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Doctor avoidance

Joseph Fogarty, Clodagh Loughrey
Hyponatraemia is common and often a source of confusion for junior doctors. It is infrequently dangerous, but when it is, is a medical emergency and requires urgent treatment to avoid life-threatening cerebral oedema. Treatment of acute hyponatraemia is also potentially hazardous; it is therefore important to be able to recognise when urgent management is not indicated, and to investigate appropriately. This paper focuses on these issues, which are most likely to be the cause of consternation for the junior doctor...
May 2017: Ulster Medical Journal
Jemima Dooley, Nick Bass, Rose McCabe
BACKGROUND: Dementia diagnosis rates are increasing. Guidelines recommend that people with dementia should be told their diagnosis clearly and honestly to facilitate future planning. Aims To analyse how doctors deliver a dementia diagnosis in practice. METHOD: Conversation analysis was conducted on 81 video-recorded diagnosis feedback meetings with 20 doctors from nine UK memory clinics. RESULTS: All doctors named dementia; 59% (n = 48) approached the diagnosis indirectly but delicately ('this is dementia') and 41% (n = 33) approached this directly but bluntly ('you have Alzheimer's disease')...
March 12, 2018: British Journal of Psychiatry: the Journal of Mental Science
Gaëlle Pédrono, Cécile Ricard, Marilyne Bouilly, Claude Béata, Guillaume Sarcey, Bertrand Thélot
INTRODUCTION: Every year in France dog bites lead to several thousand visits to emergency departments and numerous hospital admissions. OBJECTIVE: This study aims to describe the sequelae 16 months after dog bites. MATERIALS AND METHODS: Following an initial epidemiological study on the severity of 485 dog bites carried out in 8 hospital emergency departments between May 1, 2009, and June 30, 2010, a second study investigating sequelae 16 months after the bite was conducted among 298 patients between September 2010 and December 2011...
February 23, 2018: Wounds: a Compendium of Clinical Research and Practice
Irena Kovačević, Višnja Majerić Kogler, Tihana Magdić Turković, Lidija Fumić Dunkić, Željko Ivanec, Davorina Petek
BACKGROUND: Self-care is often the first choice for people with chronic musculoskeletal pain. Self-care includes the use of non-prescription medications with no doctor's supervision, as well as the use of other modern and traditional treatment methods with no consultation of the health care provider. Self-care may have positive effects on the successful outcome of a multidisciplinary approach to treatment. The aim of this study was to investigate the experiences and attitudes of patients and health care providers to the self-care of chronic musculoskeletal pain...
March 7, 2018: BMC Musculoskeletal Disorders
Mohamed Amine Mesrati, Nidhal Haj Salem, Marwa Boussaid, Yosra Mahjoub, Ali Chadly, Abir Aissaoui
The spread of the disease of HIV has been decreased since the promotion and protection of human rights. In Tunisian law, patient infected by HIV, as every citizen, enjoys of all his rights without any discrimination, including the right to life and dignity, the right to care access, the free choice of doctor, the right to be informed and consent before any health care and specially the right to medical confidentiality. The Code of patients rights and the law no° 2007-12 of 12 February 2007 supplementing the law no° 92-71 of 27 July 1992 related to transmitted diseases ensure the protection and the respect of these rights...
May 2017: La Tunisie Médicale
C Yan-Qiang, P Zhi-Zhao, L I Yun, J Cai-Xiao, L Li
Objective To analyze the overseas imported malaria situation of Shijiazhuang City from 2012 to 2015, so as to provide the evidence for exploring the prevention and control strategy. Methods The data of overseas imported malaria were collected and analyzed with the descriptive method including Plasmodium species, population characteristics, epidemic focus distribution, onset time, diagnosis and treatment in Shijiazhuang City from 2012 to 2015, and the time from the onset to first medical visit, time from first medical visit to being diagnosed, and time from onset to being diagnosed of different Plasmodium species were analyzed respectively with the statistical analysis method...
July 18, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
Francesco Marongiu, Doris Barcellona
Direct oral anticoagulants (DOACs) represent an innovation because they avoid periodic laboratory monitoring, and also reduce cerebral bleeding. An examination of the performance of DOACs versus warfarin in randomized clinical trials dedicated to atrial fibrillation would reveal the poor performance of warfarin because the percentage of major bleeding is always above 3%; however, the percentage of major bleeding is less than half of that when the management is done in anticoagulation clinics (ACs). Several years ago, a common opinion was that ACs would disappear as soon as DOACs enter the market...
