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General practioner

Maria Mahner, Christina Raus, Fabian Ludwig, Gesine Weckmann, Sylvia Stracke, Jean-François Chenot
BACKGROUND:  Many drugs require dose adjustment or are contraindicated in patients with chronic kidney disease (CKD) to avoid adverse events. The aims of this study were to assess if medication was appropriately dose adjusted in patients with CKD in primary care, to identify medications that were frequently prescribed inappropriately and to identify factors predicting mal-prescription. METHODS:  We conducted a cross-sectional observational study in 34 general practioners' offices, assessing the medication of patients with CKD stage ≥ 3 according to the corresponding pharmaceutical product information...
June 2018: Deutsche Medizinische Wochenschrift
Ivan P Katerenchuk, Lidia A Tkachenko, Tetiana Yarmola, Oleksandr I Katerenchuk
The article presents a clinical case of primary renal amyloidosis that was diagnosed in female patient. Typically, the spectrum of clinical signs of primary amyloidosis is wide: from moderate symptoms in some patients having localized amyloidosis, to life-threatening conditions that require rapid diagnosis determination and aggressive treatment. Finding a diagnosis of primary renal amyloidosis is enough difficult as for family doctors as for well-skilled nephrologists. In some cases, the primary renal amyloidosis starts with atypical symptoms, and so, only doctor's sufficient clinical experience combined with the in-time usage of highly informative diagnostic methods (morphological and immunological evaluation of the renal biopsy), allows to make an in-time diagnosis of the disease and to prescribe specific therapy that can slow down the disease progression and delay the time of severe complications development...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Jonathan Lomas, Taylan Gurgenci, Christopher Jackson, Duncan Campbell
BACKGROUND: Orofacial pain is a common presentation in the primary healthcare setting and temporomandibular dysfunction represents one of the major causes. Its aetiology is multifactorial, caused by both masticatory muscle dysfunction and derangement within the temporomandibular joint. OBJECTIVE: The aim of this article is to provide an overview of temporomandibular dysfunction, its management and referral considerations for general practioners. DISCUSSION: Temporomandibular joint dysfunction affects a large number of adults...
April 2018: Australian journal of general practice
Genevieve L Fair, Mark F Harris, Mitchell M Smith
BACKGROUND AND AIM: Transition of asylum seekers from special-purpose health services to mainstream primary care is both necessary and difficult. This study explores the issues encountered by asylum seekers undergoing this transition in Sydney, Australia. METHODS: Qualitative semistructured interviews were conducted with nine asylum seeker patients and nine staff working in the sector. RESULTS: Asylum seekers faced significant challenges in the transition to mainstream primary care...
March 15, 2018: Public Health Research & Practice
Emanuela Burdese, Marzia Testa, Pasquale Raucci, Cinzia Ferreri, Gabriele Giovannini, Enrico Lombardo, Enrico Avogadri, Mauro Feola
BACKGROUND: Home telemonitoring is a modern and effective disease management model that is able to improve medical care, quality of life, and prognosis of chronically ill patients, and to reduce expenditure. The objective of this study was to evaluate the efficacy, costs, and patients' and caregivers' acceptance of our model of telemedicine in a high-risk chronic heart failure (CHF) older population. METHODS: Patients with high risk/refractory CHF were included...
January 20, 2018: Diseases (Basel)
Michael Bryant, Andrew Gough, James Selfe, Jim Richards, Elizabeth Burgess
BACKGROUND: Evidence for optimal non-operative treatment of frozen shoulder is lacking. The present study aimed to evaluate a treatment strategy for stage II to III frozen shoulder provided by the current primary care musculoskeletal service. METHODS: General practioner referrals of shoulder pain to the musculoskeletal service diagnosed with stage II to III frozen shoulder and who opted for a treatment strategy of hydrodistension and guided physiotherapy exercise programme over a 12-month period were evaluated for 6 months...
