Anatolian Journal of Family Medicine最新文献

{"title":"A Glimpse From Behind the Mask: Thoughts from the Old Clinician","authors":"Strauss Dw","doi":"10.26420/jfammed.2021.1266","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1266","url":null,"abstract":"This is an article/essay with focus on the question of the conflict between professional mystique and transparency in the clinician-patient relationship. Implied is the assumption that the professional “mask” influences treatment outcome and can distort or enhance the genuine nature of the relationship between those being served and those who serve them. The simple purpose of the question asked in the article is to stimulate discussion as to the relative utility of the professional mystique and professional transparency as to the degree that each influences treatment outcome and clinician satisfaction.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84200348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimicrobial Pneumonia during the Early Stages of a Global Pandemic","authors":"J. H, Henriksen G","doi":"10.26420/jfammed.2021.1265","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1265","url":null,"abstract":"Community-acquired pneumonia is an acute infection of lung parenchyma which causes local and systemic inflammatory changes via cytokines. Several bacteria and viruses are responsible for this type of pneumonia, and the most common bacterial cause is Streptococcus pneumoniae. The classic symptoms are cough, fever, and pleuritic chest pain. In the Winter of 2020, a new strain of coronavirus known as SARS-CoV-2 spread throughout the world and was responsible for a global pandemic that transformed the way we live our lives. A 93-year old female presented to the hospital with respiratory distress and was found to have not only COVID-19 pneumonia but also superimposed Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa pneumonia. Following the most up-to-date guidelines, she was determined to have community-acquired pneumonia. Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa are uncommon causes of communityacquired pneumonia. She was treated with the standard of care at the time, which included vancomycin, piperacillin-tazobactam, and hydroxychloroquine. This case highlights the rarity of this specific presentation of community acquired pneumonia in regards to microbial etiology. It showcases that patients may develop certain diseases despite not having any risk factors. A major takeaway point is that apt decision making is a critical and time sensitive matter when determining whether a bacterial co-infection is present since it can affect patient outcomes. Since co-infections are relatively infrequent, antibiotic use in COVID-19 positive patients needs to be tailored accordingly. At the same time, it is crucial to keep in mind that co-infections are associated with increased severity of COVID-19 as well as poorer outcomes.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"218 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72951245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Management of Irritable Bowel Syndrome: The Viewpoint of Italian General Practitioners in Activity and in Training","authors":"B. M, T. C., R. F., M. R., Lambiase C, Visaggi P, Pancetti A, Benedetto E, D. N., M. S, D. R","doi":"10.26420/jfammed.2021.1264","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1264","url":null,"abstract":"Background: Guidelines on Irritable Bowel Syndrome (IBS) are usually developed by specialists, with a possible translational gap in primary care. Aims: To evaluate the knowledge of IBS of Italian General Practitioners (GPs) and the difference compared to doctors in Training for General Practice (ITGPs). Methods: A questionnaire was completed by 170 GPs and 64 ITGPs. Results: The Rome Criteria and Bristol Scale are more familiar to ITGPs than GPs. The most frequently used diagnostic symptoms are abdominal pain, bowel movement frequency and bloating. GPs and ITGPs think that bloating and abdominal discomfort should be introduced into the definition of IBS. Intestinal motility disorders and psychological factors are considered to be the most probable cause of IBS. GPs report more frequently than ITGPs that the patient's request and difficulties in managing the disorder are reasons for a gastroenterological referral. Conclusions: There is still a gap between the indications provided by the experts and clinical practice, and this seems greater on the part of GPs than ITGPs. Abdominal pain and bowel frequency changes are considered the main symptoms for diagnosing IBS, but most GPs and ITGPs would like to include bloating among the diagnostic criteria. It would be highly desirable to develop commonly shared guidelines between gastroenterologists and GPs.