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Valentina Forni Ogna, Philippe Braconnier, Arlene Wuerzner, Michel Burnier, Grégoire Wuerzner
Considering the high prevalence of hypertension among general population, the general practitioner is frequently challenged to start an antihypertensive therapy, which aims to lower blood pressure and to reduce the cardiovascular risk. At the initial stage, several critical questions must be asked : « Is a pharmacological treatment necessary ? », « Which are the target blood pressures ? » and « Which antihypertensive drug should be chosen to start therapy ? »The aim of this article is to give general practicioners some practical tools to guide them in the initial management of hypertensive patients...
September 13, 2017: Revue Médicale Suisse
Silvia Bonfanti, Victoria Duthon, Jean-Luc Ziltener, Jacques Menetrey
Sport-related concussion is a frequent and complex pathology whose physiopathological mechanisms are not completely understood yet. A recent consensus statement has been published with the objective to provide practicioners with an overview of literature and give some guidelines based on the current state of knowledge. An 11R approach (Recognise, Remove, Re-evaluate, Rest, Rehabilitation, Refer, Recover, Return to sport, Reconsider, Residual effects and sequelae, Risk reduction) is proposed to evaluate and manage sport-related concussion...
July 12, 2017: Revue Médicale Suisse
D M Campagne
Data of the last decade indicate that, in the Western world and also in Spain, an important part of general practicioners' consultations are related to mental health, but depression is consistently underdiagnosed. Causes are lack of time and back-up, as well as lack of specific training. In Spain, there is no national health service primary care database with actualized clinical information as to mental health. There is evident clinical interest in a more agile diagnostic, resulting from a recollection of data from voluntary selective screening and continuing evaluation of adult depression along the model used by other National Health Systems...
June 19, 2017: Semergen
F Poropat, P Heinz, E Barbi, A Ventura
BACKROUND: To compare paediatric Emergency Department (ED) attendances and admission outcomes in two European hospitals with different paediatric primary care set-up. METHODS: This is a retrospective prevalence study comparing all paediatric ED attendances during calendar years 2013 in two EDs with similar catchment area: one in Italy (Trieste) where paediatric primary care is provided by office paediatricians, the other, in the UK (Cambridge), where paediatric primary care is provided by general practitioners...
March 8, 2017: Italian Journal of Pediatrics
Herwig Oberlerchner, Kerstin Findenig, Otto Liechtenecker, Bernadette Mörtl-Kessler, Margot Reiter, Ursula Riess, Sabrina Suppan, Iris Walcher, Birgit Senft
BACKGROUND: Based on the data of an analysis of costs of psychopharmacological treatment by the Austrian Rechnungshof in 2011, which also revealed remarkable differences between Salzburg and Carinthia (federal states of Austria), a panel of experts discussed the potential causes. A consequence was the following prospective study, which took place at the department of psychiatry and psychotherapy in Klagenfurt/Carinthia. METHODS: The aim in this mirror design study was to analize the data of psychopharmacologic treatment, epidemiological data of the treated patients (N = 230) and utilization of healthcare ressources such as contacts to psychiatrists or practicioners after discharge...
March 2017: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
Barbara Biesecker, Jehannine Austin, Colleen Caleshu
Whether genetic counseling is a form of psychotherapy is open for debate. Early practicioners in genetic counseling described it as such, and this claim has been replicated in recent publications. This commentary is a rebuttal to the claim that genetic counseling is distinct from psychotherapty. We argue that it is a a form of psychoterapy that aims to help clients manage a health threat that affects their psychological wellbeing, paralleling the goals of psychotherapy.
