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https://www.readbyqxmd.com/read/28728201/-fever-and-headache-after-a-vacation-in-thailand
#1
Benedikt Schwermer, Daniel Eschle, Constantine Bloch-Infanger
History 50 year-old man with fever and headache starting one week after returning from his vacation in Thailand. His general practitioner prescribed amoxicillin/clavulanic acid, without further analyses to pinpoint the infection. Examinations The examination of cerebro-spinal fluid was crucial for the final diagnosis. Lumbar puncture demonstrated a predominantly mononuclear pleocytosis of 80 cells/µl (< 5) with an elevated protein of 782 mg/l (< 450); glucose and lactate were within normal limits...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28728199/-polypharmacy-solutions-for-enhanced-drug-safety
#2
Olaf Krause, Gesine Picksak, Ulrike Junius-Walker
Polypharmacy (≥ 5 drugs) is common among older people and may lead to falls, ADEs and delirium. Adherence is an important part in the medication management. Simple questions (i. e. for OTC, handling and omission of drugs) are effective. As most old people are treated by general practitioners (GP), they play a key role for drug safety and reducing polypharmacy. The involvement of pharmacists in analyzing one patient's drugs can enhance solutions for drug problems ("two-man rule"). An IT-based medication plan acts as an important communication tool for an enhanced team work between doctors, pharmacists and nursing care...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28727755/no-abatement-of-steroid-injections-for-tennis-elbow-in-australian-general-practice-a-15-year-observational-study-with-random-general-practitioner-sampling
#3
Bill Vicenzino, Helena Britt, Allan J Pollack, Michelle Hall, Kim L Bennell, David J Hunter
OBJECTIVE: Evaluate general practitioner (GP) management of tennis elbow (TE) in Australia. METHODS: Data about the management of TE by GPs from 2000 to 2015 were extracted from the Bettering the Evaluation of Care of Health program database. Patient and GP characteristics and encounter management data were classified by the International Classification of Primary Care, version 2, and reported using descriptive statistics with point estimates and 95% confidence intervals...
2017: PloS One
https://www.readbyqxmd.com/read/28727521/ethical-guidance-for-disaster-response-specifically-around-crisis-standards-of-care-a-systematic-review
#4
Jonathon P Leider, Debra DeBruin, Nicole Reynolds, Angelica Koch, Judy Seaberg
BACKGROUND: Terrorism, disease outbreaks, and other natural disasters and mass casualty events have pushed health care and public health systems to identify and refine emergency preparedness protocols for disaster response. Ethical guidance, alongside legal and medical frameworks, are increasingly common components of disaster response plans. OBJECTIVES: To systematically review the prevalence and content of ethical guidance offered for disaster response, specifically around crisis standards of care (CSCs)...
July 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28727340/-phosphocalcic-anomalies-and-bone-fragility-keys-for-the-general-practitioner
#5
Bérengère Aubry-Rozier, Delphine Stoll, Elena Gonzalez-Rodriguez
How to recognize secondary causes of bone fragility in relation with an abnormal calcium and phosphate laboratory in general practice ? Through clinical cases presentations we will discuss the calcium and phosphate abnormalities which can be related to bone fragility and for which a-specific approach must be proposed. It can be abnormal results of calcium, phosphate or vitamin D. Some causes are frequent, others are iatrogenic, and others are related to a rare disease sometimes of genetic cause which consequences are more important than expected...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28725628/perspectives-on-reflexology-a-qualitative-approach
#6
Nurul Haswani Embong, Yee Chang Soh, Long Chiau Ming, Tin Wui Wong
INTRODUCTION: Reflexology is the systematic practice of applying some pressure to particular points on the feet and hands to impact on health of related parts of the body. OBJECTIVE: To explore the practitioners' perspectives of reflexology in Malaysia. METHODS: Data was collected using face-to-face semi-structured interviews with practitioners in Malaysia. The interviews were conducted in the Malay language and recorded. Interview conversations were translated and transcribed verbatim...