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79058109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the Differential for Left Lower Quadrant Pain: A Case of Epiploic Appendagitis","authors":"Smith Jl, Potts Se","doi":"10.26420/jfammed.2021.1263","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1263","url":null,"abstract":"Appropriate triage of abdominal pain in the outpatient setting is critical for safe and effective management of patients. Abdominal pain has a broad differential, heavily dependent on elicitation of a clear history, and pertinent physical exam findings. In adults >50 with left lower quadrant pain, diverticulitis is the most common cause. Diverticulitis can cause significant morbidity in this population, frequently requiring inpatient management, systemic antibiotics, and occasionally surgical intervention. A frequently overlooked cause of left lower quadrant pain in adults is Epiploic Appendagitis (EA). While similar in presentation, unlike diverticulitis, EA rarely requires more than outpatient treatment with non-steroidal anti-inflammatories for pain management. Here we present a report of left lower quadrant pain consistent with diverticulitis in a 55 yo female in the outpatient setting, found to have EA by imaging. This case demonstrates that the differential for LLQ pain without signs of an acute abdomen in an adult, should include EA.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85390661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up Care of Monoclonal Gammopathy of Undetermined Significance: A Guide for Primary Care Physicians","authors":"Z. Hammad, E. Hernandez, S. Tate","doi":"10.26420/jfammed.2021.1261","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1261","url":null,"abstract":"Monoclonal Gammopathy of Undetermined Significance (MGUS) is a condition in which M protein, an abnormal monoclonal immunoglobulin, is present in the blood at a nonmalignant level. Specifically, it is defined by: blood serum M protein concentration <3 g/dL (<30 g/L), <10% plasma cells in the bone marrow, and no evidence of end organ damage [1,2]. Evidence of end organ damage includes hypercalcemia, renal insufficiency, anemia, and bone lesions. These are indicative of MGUS progression and which can be attributed to the monoclonal plasma cell proliferative process [3]. MGUS occurs in 3% of the general population older than 50 years. Incidence increases with age and varies with sex with higher rates observered in males than females [1,4]. MGUS is the most common plasma cell disorder, with 60% of patients that present to the Mayo Clinic with a monoclonal gammopathy being diagnosed with MGUS [3]. While it is typically an asymptomatic condition, it is premalignant disorder to other monoclonal gammopathies. Multiple Myeloma (MM) is almost always preceded by MGUS and the majority of patients will have detectable levels of M protein for at least 5 years prior to MM diagnosis [5,6]. MGUS also precedes immunoglobulin light chain (AL) amyloidosis and Waldenstrom Macroglobulinemia (WM) and tends to progress to disorders at a fixed but unrelenting rate of 1% per year [4].","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81190891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report: Acute Respiratory Distress in a Patient with Anemia","authors":"S. Kotnala, S. Wadhawan, Parmar Gm","doi":"10.26420/jfammed.2021.1262","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1262","url":null,"abstract":"Acute respiratory distress can be life threatening if proper management is delayed. The cause of respiratory distress needs to be diagnosed quickly in order to administer appropriate and timely treatment. However, it is sometimes difficult to tease out various conditions that can present as acute respiratory distress. We present such a unique case of acute respiratory distress in a patient with anemia. We show how the ability to differentiate between cardiogenic and non-cardiogenic pulmonary edema can help in diagnosis and appropriate timely management of acute respiratory distress.