March 2, 2018: Internal and Emergency Medicine
Chi Zhang, Xiang Hu
In the past, people only focused on surgical resection of gastric cancer to obtain satisfactory therapeutic effect, while the concept of function-preserving in gastric cancer surgery has not been emphasized. Gastric function-preserving surgery was originally performed by Japanese doctor Maki for surgical treatment of gastroduodenal ulcer. With the definition of early gastric cancer being accepted, the pylorus-preserving gastrectomy can be used continuously in the treatment of gastric cancer. Because of high incidence of early gastric cancer in Japan, a variety of application and research about function-preserving gastrectomy in other areas for treatment of early gastric cancer, such as proximal gastrectomy and jejunal interposition, segmental gastrectomy, gastric local resection and laparoscopic and endoscopic cooperative surgery (LECS) at the same time, and regional or sentinel lymph node dissection were performed for the purpose of radical cure...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Reinier G Hoff, Joost Frenkel, Saskia M Imhof, Olle Ten Cate
Postgraduate medical training in the Netherlands has become increasingly individualized. In this article, the authors describe current practices for three residency programs at the University Medical Center Utrecht: anesthesiology, pediatrics, and ophthalmology. These programs are diverse yet share characteristics allowing for individualized residency training. New residents enter each program throughout the year, avoiding a large simultaneous influx of inexperienced doctors. The usual duration of each is five years...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Piotr Szkodziak, Filip Szkodziak, Kamila Trzeciak, Piotr Czuczwar
Uterine fibroids are benign uterine tumors. In women during the reproductive period, uterine fibroids occur in about 25%, whereas after this time, they are observed in more than 40% of women. In the majority of women (about 20-50%), such tumors do not cause discomfort and do not require treatment. Asymptomatic uterine fibroids usually undergo only regular medical control, whereas symptomatic fibroids are an indication for treatment. Current treatment methods include surgical, pharmacological and minimally invasive treatment...
December 2017: Przeglad Menopauzalny, Menopause Review
James McGann, Jaqueline Manohar, Harriet Hiscock, Denise O'Connor, Jan Hodgson, Franz Babl, Valerie Sung
AIM: The aim of this study was to determine the barriers and enablers influencing the uptake of two recommendations from a tertiary paediatric hospital's clinical practice guidelines by maternal and child health nurses (MCHNs) and emergency department (ED) doctors: (i) explaining normal crying; and (ii) avoiding attributing crying to gastro-oesophageal reflux (GOR) and limiting anti-reflux medication use. METHODS: The study was designed as 1-h focus group discussions, guided by the Theoretical Domains Framework, and a short questionnaire, with a purposive sample of MCHNs and ED doctors in Victoria, Australia in (March to September) 2015...
February 22, 2018: Journal of Paediatrics and Child Health
B Ludes, A Geraut, M Väli, D Cusack, D Ferrara, E Keller, P Mangin, D N Vieira
Sexual assault is a complex situation with medical, psychological, and legal aspects. Forensic experts play a major role in terms of forensic and gynecological medical examination and evidence collection in order to maintain the chain of custody. Victims should be examined by a specially trained medico-legal examiner in order to avoid multiple examinations in the surroundings that do not meet minimum health standards. The evolution and treatment of sexual assault victims are time-intensive and should optimally be provided by a team that includes a forensic medical doctor...
February 21, 2018: International Journal of Legal Medicine
María José Suárez, Cristina Muñiz
Labour absenteeism may be detrimental to firms and society because of the economic costs, organizational problems and production cuts that it involves. Although involuntary absenteeism due to accident or illness that prevents workers from performing their work is unavoidable, avoidable voluntary absenteeism may also emerge due to asymmetric information given that neither employers nor doctors have perfect information about workers' health status. Assuming that there is heterogeneity in individual's behaviour and thus some workers are more likely to take sick leave than others due to differences in observable and unobservable characteristics, we specify a Finite Mixture Model to analyse sick leave days per year using a sample of employees from the 2014 European Health Survey in Spain...
