Journal of general practice (Los Angeles, Calif.)最新文献

{"title":"National governments collaborating to improve the health and well-being of migrants and refugees","authors":"pPaul Dougp","doi":"10.4172/2329-9126-C1-009","DOIUrl":"https://doi.org/10.4172/2329-9126-C1-009","url":null,"abstract":"","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70286036","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":"Importance of Lymphoscintigraphy to Find Sentinel Ganglion in the Context of Malignant Neoplasm of Breast","authors":"S. Gonçalves, F. Gonçalves, C. Rodrigues, R. Macedo","doi":"10.4172/2329-9126.1000356","DOIUrl":"https://doi.org/10.4172/2329-9126.1000356","url":null,"abstract":"Aim: To assess the importance of the sentinel ganglion (GS) detection technique by lymphoscintigraphy in order to avoid lymphedema of the upper limbs in malignant neoplasms of the breast. The sentinel ganglion is the first ganglion of the lymphatic chain to drain the lymph from the primary tumor. The lymphoscintigraphy allows to identify this ganglion, to facilitate its removal by the surgeon and to be analyzed by the pathological anatomy through an extemporaneous analysis in order to avoid axillary emptying in case of negative analysis for metastases. \u0000Material and Methods: All lymphoscintigraphy were performed with the BrigthView Philips model camera at the SESARAM, E.P.E.. All of these studies followed the same protocol according to the EANM guidelines. An anamnesis of the patient was carried out, the explanation of the procedure and the positioning of the patient according to the protocol in force. A dynamic study was performed immediately after administration of the radiopharmaceutical and then static, anterior, oblique and lateral images. After processing the acquired images and marking GS on the skin with the aid of the Europrobe 3 probe, clinical reports were performed. For the analysis of the data, we selected female patients with breast neoplasia, who underwent the examination between June 23, 2017 and March 22, 2018, aged between 33 and 88 years. \u0000Results: Through the evaluation of the sample of 56 users we can verify that this technique allowed to avoid axillary emptying in 39 patients. Of the 56 patients, 2 had bilateral breast neoplasia, 33 right breast neoplasm and 21 left breast cancer. Of the 2 patients with bilateral malignant neoplasia, one presented both negative ganglia and the other presented negative right GS and positive left GS and consequent axillary emptying. Of the 33 patients with neoplasia of the right breast 8, they emptied, and of the 21 patients with left breast neoplasia, 9 performed emptying. \u0000Conclusions: According to the data obtained in the SESARAM E.P.E. Nuclear Medicine study, it was verified that lymphoscintigraphy allowed to avoid axillary emptying in 39 patients, which corresponds to 70% of the sample. It is confirmed that this diagnostic technique is an asset in the preservation of the lymphatic chain. The availability of this technique in a hospital regimen for the detection of sentinel ganglion in the Regional Health Service is considered important to avoid the limitations associated with axillary emptying and consequent improvement in the quality of life of these patients\".","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47081539","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":"To Cath or Not to Cath: PCI for Chest Pain in Stable Coronary Artery Disease","authors":"M. Khalil","doi":"10.4172/2329-9126.1000353","DOIUrl":"https://doi.org/10.4172/2329-9126.1000353","url":null,"abstract":"Most patients with symptomatic Coronary Artery Disease (CAD) are seeking quick relief for their angina by requesting Percutaneous Coronary Intervention (PCI) that proved to be effective in Acute Coronary Syndrome (ACS), however, their request for PCI may be appropriately denied in stable CAD. Temptations for complete revascularization in CAD make certain valid target for patients as well as their treating physicians; nonetheless, cost effectiveness based on documented outcomes may not support interventional strategy.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48317841","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":"Hocus POCUS or Crucial Tool? Attitudes of General Practice Training Scheme Program Directors to Point of Care Ultrasound","authors":"M. O'Sullivan, S. Walkin","doi":"10.4172/2329-9126.1000351","DOIUrl":"https://doi.org/10.4172/2329-9126.1000351","url":null,"abstract":"Introduction: Point of care ultrasound is used in several medical specialties but has not yet been widely adopted in primary care in Ireland. This study explored the attitudes of GP training scheme program directors towards POCUS. This included views on clinical use and implications for postgraduate GP training.Methods: This was a mixed methods study. A survey was distributed to all GP training scheme program directors in the Republic of Ireland. The survey included questions regarding clinical use and current provision of education in point of care ultrasound to GP trainees in individual schemes. A focus group examining similar themes was also done.Results: 50% of PDs responded to the survey. No scheme had an established training program in POCUS, and only one was considering starting one. Reasons cited included perceived lack of trainee interest, lack of faculty expertise, and lack of time and resources, including equipment. Potential uses for POCUS included basic obstetric examinations for detection of foetal heart activity, and right upper quadrant ultrasound for investigation of biliary colic. Facilitators to the use of ultrasound included rapidity of diagnosis and patient satisfaction, while barriers included lack of expertise and equipment, and concerns about clinical indemnity. The focus group corroborated these findings. PDs participating in the focus group also raise concerns about time and resource constraints both in practice and in training programs, the lack of a critical mass of expertise in the GP training community, the risk of over diagnosis, and concerns around quality assurance. The potential for “creep” effect was recognized. The group saw POCUS as having a limited potential role in a small number of clinical scenarios. Facilitators to use included patient satisfaction and increasing miniaturization and affordability of equipment.Conclusions: There are currently no established training programs in POCUS for GP trainees in Ireland and there are no immediate plans to establish any. There is limited interest in its use in clinical practice, with multiple barriers identified.