoactive, and mixed. It occurs in 11% to 25% of older adults in inpatient settings and is associated with a significant financial burden. Older age, multiple comorbidities, recent surgery, an...

Hemoptysis is the expectoration of blood from the lower respiratory tract and has an extensive differential diagnosis that can be divided into pseudohemoptysis, infectious, neoplastic, vascular, autoimmune, and drug-related categories. Pseudohemoptysis is the expectoration of blood from a different source and needs to be ruled out. Clinical and hem...

Dyspnea is a common presenting symptom that may derive from pulmonary or extrapulmonary origins. Dyspnea may develop from exposure to drugs or environmental and occupational factors, so a thorough history and physical examination may help differentiate the cause. Chest x-ray followed by chest computed tomography scan if needed is recommended as the...

Wheezing is a common presenting concern in the primary care setting, but its etiology can be elusive. Wheezing is associated with many disease processes, but most commonly, asthma and chronic obstructive pulmonary disease. Initial tests for wheezing typically include a chest x-ray and pulmonary function testing with bronchodilator challenge. Advanc...

In adults, chronic cough is a nonproductive or productive cough lasting longer than 8 weeks. Coughing is a reflex to clear the lungs and airways, but repetitive, long-term coughing can cause chronic irritation and inflammation. Approximately 90% of chronic cough diagnoses have common nonmalignant etiologies, including upper airway cough syndrome, a...

Dementia is growing exponentially worldwide. Unfortunately, the treatment available does not reverse any type of cognitive impairment. As a result, healthcare professionals are focusing on other evidence-based options, such as lifestyle medicine (LM). Current evidence demonstrates improvement in neurocognitive decline by applying the six pillars of...

Geriatric practices will see more people living with human immunodeficiency virus (HIV), as their life expectancy is close to the general population due to effective antiretroviral therapy (ART). Geriatricians focus more on HIV-associated, non-acquired immunodeficiency syndrome (AIDS) disorders than HIV alone. We will review the most common chronic...

Sleep disorders in older adults increase with aging, likely due to increased sleep latency, decreased sleep efficiency, and total sleep time. Common sleep issues include chronic insomnia, circadian rhythm sleep-wake disorders, sleep-related movement disorders, and sleep-disordered breathing. Diagnostic tools, such as a comprehensive sleep history a...

Alzheimer's dementia (AD) is the most common major neurocognitive impairment and the fifth leading cause of death in older adults in the United States. The diagnosis is clinical; however, laboratory tests and imaging frequently rule out secondary causes of dementia. Unfortunately, the treatment available for AD does not reverse dementia, but it may...

Lightheadedness and dizziness are common chief complaints in a primary care clinic. These symptoms affect a person’s life in multiple ways and have a wide range of differential. We present a case of a teen female with these symptoms whom we diagnosed with having Wolff-Parkinson-White Syndrome, but we could not pinpoint whether this entirely caused...

At the beginning of the COVID-19 pandemic, many people delayed care for major medical conditions, leading to more severe complications. There was a pervasive fear of being exposed to COVID-19 when going to a hospital emergency department. In this case, a 35-year-old female patient that had scheduled monthly appointments presented by video telehealt...

B vitamins are a group of 8 water-soluble vitamins. The body does not store them, so they need to be replaced daily. B vitamins are found in animal proteins, dairy products, leafy green vegetables, and beans. Overall, their function can generally be divided into catabolic metabolism, leading to energy production, and anabolic metabolism, resulting...

Background Family medicine residency clinics and underserved Federally Qualified Health Center clinics often have lower rates of cervical cancer screening (CCS). Methods A series of resident-run, team-based quality improvement projects were conducted to iteratively improve CCS rates in an urban Federally Qualified Health Center in a high-need and...