July 2017: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/28725452/mapmysmoke-feasibility-of-a-new-quit-cigarette-smoking-mobile-phone-application-using-integrated-geo-positioning-technology-and-motivational-messaging-within-a-primary-care-setting
#7
Robert S Schick, Thomas W Kelsey, John Marston, Kay Samson, Gerald W Humphris
BACKGROUND: Approximately 11,000 people die in Scotland each year as a result of smoking-related causes. Quitting smoking is relatively easy; maintaining a quit attempt is a very difficult task with success rates for unaided quit attempts stubbornly remaining in the single digits. Pharmaceutical treatment can improve these rates by lowering the overall reward factor of nicotine. However, these and related nicotine replacement therapies do not operate on, or address, the spatial and contextual aspects of smoking behaviour...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28724698/acute-achilles-tendon-rupture
#8
Dishan Singh
This is one of a series of occasional articles highlighting conditions that may be more common than many doctors realise or may be missed at first presentation. The series advisers are Anthony Harnden, professor of primary care, Department of Primary Care Health Sciences, University of Oxford, and Richard Lehman, general practitioner, Banbury. To suggest a topic for this series, please email us at practice@bmj.com.
August 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28724498/patients-with-hiv-and-coronary-disease-are-we-meeting-national-guidelines
#9
Sam Emmanuel, James Nadel, Damien Fagan, Sirinya Teeraananchai, Matthew Law, Cameron J Holloway
Cardiovascular disease (CVD) has a higher incidence in patients with HIV infection. This study sought to determine whether HIV-infected patients with established CVD were being managed according to national guidelines. Data were collected from Australian general practitioners for 77 HIV-infected patients with a median age of 59 (range 54-64). There was good adherence to guidelines with regards to anti-platelet (84%; n=65; 95% confidence interval (CI) 74-92%) and statin therapy (97%; n=75; 95% CI 91-100%), despite a failure to meet cholesterol targets, with only 31% (n=24; 95% CI 21-42%) of the cohort meeting low-density lipoprotein target values...
July 20, 2017: Sexual Health
https://www.readbyqxmd.com/read/28724423/effectiveness-and-cost-effectiveness-of-telephone-based-cognitive-behavioural-therapy-in-primary-care-study-protocol-of-tide-telephone-intervention-for-depression
#10
Birgit Watzke, Elisa Haller, Maya Steinmann, Daniela Heddaeus, Martin Härter, Hans-Helmut König, Karl Wegscheider, Thomas Rosemann
BACKGROUND: Despite the availability of evidence-based treatments for depression, a large proportion of patients remains untreated or adequate treatment is initiated with delay. This situation is particularly critical in primary care, where not only most individuals first seek help for their mental health problems, but also depressive disorders - particularly mild to moderate levels of severity - are highly prevalent given the high comorbidity of chronic somatic conditions and depression...
July 19, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28723479/infectious-complications-of-circumcision-and-their-prevention
#11
REVIEW
Itzhak Brook
CONTEXT: A growing body of evidence supports the health benefits of circumcision, but the occurrence of infectious complications is of concern. OBJECTIVE: To review literature presenting past data and studies of infectious complications of circumcision and their prevention. EVIDENCE ACQUISITION: A literature search was conducted of the Cochrane Library, Embase, Turning Research into Practice, PubMed, and Medline databases from their inception through June 25, 2015...
October 2016: European Urology Focus
https://www.readbyqxmd.com/read/28722379/-nail-changes-diagnostic-considerations-in-everyday-medical-general-practice
#12
Caroline De Lorenzi, Marem Abosaleh, Wolf-Henning Boehncke
Consultations for nail changes are frequent in everyday practice with direct diagnostic considerations into different directions, traumatism, infection, inflammation being the most common ones, and neoplasia being less frequent. The most common symptom is ungual dystrophia ; that is an alteration or perturbation of ungual growth. It presents differently depending on nature or length of the underlying pathologia. The purpose of this article is to highlight some ungual disorders to help the general practitioner to identify and refer them to the specialist if necessary...