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88812791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Testing in Young Individuals and Pandemics Monitoring: Low Susceptibility to the Infection and Lack of Positive Results","authors":"Watanabe Asa, Dias Vc, Machado Abf, Diniz Cg, Davis Vl","doi":"10.26420/jfammed.2021.1260","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1260","url":null,"abstract":"Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV- 2), a novel betacoronavirus, is the etiological agent of coronavirus disease 2019 (COVID-19), a global health threat. The rapid spread of COVID-19 has resulted in an urgent requirement for rapid diagnosis and effective therapeutic strategies against SARSCoV- 2 [1]. Besides symptomatic patients, recent studies indicate that people who are infected but do not presented symptoms also play a role in the spread of COVID-19. Spread happens when an infected person coughs, sneezes, or talks, and aerosol/droplets from their mouth or nose are launched into the air and reaches the mucous membranes of people nearby [2]. Although some point-of-test assay and Enzyme Linked Immuno Sorbent Assay (ELISA) based protocols are available for COVID-19 diagnosis, the reverse transcriptase real-time quantitative polymerase chain reaction (RT-qPCR) remains as gold standard diagnostic tool and is supposed to present high sensitivity and reliability of viral genome in clinical specimens [3]. Healthcare Workers (HCW) are at high risk of SARS-CoV-2 infection and epidemiological features of its transmission into household are limited. Several families, mainly from HCW, are temporarily separated due to isolation and quarantine, and the risks associated with these professions and the dynamics of household transmission must be evaluated [4]. These questions are still more notorious in low income and developing countries, such as Brazil, once public health policies anti-COVID-19 is extremely fragile. During COVID-19 pandemics, a 39-year-old Brazilian woman, intensive care physician at tertiary hospital in our region, in the third trimester of pregnancy, experiencing hyposmia and ageusia (temporary loss of smell and taste respectively), presenting cough, sneeze and nasal congestion, was diagnosed with COVID-19 by RT- qPCR. Other signs and symptoms such as fever, sore throat, dyspnea, oxygen saturation <95%, vomiting, respiratory distress or diarrhea was not observed. As an intensive care physician, she was immunized against Influenza virus (A and B) by vaccination early in the beginning of 2020 and was working in the frontline in a Brazilian tertiary hospital, where several patients tested positive for COVID-19 at the same time. Further, her husband (39 years old) and her son (13 years old) were also screened for COVID-19, by RT-qPCR, according to the disease transmission containment protocol. The husband tested also positive for COVID-19 while her son presented negative result for SARS- CoV-2 from the combined oropharyngeal and nasal swab. The husband reported sore throat, sneezing and headache. The son presented cough, nasal congestion and coryza. Until the moment of COVID-19 test, the husband and the child did not receive the 2020 Influenza virus (A and B) vaccine. Frontline HCWs could be at high risk of infection due to the close contact with patients and reports have described COVID-19 cases in HCWs since early in the ","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78562193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Personality Traits be Related to Medical Adherence in Patients with Myocardial Infarction?","authors":"Brazaitiene Ma, Adomaitiene V, Gustiene O","doi":"10.26420/jfammed.2021.1258","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1258","url":null,"abstract":"Background: For myocardial infarction survivors, long-term pharmacotherapy is an important element of a complex treatment and a better prognosis may be achieved through better medication adherence. Aim: The purpose of this study is to find out whether it is possible to predict medication adherence of the patients who survived myocardial infarction via assessing their personality. Design and Setting: Analytic cross-sectional study. Methods: The study was held in Hospital of Lithuanian University of Health Sciences Kaunas clinics (HLUHS KK) department of cardiology. Patients with ST-segment elevation myocardial infarction were randomly included and completed questionnaire before discharge from Cardiology unit. We recruited 198 patients with myocardial infarction who completed questionnaire (ICD-10 diagnoses I21.0, I21.1 or I21.2). Medical adherence association with personality was assessed with Morisky-Green medical adherence scale (MMAS-8) and the Big-Five inventory. Results: Medical adherence was associated with conscientiousness, agreeableness, neuroticism and extraversion. There was no significant association with openness to experiences. Neuroticism negatively affected medical adherence. It was determined, that conscientiousness, agreeableness and extraversion positively affected medical adherence. Conclusion: This study demonstrated that good medical adherence in patients with ST-segment elevation myocardial infarction was associated with higher scores in conscientiousness and agreeableness personality traits and lower scores in neuroticism.