A 63-year-old man presents to the primary care office with a productive cough, myalgias, fatigue, and a temperature ranging from 100.1 to 101 F for a one-week duration. He has atrial fibrillation, hypertension, benign prostatic hypertrophy, and a history of pancreatic cancer status post partial pancreatectomy and splenectomy three months prior, res...

A 34-year-old male with a history of quadriplegia following a spinal cord injury presented to the clinic endorsing persistent dry cough and mild chest pain for the past three weeks. The patient appeared comfortable, in no acute distress, and with stable vital signs during the visit. His physical exam was unremarkableexcept for no air movement in th...

Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is an uncommon disorder characterized by increased intracranial pressure with no identifiable cause. It is commonly found in obese women of childbearing age and can lead to a decreased quality of life if left untreated. Diagnosing pseudotumor cerebri can be difficult due...

Musculoskeletal concerns are a common concern in busy primary care practice. When the musculoskeletal concern is a manifestation of systemic inflammation, as in inflammatory spondyloarthropathy, its early diagnosis is critical in preventing progression to irreversible joint damage, disability, morbidity, and mortality. This case explores an atypica...

With an estimated prevalence of 4%, substance abuse amongst persons who are 65 years and older is increasing. The most common substances abused are alcohol, prescription drugs such as opiates and benzodiazepines (BZD), and over-the-counter (OTC) medications. This increase is believed to be partially endorsed by the baby boomer generation, born betw...

Ossification of the posterior longitudinal ligament (OPLL), is a progressive disease that typically presents with mild, non-specific symptoms. Symptoms may include neck and low back pain, tingling, and numbness in the upper extremities, and as the disease advances, it may impair activities of daily living. Occasionally, OPLL can be misdiagnosed if...

A visionary leader is someone that encourages, motivates, and creates necessary changes that will make an organization grow. They trust their staff without micromanaging and listen to their opinions and suggestions. Because of these outstanding qualities, a visionary leader can lead different types of teams such as functional, cross-functional, sel...

Markups and profit margins are different accounting terms that analyze similar transactions and use the same inputs but show additional information. The two use costs and revenues as in their calculations. The critical difference is that while profit margins refer to sales less the cost of goods sold, markups refer to the amount that needs to be ad...

The leadership skills model is an approach that shows that leadership skills can be learned, and anyone can become a leader. The model focuses on five elements: individual attributes, competencies, leadership outcomes, care experiences, and environmental influences. One of the essential elements in this model is competencies which determine leaders...

Being a parent is a blessing and a great responsibility. Parents are tasked with mod- eling life skills, values, resiliency, and grit (among other things) for their children. Although mother figures continue to bear the majority of child care, parenting roles are evolving and it truly does take a village to raise children now. Physician parents are...

Pancreatic neuroendocrine neoplasms (pNENs) are rare, representing only a small percentage of all pancreatic tumors. We report the clinical and radiological features of pNENs. Intraoperative pathology confirmed pNENs with clear margins and the patient did not require adjuvant chemoradiation. The patient is currently doing well and being closely mon...

Nursing homes are institutions where individuals who do not need to be in hospital and cannot be cared for at home can receive care. These institutions are equipped with trained nurses who aid the patients through caregiving and giving medication as prescribed by doctors or clinical officers. Some nursing homes adopt hospital setups , also known as...

Successful marketing requires a complete understanding of consumer needs. As a result, it forms a basis of selling points to influence the target market. Thus, comprehensive research incorporating segmenting, targeting, and potential positioning clients is done through various criteria. In the long run, the organization will tailor its marketing pl...

To efficiently market, sell and offer support to customers, there is a need to have a deep understanding of the customers and get to know them better. In accomplishing this, organizations or even individuals create customer profiles and maintain them. Therefore, a customer profile aims to describe the specific demographics, psychographics, and othe...

Many studies have shown that exercise boosts cognitive function and overall brain health, and thus is significant in slowing the onset of dementia. Neurodegenerative disease includes a realm of chronic disorders characterized by memory problems, impaired reasoning, and personality changes. In the past decade, there has been a growing body of resear...