March 29, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28722079/physicians-experience-with-follow-up-care-of-childhood-cancer-survivors-challenges-and-needs
#13
Gisela Michel, Micol Eva Gianinazzi, Janine Vetsch, Luzius Mader, Judith E Lupatsch, Nicolas X von der Weid, Corina Silvia Rueegg
BACKGROUND: Regular follow-up care is essential for childhood cancer survivors, but we know little about physicians' experience with it. We aimed to describe: (1) involvement of Swiss physicians in follow-up care; (2) content of follow-up care provided; (3) problems encountered; and (4) additional resources needed. MATERIALS AND METHODS: Within this cross-sectional survey we sent adapted questionnaires via professional associations to a sample of medical oncologists (MOs), paediatric oncologists (POs), general practitioners (GPs) and paediatricians (P) in Switzerland...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28721085/ambulatory-and-home-blood-pressure-monitoring-gaps-between-clinical-guidelines-and-clinical-practice-in-singapore
#14
Sajita Setia, Kannan Subramaniam, Boon Wee Teo, Jam Chin Tay
PURPOSE: Out-of-office blood pressure (BP) measurements (home blood pressure monitoring [HBPM] and ambulatory blood pressure monitoring [ABPM]) provide important additional information for effective hypertension detection and management decisions. Therefore, out-of-office BP measurement is now recommended by several international guidelines. This study evaluated the practice and uptake of HBPM and ABPM among physicians from Singapore. MATERIALS AND METHODS: A sample of physicians from Singapore was surveyed between 8 September and 5 October 2016...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28720876/not-performing-an-ogtt-results-in-significant-underdiagnosis-of-pre-diabetes-in-a-high-risk-adult-caucasian-population
#15
A S Meijnikman, C E M De Block, E Dirinck, A Verrijken, I Mertens, B Corthouts, L F Van Gaal
OBJECTIVE: Type 2 diabetes (T2DM) is known to be underdiagnosed. Tests for diagnosis include fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) and HbA1c. HbA1c can be tested in non-fasting conditions. Therefore, general practitioners almost no longer execute OGTT's. We evaluated the performance of OGTT versus HbA1c in a population consisting of overweight and obese subjects, which can be considered a 'high risk' population. RESEARCH DESIGN AND METHODS: 1241 overweight and obese subjects without a history of diabetes (Male/Female: 375/866, age 44±13 y, Body Mass Index 38...
July 19, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28720751/exploring-the-perspectives-of-clinical-professionals-and-support-staff-on-implementing-supported-self-management-for-asthma-in-uk-general-practice-an-imp-2-art-qualitative-study
#16
Susan Morrow, Luke Daines, Sharon Wiener-Ogilvie, Liz Steed, Lorna McKee, Ann-Louise Caress, Stephanie J C Taylor, Hilary Pinnock
Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices...
July 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28718661/anxiety-and-self-care-behaviour-in-patients-with-chronic-systolic-heart-failure-a-multivariate-model
#17
Thomas Müller-Tasch, Bernd Löwe, Nicole Lossnitzer, Lutz Frankenstein, Tobias Täger, Markus Haass, Hugo Katus, Jobst-Hendrik Schultz, Wolfgang Herzog
BACKGROUND: While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interactions between anxiety, depression and self-care behaviours in patients with CHF. METHODS: The self-care behaviour of CHF outpatients was measured using the European Heart Failure Self-care Behaviour Scale (EHFScBS)...
July 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#18
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28717658/targeting-breast-cancer-outcomes-what-about-the-primary-relatives
#19
Alison Johnston, Michael Sugrue
BACKGROUND: Up to 65% of newly diagnosed breast cancer patients had not been screened correctly before diagnosis resulting in increased stage of cancer at presentation. This study assessed whether their primary relatives are, in turn, assessed appropriately. METHODS: An ethically approved prospective study involving 274 primary relatives of women diagnosed with breast cancer, between 2009-2012, at a symptomatic breast unit in Ireland. Telephone interview established: demographics, menstrual history, family history verification, breast screening history...
July 2017: Molecular Genetics & Genomic Medicine
https://www.readbyqxmd.com/read/28716504/series-pragmatic-trials-and-real-world-evidence-paper-8-data-collection-and-management-data-collection-in-pragmatic-trials
#20
Anna-Katharina Meinecke, Paco Welsing, George Kafatos, Des Burke, Sven Trelle, Maria Kubin, Gaelle Nachbaur, Matthias Egger, Mira Zuidgeest
Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice...
July 14, 2017: Journal of Clinical Epidemiology
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