Practicioner

Polypharmacy remains an important challenge for patients with extensive medical complexity. Given the primary care shortage and the increasing aging population, effective polypharmacy management is crucial to manage the increasing burden of care. The capacity of large language model (LLM)-based artificial intelligence to aid in polypharmacy management has yet to be evaluated. Here, we evaluate ChatGPT's performance in polypharmacy management via its deprescribing decisions in standardized clinical vignettes...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Workflow interruptions are common for emergency physicians and are shown to have downstream consequences such as patient dissatisfaction, delay in clinical response, and increase in medical error. However, the impact of passive interruptions on physician productivity is unclear and has not been well studied. We sought to evaluate if the number of pages received per hour significantly affects the number of patients seen per hour. METHODS: Retrospective data was collected on resident physician (RP) emergency department shifts from July 1st, 2021 to June 30th, 2022 at an academic medical center with an annual census of 55,000 patients...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Diagnostic imaging for low back pain (LBP) without any indication of a serious underlying cause does not improve patient outcomes. However, there is still overuse of imaging, especially at emergency departments (EDs). Although evidence-based guidelines for LBP and radicular pain management exist, a protocol for use at the ED in the Belgian University Hospitals Leuven was not available, resulting in high practice variation. The present paper aims to describe the process from protocol development to the iterative implementation approach and explore how it has influenced practice...

CME Rheumatology 26: Bone Marrow Edema of the Sacro-Iliac Joint = Spondyloarthritis? What the General Practicioner Should Know Abstract. Axial spondyloarthritis is a chronic inflammatory joint disease mainly involving the sacroiliac joints (ISG) and the spine. The diagnosis can be made early due to acute inflammatory changes in the ISG on magnetic resonance imaging (MRI). Radiographs of the ISG do not help in early diagnosis because structural damage is not apparent on radiographs until an advanced stage. In recent years, however, several studies have shown that bone marrow edema - hyperintense signals (= bright spots) as a possible MRI correlate for inflammation - does not specifically occur in axial spondyloarthritis, but can also be seen in healthy people, athletes, people with high mechanical stress (e...

According to a recent study regarding the management of hypertension in general practice, no therapeutic action was taken during follow-up in 87% of the selected population with uncontrolled hypertension (n = 6400). Older age, lower systolic, diastolic and near-target systolic blood pressure, as well as diabetes were positively associated with therapeutic inertia. This commentary questions whether the observed inertia in fact is appropriate inaction following conscious shared decision making. Also, the role of changing target values in old age in consecutive guidelines is discussed...

Palliative care of patients with non-oncological, chronic diseases is for the most part achieved by general practicioners (GP). Currently however standardized questionnaires are barely used by GPs to determine the demand. It is far more an intuitive, individual decision, at what time and to what extend a palliative treatment takes place at home. Based on an example of a patient with chronic heart failure, it's determined, if and with which assessment-tools the need for a (specialised) palliative care in general medicine can be detected...

General practitioners play a major role in the health care of the population. Only a small proportion of patients receives care from specialised consultants, in a hospital or in a university hospital. Most of the patients consult a general practitioner. The strengthening of general practice that is called for in the Master Plan for Medical Studies 2020 in new state examination formats, for instance, means that this central position in patient care will be reflected in studies and examinations in the future...

Advances in medical informatics and the widespread collection of patients’ data have led to the development of new medical decision support systems. Some of them are simply used to guide the medical practicioner, while others automatically generate decisions. Known under various names (“expert systems”, “decision support systems”, “medical AI”), they can be used for diagnosis, prognosis or care. They all function by means of algorithms that process data...

This concise review of the epidemiology, pathophysiology, evaluation, acute management, and prevention of ischemic stroke targets internists, family practicioners, and emergency physicians who manage patient with stroke.

Background: There is little research that examines the accuracy of paediatric referrals into secondary and tertiary care, particularly those from general practicioners (GPs) to ophthalmology and orthoptic departments. Inaccurate referrals could have a detrimental effect on service delivery and NHS funding as well as patient experience. Available evidence shows GP referral accuracy to range between 39% and 90% across different areas of medicine with accuracy of GP referral to ophthalmology between 56% and 66%...

In this paper we apply a series of Machine Learning models to a recently published unique dataset on the mortality of COVID19 patients. We use a dataset consisting of blood samples of 375 patients admitted to a hospital in the region of Wuhan, China. There are 201 patients who survived hospitalisation and 174 patients who died whilst in hospital. The focus of the paper is not only on seeing which Machine Learning model is able to obtain the absolute highest accuracy but more on the interpretation of what the Machine Learning models provides...

This study evaluated early and frequent seated breaks from standing work to reduce low back pain (LBP) in known pain developers (PD). Twenty-four participants, classified as either PD or non-PD during a separate 2-hour standing session, performed 124 minutes of standing work with seated breaks at a 3:1 stand-sit ratio with increasing durations from 3:1 minute to 48:16 minutes. Back pain and spine posture measures showed no differences between PD and non-PD. Females had greater left glutaeus medius activation (8...

Background: The internet is a broadly preferred source of information both by patients and medical professionals. YouTube™ is a significant information source that may be a useful tool to inform the public, medical students, and residents, and may improve the learning experience if used adequately. In this study, we aimed to estimate the quality and accuracy of videos regarding Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) aired on YouTube, which is the most popular video platform of the online world...

Traumatic dislocation of the shoulder - a guide for medical practicioners Abstract. Traumatic dislocation of the shoulder joint is a common injury. Young patients suffer from dislocations usually during leisure and competitive activities, the elderly are prone for injuries because of falls. We provide an overview about state-of-the-art management in first traumatic shoulder dislocations. Besides an overview for mechanisms leading to injuries, we describe first line therapy as well as techniques to reposition the shoulder...

The management of many traumatic conditions of the hand and wrist can be done or at least initiated by the primary care physician, often the first actor of the scenario. To do so, he must first have performed a correct reading of X-rays made with specific incidences to the suspected pathology. This article reviews the radiological diagnosis of the most common pathologies in hand and wrist traumatology to facilitate interpretation by general practitioners.