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76754007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Ketoacidosis Triggered by an Emphysematous Urinary Tract Infection: A Case Report and Mini-Review of Literature","authors":"Buenrostro-Valenzuela Jc, J. Amezquita-Perez, W. Schlie-Villa, J. Romero-Bermúdez","doi":"10.26420/jfammed.2021.1259","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1259","url":null,"abstract":"Generally, the most common triggers for Diabetic Ketoacidosis (DKA) are infectious diseases, such as Urinary Tract Infections (UTIs) or pneumonia. However, emphysematous infections are significant diseases rarely associated with DKA. Here, we present two cases of emphysematous urinary tract infection associated to diabetic ketoacidosis, highlighting the importance of a timely intervention and treatment. We review the need for appropriate laboratory and image testing in the context of infected patients who do not reach inflammatory/ glycemic goals to diagnosticate complicated infectious processes. This case report and mini-review also explore pathophysiology, the association of DKA and urinary emphysematous infections and treatment options.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75161669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Zinc Deficiency and Its Influence Factors in Children Under 14-year-old in China","authors":"Cai-Jin Y, Jing-Ying S, Gang-Xi L","doi":"10.26420/jfammed.2021.1257","DOIUrl":"https://doi.org/10.26420/jfammed.2021.1257","url":null,"abstract":"Background: In recent years, zinc deficiency in children has attracted global attention. There are some differences in zinc deficiency in different countries and regions. However, there are few multi-center and large-sample studies on zinc deficiency in children in mainland China. Objective: To evaluate the status of zinc deficiency and its influence factors in children under 14-year-old in mainland China, and to provide evidence-based evidence for the strategy of prevention and treatment of zinc deficiency in children. Methods: PubMed, Embase, CNKI and other databases were searched about the cross-sectional survey literature on zinc deficiency and its influencing factors of under 14-year-old children in mainland China from 2005 to 2021. Stata 14.0 statistical software was used for Meta-analysis. Two independent reviewers identified eligible studies. Results: We identified 55 studies with 292,877 healthy children and adolescents in the Meta-analysis. The overall zinc deficiency rate was 27.0% (95% CI 22.8%-31.3%). From coastal areas of China showed that the zinc deficiency rate was 21.7% (95% CI 16.2%-27.1%) as 29.6% (95% CI 24.9%- 34.4%) from inland area of China. The zinc deficiency rate in the male group was greater than in the female group, and the difference was statistically significant [OR=1.052, 95% CI (1.019, 1.087), p=0.002]. The zinc deficiency rate in infant group was higher than that in toddler group [OR=1.38, 95% CI (1.16, 1.64), p=0.000], preschool group [OR=1.475, 95% CI (1.163, 1.870), p=0.001], and school-age group [OR=1.746, 95% CI (1.257, 2.425), p=0.001], with statistical significance. There was no significant difference in zinc deficiency rate between the toddler group and the preschool group [OR=1.059, 95% CI (0.918, 1.222), p=0.429], the toddler group and the school-age group [OR=1.136, 95% CI (0.848, 1.523), p=0.394], and the preschool group and the school-age group [OR=0.986, 95% CI (0.754, 1.291), p=0.919]. There was no statistically significant difference in zinc deficiency rate between the groups of well-educated and the poor-educated dietary provider. (OR=1.095, 95% CI (0.867, 1.383), p=0.446), and no statistical significance in zinc deficiency rate between urban group and rural group [OR=1.152, 95% CI (0.810, 1.637), p=0.432]. Conclusions: At present, zinc deficiency in children and adolescents in mainland China is still serious, especially in infants. The zinc deficiency rate in male children was more serious than that of female children. The zinc deficiency rate of children in inland areas was higher than that in coastal areas. Factors such as different educational level of food providers and different areas from urban or rural were not the major influencing factors of zinc deficiency.","PeriodicalId":33070,"journal":{"name":"Anatolian Journal of Family Medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78228606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}