October 2017: Shoulder & Elbow
Krishnappriya Ramachandran, Balamugesh Thankagunam, Reka Karuppusami, D J Christopher
INTRODUCTION: Lung cancer is associated with a poor prognosis, if detected late in the disease course. Delay in seeking health care, wrong diagnosis and delay in specialist referral can contribute to delay in diagnosis. AIM: This study was done to assess physician related delays in the diagnosis of lung cancer and the treatments given before presenting to our center. MATERIALS AND METHODS: A total of 96 consecutive patients diagnosed with lung cancer were enrolled in this study...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
Stefan Neuner-Jehle, Oliver Senn, Thomas Rosemann
AIM: As part of the "Choosing wisely" campaign expert-driven recommendations of inappropriate interventions which lead to overdiagnosis and overtreatment are being published. The aim of our work was to describe an innovative method for developing recommendations together with general practitioners (GPs) and to compare the results with the "Choosing wisely" campaign lists as well as with the Swiss "Smarter medicine" shortlist. METHODS: We asked 109 GPs who attended a medical education conference to form groups (of 5 to 7 GPs each) and develop three interventions that are relevant to their work and should be avoided...
December 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Devavrat G Harshe, Sneha D Harshe, Gurudas R Harshe, Gayatri G Harshe
Abdominal Epilepsy (AE) is a variant of temporal lobe epilepsy and is commonly seen in pediatric age group. There are however, multiple reports of abdominal epilepsy in adolescents and even in adults. Chronic and recurrent gastrointestinal symptoms with one or more neuropsychiatric manifestations are often the presenting picture for a patient with AE. Such patients therefore, are more likely to consult a general practioner, a physician, a surgeon or a gastroenterologist than consulting a psychiatrist or a neurologist...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
Bertrand Glize, Étienne Santos, Sophie Broussy, Igor Sibon, Pierre-Alain Joseph, Patrick Dehail
OBJECTIVE: Post-stroke medical management, defined by national and international guidelines, involves many professionals, allowing optimal secondary prevention. The general practitioner is as a major player in this management. The improved of this management appears as the new challenge following the stroke Plan 2009-2014. The aim of this study was to evaluate the medical and paramedical management of patients in the year following a stroke. MATERIAL/PATIENTS AND METHODS: This was an observational study among general practitioners of stroke patients in Aquitaine...
September 2016: Annals of Physical and Rehabilitation Medicine
Coen Itz, Frank Huygen, Maarten van Kleef
Low back pain in general and specifically chronic low back pain forms a major burden for the patient and society. Recently studies demonstrated that up to 65% of patients evolve to chronic pain as opposed to the previously accepted 8%. As low back pain patients present first with their general practitioner, the latter should establish a treatment plan, including the appropriate referrals. There are, however, no clear guidelines as to how to refer low back pain patients. The process of trial and error of different specialties and treatment possibilities often results in a long and costly trajectory...
November 2016: Current Medical Research and Opinion
Zahir Mughal, Vijay Thirunavukarasu, Adnan Darr, Mudit Jindal
BACKGROUND: Grommet insertion is a common procedure in children. A lengthy otolaryngology follow-up can have an adverse impact on clinic waiting times, new patient appointment availability, and pecuniary disadvantage for the hospital. OBJECTIVE OF REVIEW: To consolidate research and opinion concerning follow-up care following grommet insertion in a pediatric population. SEARCH STRATEGY: The literature between January 1990 and September 2015 was searched on MEDLINE (Ovid), Google Scholar, PubMed and Web of Science databases...
September 2016: International Journal of Pediatric Otorhinolaryngology
Lonneke van Hoeven, Yvonne Vergouwe, Bart W Koes, Johanna M W Hazes, Angelique E A M Weel
BACKGROUND: Axial spondyloarthritis (axSpA) is a disabling inflammatory joint disease with chronic low back pain (CLBP) as leading symptom. Recognizing axSpA in the large amount of CLBP patients is difficult for general practioners (GP). This evaluation aims to assess the effect of a referral strategy for axSpA in young primary care patients with CLBP by comparing the use of the strategy with usual care. The effect is measured at three different levels; by patient reported outcomes (the clinical effect), process and costs evaluation...