April 2017: Journal of Genetic Counseling
Semjén David, Farkas András, Kalman Endre, Kaszas Balint, Kovács Árpad, Pusztai Csaba, Szuhai Karoly, Tornóczky Tamás
Benign testicular teratomas are always thought to be pediatric neoplasms and previously all the teratoid tumors in the adult testis regarded as malignant. Recently, three publications reported benign testicular teratomas in adulthood and the latest WHO classification refers them as "prepubertal type of teratomas" which rarely appear in adulthood. These neoplasms behave benign and seemingly analogous independently whether they appear in pre- or postpubertal patients. The aim of our study was to investigate the frequency of benign testicular teratomas both in children and adults...
July 2017: Pathology Oncology Research: POR
Andrea O Rossetti, Serge Vulliémoz
Epileptic seizures represent a relatively frequent issue in patients with intracranial neoplasms, and very frequently imply the start of an antiepileptic treatment as secondary prophylaxis. Even if the current level of evidence is relatively low, compounds with a limited risk of pharmacokinetic interactions are clearly preferred. Levetiracetam is probably the most prescribed agent in this setting, while pregabalin, valproate, lacosamide and lamotrigine are valuable alternatives. The treatment choice has to consider the different profiles of side effects and should be tailored to each patient...
April 27, 2016: Revue Médicale Suisse
L Colin Tixhaj, E Sabani, P Estoppey, F Stiefel, R Maire
There are no effective therapies for the treatment of chronic subjective tinnitus. The present study aims to compare two therapeutic approaches: Tinnitus Retraining Therapy (TRT) and a Biopsychosocial Approach (BPS). Results show no difference in evolution of tinnitus' perception between the beginning of the study and after 12 months of treatment in both treatment groups. Important anxiety could be a factor contributed towards the abandonment or ineffectiveness of treatments. Patients with more biopsychosocial comorbidities are more receptive to therapies...
September 30, 2015: Revue Médicale Suisse
Tanja Planinšek Ručigaj, Kristina Janežič, Jasna Lipozenčić
No abstract text is available yet for this article.
2015: Acta Dermatovenerologica Croatica: ADC
A Kronenthaler, H Hiltner, M Eissler
INTRODUCTION: Due to the increasing numbers of Muslims in Germany(1)--about 4.3 million at the moment--more Muslim patients are medicated in the practices of family doctors. Their heterogeneous cultural and religious backgrounds are nontheless unknown and unfamiliar for the treating general practitioner. Based on the daily experiences of the latter and in order to capture their development of intercultural competence, in the present study a brainwriting with general practitioners was conducted to record their spontaneous associations with Muslim patients...
July 2014: Das Gesundheitswesen
Angélica Miguélez-Chamorro, Carmen Ferrer-Arnedo
It is estimated that the chronic, fragile and complex patient represents 5% of the general population, but uses up to 65% of the total amount of health care resources. Older people who are dependent, with chronic illnesses and comorbidities need professional care that promotes self-care and self-management of their illnesses. Thus, new strategies need to be considered to channel those professional care services to focus on this group. Nurse practicioners are professionals who could lead this change to improve the sustainability of the health care system, since they are in a position to respond in an effective way to the demands of patients with chronic illnesses, dependency or fragility...
January 2014: Enfermería Clínica
W Pitchot, G Scantamburlo
Today, the term depression has lost its meaning. Recent scientific data suggests a change in our classifications of mental disorders. Depression is frequently used to refer to "normal" sadness, anxiety disorders, personality disorders or adjustment disorders... Moreover, in our society, this diagnosis remains badly accepted. It is really time to be aware of the deterioration of the image of psychiatry, and particularly the bad image of depression and its treatment with antidepressants. This paper is a reflexion inviting general practicioners and psychiatrists to progressively avoid the term depression and rather use the diagnosis of unipolar mood disorder, a broader concept, more adapted to new scientific data, less stigmatizing, and closer to the evolution of our society...