There are countless ways and forms in which one would create or engage in an activity that may pose an ethical conflict. Ethical problems tend to arise between a person and another, which may not be in the interest of one or both parties where a conflict may appear. In order to better understand what a conflict of interest is, we must first define...

Background To stop the spread of COVID-19 in outpatient primary care clinics, infection control strategies were needed including social distancing and masking in Fall 2020. Studies show a significant decrease in COVID-19 transmission when healthcare professionals comply with preventive measures. We tested whether an educational video would improve...

Background: Neurosyphilis is defined as an infection of the central nervous system by spirochete bacterium, Treponema pallidum (T. pallidum). After infection by T. pallidum, symptoms may develop from weeks to months, most commonly within two years. The clinical manifestations of neurosyphilis are classified into two forms: early and late forms. Ear...

Publicly the tobacco industry has denied for far too along with the fact that smoking causes lung cancer, among other dangerous diseases. However, doctors and health researchers have established that cigarettes' carcinogenic nature is responsible for causing infections and the addictive quality that makes them sell. It is now evident that lawyers a...

Rudimentary information on finance is essential as it helps one in making decisions regarding the allocation of funds. Through finance, it is possible to make decisions on what, where, and when to spend. For example, finance helps individuals to make capital budgeting decisions and choose projects with maximum returns. In addition, finance knowledg...

Introduction: The broad range of patients and diagnoses addressed by primary care physicians lends to a larger after-work clinic load. The resulting after-clinic work, including various in-basket tasks, can be a substantial burden to physicians, and potentially leading to burnout. The goal of this study is to generate a standardized workflow to imp...

Personality is among the human aspects that play a central role in an individual’s organizational behavior. The aspect influences a person’s manner of thinking, feelings, and behaviors, among other factors at the workplace. Moreover, a person’s attitude towards people and issues and their decisions and responses are highly dependent on their person...

Even accomplished physicians can experience self-doubt. These tips can help you move past it.

Physicians play an essential part in the health care industry. They act as both the patient's health care consultant and medical service provider, acting on behalf of the patient to choose medical services. However, they also organize into firms and can thus serve as profit-maximizing agents. Consequently, by stretching their bargaining muscles by...

Objective: To determine if pocket-sized, reference guides are helpful tools for teaching geriatric medicine to family medicine residents. Setting: Loma Linda University Healthcare Education Consortium, a family medicine residency in San Bernardino County, California. Participants: Family medicine residents that successfully completed the required g...

Obesity is a chronic, relapsing, multifactorial and neurobehavioral disease. An increase in body fat endorses abnormal fat mass physical forces and dysfunction, resulting in unfavorable metabolic, biomechanical, and psychosocial health consequences.1,2 Examples of adverse metabolic consequences: Hypertension, diabetes mellitus type 2, hyperlipidemi...

Supply and demand are amongst the essential requirements before starting up a business. Understanding the quantity of a commodity wished to be sold by producers based on different prices and the item needed by consumers wish purchasing is essential in coming up with ideas. Based on the understanding of this and background research on costs in healt...

A thorough history and physical are key to proper diagnosis and treatment following a patient's encounter with an insect, arachnid, or other arthropod.

There's nothing more frustrating than not getting credit for work performed. Physicians often leave large amounts of compensation on the table, because even though services were provided, insurance payers do not recognize the work due to suboptimal documentation. This problem is especially apparent in preventive medicine and wellness visits with ad...

Category: Substances Definition: Sleeping pills addiction describes the condition in which individuals develop physical and psychological dependence on pills, both prescription and over-the-counter (OTC) medications, that aid in sleeping.

The purpose of this article is to review the current available material pertaining to atopic dermatitis, contact dermatitis, urticaria, and angioedema. This article focuses on each disease process's clinical presentation, diagnosis, and management. Although atopic dermatitis and contact dermatitis are similar, their development is different and can...