July 12, 2016: BMC Musculoskeletal Disorders
Alexander Cho, Martin Ball, Katherine Read, Pavithira Tharmapoopathy, Andrew R Ross, Azad Mathur, Ashish Minocha, Thomas Tsang, Milind Kulkarni
INTRODUCTION: Recent recommendations have lowered the ideal age of surgery for undescended testis (UDT) to 3-6 months of age. However, many publications demonstrate that age at surgery is still above the recommended age of 1 year as originally suggested in 1996. AIM: Through a web-based educational survey, we aimed to combine questions regarding General Practioner's (GPs) management of these patients with educational slides with advice to update them with current recommendations...
June 2016: Journal of Pediatric Urology
J Servet, P-A Bart, J-B Wasserfallen, J Castioni
How to recognize, announce and analyze incidents in internal medicine units is a daily challenge that is taught to all hospital staff. It allows suggesting useful improvements for patients, as well as for the medical department and the institution. Here is presented the assessment made in the CHUV internal medicine department one year after the beginning of the institutional procedure which promotes an open process regarding communication and risk management. The department of internal medicine underlines the importance of feedback to the reporters, ensures the staff of regular follow-up concerning the measures being taken and offers to external reporters such as general practioners the possibility of using this reporting system too...
November 4, 2015: Revue Médicale Suisse
Sundeep Mishra
Health-care providers are currently facing a huge challenge. At one end they are expending a huge amount of time and energies on health-care delivery including time spent on upgradation of their knowledge and skills (to remain abreast with the field and be able to provide state-of-art patient care), sometimes even at the expense of themselves and their families. On the other hand they are not receiving adequate re-imbursement for their efforts. To compound the problem several "traders" have entered the profession who are well adept in the materialistic approach abandoning the ethics (which currently happens to be the flavor of society in general), giving a bad name to the whole profession and causing severe grief, embarrassment and even dis-illusion to an average physician...
January 2015: Indian Heart Journal
Ananthalakshmi Ramamoorthy, Sathiya Jeeva Jeevakarunyam, Sunitha Janardhanan, Nadeem Jeddy, Srikaanth Aranmanai Vasan, Arundayanadhi Raja, Parvez Ikram
BACKGROUND: The therapeutic potential of yoga are often considered complementary to various forms of medical practice. Very few studies have evaluated the effects of yoga in the treatment of occupational hazards among dentists. Hence, this cross-sectional study was designed to evaluate the adoption of yoga techinques as an alternative therapy in treatment of physical and psychological occupational hazards among dental general practitioners in Chennai, India. MATERIALS AND METHODS: A validated closed-ended questionnaire was circulated to 500 dental general practitioners in Chennai, India and we received 394 completed questionnaires...
January 2015: Journal of Natural Science, Biology, and Medicine
Gudmund Grønhaug, Nina Østerås, Kåre Birger Hagen
BACKGROUND: Osteoarthritis (OA) is one of the most common causes of pain and disability in the adult population. Several studies have documented discordance between general practioners (GP) practice and management recommendations, but there is limited published information about patient reported experience of quality of care. The primary aim of this study was to assess the patient perceived quality of OA management in primary health care. Secondly, we wanted to explore the factors associated with the perceived quality of OA care...
2014: BMC Health Services Research
Jørgen Jevne, Jan Hartvigsen, Henrik Wulff Christensen
BACKGROUND: Adverse events are commonly observed in all parts of health care and have been reported extensively following manual therapy, including chiropractic. The majority of reported adverse events following chiropractic care are mild, transitory and self-limiting. However, little is known about patient filed compensation claims related to the chiropractic consultation process. The aim of this study was to describe claims reported to the Danish Patient Compensation Association and the Norwegian System of Compensation to Patients related to chiropractic from 2004 to 2012...
2014: Chiropractic & Manual Therapies
Shahkamal Hashmi, Syed Imtiaz Ali, Farzeen Tanwir, Taiba Yousuf Shamsi, Farrukh Rafiq Ahmed, Kelash Rai
INTRODUCTION: Chlamydia trachomatis is a frequently encountered condition by general physicians, urologists and infectious diseases specialists. It can affect both genders and causes significant morbidity if not treated properly and promptly. In addition, it can cause ophthalmia neonatorum, which manifests as neonatal conjunctivitis in the newborns. METHODOLOGY: The data was collected from fourteen tertiary care hospitals in two provinces of Pakistan during the time period of four months (September-December 2013)...
2014: International Journal of Emergency Mental Health
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