April 2013: Revue Médicale de Liège
Harold Davis, Tracey Jensen, Anthony Johnson, Pamela Knowles, Robert Meyer, Renee Rucinsky, Heidi Shafford
Fluid therapy is important for many medical conditions in veterinary patients. The assessment of patient history, chief complaint, physical exam findings, and indicated additional testing will determine the need for fluid therapy. Fluid selection is dictated by the patient's needs, including volume, rate, fluid composition required, and location the fluid is needed (e.g., interstitial versus intravascular). Therapy must be individualized, tailored to each patient, and constantly re-evaluated and reformulated according to changes in status...
May 2013: Journal of the American Animal Hospital Association
Ugo Montanari, Domenico Quadrelli, Giuseppe Donato, Maddalena Mercuri, Antonio Scorletti, Franco Berti
In Italian Territory Medicine there is no consolidated habitude, by Family General Practicioners and Paediatricians, to use Guidelines for diagnosis and management of diseases. Therefore, 19 General Practicioners, organized in a cooperative group, have identified a guideline on COPD, a disease often underdiagnosed and inappropriately treated, and verified, over 3 years of application, if it is possible, in clinical practice, to modify diagnostic-therapeutic habitudes. The results - even inferior to expectations for most of the indicators used - showed an increase in the number of cases diagnosed as COPD, possibly linked to a greater use of spirometry and chest Rx...
January 2013: Recenti Progressi in Medicina
Snezana Medic, Vladimir Petrović
INTRODUCTION: An adverse event after immunization is a medical incident following the administration of vaccine, which can be connected with vaccine usage. This event could be a reaction to a vaccine component or lapse in vaccine handling, transport and storage or coincidental event. The assessment of severity of this reaction and the decision about prospective permanent contraindications for futher immunization are to be made by the regional expert team for permanent contraindications...
March 2012: Medicinski Pregled
C Seligmann, M Kusus-Seligmann
Germany wants to introduce some models to allow nurses to work in medical roles. Although hospital nurses worked hard during the last couple of years to concentrate on pure patient care and to detach themselves from medicine, a short additional training of 6-12 months duration is planned to allow them to work independently in well defined areas of medicine (high blood pressure, wound care, dementia, diabetes). However, success of such models has only been tested in a few studies. Study results and experience with such models in the UK - where these developments are much more advanced - are not only positive...
June 2012: Deutsche Medizinische Wochenschrift
M Egli, J Ruiz
During an acute hospital stay, unpredictable glycemic changes related to the combined effects of multiple factors always ask for an increased attention to diabetes management. Initially an insulin treatment which has to be adjusted individually based on continuous glycemic follow-up is usually inevitable. This requires adequate coordination between the various health-care professionals who are simultaneously and successively involved in patient care. A proper discharge plan including reassessment of treatment, developed in consultation with the practicioners in charge of outpatient follow-up is a key component of this process...
June 8, 2011: Revue Médicale Suisse
A Richter, R Dörr, B Maisch
In November 2009 the first European guidelines were presented regarding preoperative risk assessment and perioperative management in non-cardiac surgery. They were designed by the European Society of Cardiology (ESC) and endorsed by the European Society of Anesthesiology.In a standardized manner, patient-specific clinical variables, their exercise capacity and surgery-specific risk factors are summarized to a recommendation concerning medication and preoperative cardiac evaluation. These guidelines are straightforward and feasible for cardiologists as well as specialists in internal medicine and general practicioners...
December 2010: Herz
Songbo Chai, Shuoren Wang, Lifang Yao, Aiming Wu, Yuxin Liu, Chunmei Rao
OBJECTIVE: To study the effect of shensongyangxin capsule on myocardial remodeling and ventricular fibrillation characteristics in rat with coronary artery ligation. METHOD: Twenty-three male rats were randomly divided into sham-group (n = 5), model group (n = 6), anmiodarone group (n = 6) and shensongyangxin capsule group (n = 6). Drugs were administrated after modeling of 2 days, lasting four weeks. Two dimensional and Doppler images were acquired by a 15 MHz high-frequency linear ultrasound transducer at 4 weeks after operation, and chest was opened to detect ventricular fibrillation threshold value and persistent time...
August 2009: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
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