February 21, 2018: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Mohammed Tag-Adeen, Keiichi Hashiguchi, Yuko Akazawa, Ken Ohnita, Sawayama Yasushi, Niino Daisuke, Kazuhiko Nakao
Adult T-cell Leukemia/Lymphoma (ATL) is a rare disease, related to human T-lymphotropic virus-1 (HTLV-1) and presented mainly in adulthood by generalised lymphadenopathy, hepatosplenomegaly, skin lesions and hypercalcaemia, with rare gastrointestinal and/or oral manifestations. We reported this case to raise awareness and demonstrate the therapeutic challenges of this rare disease. A 49-year-old Japanese female presented with skin papules on both forearms, painful mouth ulcers and multiple neck swellings since early February 2017...
2018: Ecancermedicalscience
Carmen Tereanu, Giuseppe Sampietro, Francesco Sarnataro, Dumitru Siscanu, Rodica Palaria, Victor Savin, Tatiana Cliscovscaia, Valentina Pislaru, Valeriu Oglinda, Larisa Capmare, Mugurel Stefan Ghelase, Tamara Turcanu
Background and aims: The Republic of Moldova is a small ex-soviet country in the Central Eastern European group of states, whose official language is Romanian. In countries with limited resources, quality improvement in healthcare and patient safety are very challenging. This study aims to identify which areas of the patient safety culture (PSC) need prompt intervention. Methods: A cross-sectional study was conducted in three Moldovan healthcare settings, using the Romanian translation of the US Hospital Survey on Patient Safety Culture HSOPSC...
2018: Clujul Medical (1957)
Ingrid Vargas, Irene Garcia-Subirats, Amparo-Susana Mogollón-Pérez, Marina Ferreira-de-Medeiros-Mendes, Pamela Eguiguren, Angelica-Ivonne Cisneros, María-Cecilia Muruaga, Fernando Bertolotto, María-Luisa Vázquez
An adequate use of referral and reply letters-the main form of communication between primary care (PC) and out-patient secondary care (SC)-helps to avoid medical errors, test duplications and delays in diagnosis. However, it has been little studied to date in Latin America. The aim is to determine the level and characteristics of PC and SC doctors' use of referral and reply letters and to explore influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was conducted through a survey of PC and SC doctors working in public healthcare networks (348 doctors per country)...
February 14, 2018: Health Policy and Planning
Alexandra M Schnoes, Anne Caliendo, Janice Morand, Teresa Dillinger, Michelle Naffziger-Hirsch, Bruce Moses, Jeffery C Gibeling, Keith R Yamamoto, Bill Lindstaedt, Richard McGee, Theresa C O'Brien
The Graduate Student Internships for Career Exploration (GSICE) program at the University of California, San Francisco (UCSF), offers structured training and hands-on experience through internships for a broad range of PhD-level careers. The GSICE program model was successfully replicated at the University of California, Davis (UC Davis). Here, we present outcome data for a total of 217 PhD students participating in the UCSF and UC Davis programs from 2010 to 2015 and 2014 to 2015, respectively. The internship programs at the two sites demonstrated comparable participation, internship completion rates, and overall outcomes...
2018: CBE Life Sciences Education
Robert Preston
Background: Physician-administered euthanasia (PAE) was legalized, along with physician-assisted suicide (PAS), in The Netherlands in 2001. Sources of data: Annual reports of the Dutch Regional Euthanasia Review Committees, the committees' 2015 published Code of Practice and research studies. Areas of agreement: There is a general openness about the practice of PAE/PAS in The Netherlands and an avoidance of misleading euphemisms. The 2001 law also includes arrangements for post-event review of PAE/PAS decisions...
February 12, 2018: British Medical Bulletin
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
Utkarshani Jaimini
According to a study done in 2014 by National Health Interview Survey around 6.3 million children in United States suffer from asthma [1]. Asthma remains one of the leading reasons for pediatric admissions to children's hospitals, and has a prevalence rate of approximately 10% in children and it leads to missed days from school and other societal costs. This occurs despite improved medications to control asthma symptoms. Asthma management is challenging as it involves understanding asthma causes and avoiding asthma triggers that are both multi-factorial and individualistic in nature...
May 2017: Proc Int Conf Smart Comput SMARTCOMP
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