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46977586","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":"Changing on Patient-Centred Attitudes on Same Students Group; A Qualitative Study","authors":"Tontus Ho, S. Nebioğlu","doi":"10.4172/2329-9126.1000350","DOIUrl":"https://doi.org/10.4172/2329-9126.1000350","url":null,"abstract":"Objective: Study aimed to clarify the effect of educational activities on same students in their pre-med students and medical students standing point about patient centred care.Methods: The PPOS questionnaire used to examine patient-centredness and has been used in pre-med student and medical student samples. We surveyed students in their first month in undergraduate medical education following their enrolment in 2010. Three years later in 2013-2014 educational year same group included to same questionnaire, when they are 4th year students. Same 128 students filled questionnaire forms in two different years. The survey utilized the patients practitioners orientation scale (PPOS) to measure students’ changing attitudes.Results: 59% of respondents were female and mean age was 18.52 in their 1st year. In total PPOS scores were 55.58 for Year 4 students and 62.41 for Year 1 students. We found that sharing and caring domains scores lowered when students finished their basic medical science education including empathy, communication and ethics lectures.Conclusion: Despite encouraging patient-centred attitudes of undergraduate medical students by curricular models, our findings showed that in their further level, students became less patient centred. Depending on respondents’ score, curriculum organisers should re-check their curricular aim and educational program or activities. Feedback in medical education can be accepted as “specific information about the students’ perception and attitudes”. These findings give great information concerning effectiveness of program on specific areas with the clues to improve the program’ performance”.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"6 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48728676","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":"Steven Johnson Syndrome: Adverse Drug Reaction","authors":"P. Chandaluri, M. Prabhanjan","doi":"10.4172/2329-9126.1000349","DOIUrl":"https://doi.org/10.4172/2329-9126.1000349","url":null,"abstract":"The Steven-Johnson Syndrome (SJS) is a rare immune complex mediated hypersensitivity condition. Here we report the case of Steven-Johnson Syndrome due to the co-administration of aceclofenac and cefixime. NSAIDs are the rare type of medication that causes SJS and cefixime is a traditional medication that causes the condition. A 22- years-old patient was admitted in the hospital with a complaint of fever for 15 days and he was treated by giving aceclofenac, cefixime and general symptomatic treatment. On the 4th day of treatment erythromatous patches were observed throughout the body. Laboratory investigations were performed and the case was identified as Steven-Johnson Syndrome. The treatment was withdrawn and he was administered with steroids, amoxicillin, metronidazole and general symptomatic treatment. The patient has recovered after a week.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"2018 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47529216","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":"Hamstring Strain Injury-Testing and Occurrence Prediction","authors":"Ł. Oleksy, A. Mika, Renata Kielnar, W. Czarny","doi":"10.4172/2329-9126.1000e121","DOIUrl":"https://doi.org/10.4172/2329-9126.1000e121","url":null,"abstract":"Łukasz Oleksy1,2, Anna Mika1*, Renata Kielnar3 and Wojciech Czarny4 1Department of Clinical Rehabilitation, University of Physical Education in Krakow, Poland 2Oleksy Physiotherapy Clinic, Poland 3Faculty of Medicine, University of Rzeszów, Poland 4Department of Physical Education, University of Rzeszów, Poland *Corresponding author: Anna Mika, Department of Clinical Rehabilitation, University of Physical Education in Krakow, Poland, Tel: 48126831134; Email: anna.mika@awf.krakow.pl","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000e121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42889495","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 Epidemiology of Multimorbidity in Primary Care","authors":"K. Rhodes, D. Edwards, A. Cassell, A. Harshfield, J. Brimicombe, S. Griffin","doi":"10.17863/CAM.17685","DOIUrl":"https://doi.org/10.17863/CAM.17685","url":null,"abstract":"This study received no specific funding. Kirsty Rhodes was supported by the UK Medical Research Council (grant number: U105260558).","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45767288","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":"Practical Challenges in Implementing a Simplified Leaflet for HIV Patients in Resource Poor Settings: The Practice towards Public Health","authors":"S. K. Barik, S. Tomar, R. Tandon, K. K. Mohanty, B. Joshi, D. Bisht, S. Jena, S. Tripathy","doi":"10.4172/2329-9126.1000347","DOIUrl":"https://doi.org/10.4172/2329-9126.1000347","url":null,"abstract":"A simple and readable patient information leaflet has been developed to access the socio-demographic, biological features, clinical profiles as well as biochemical parameters of HIV patients. The main objectives are to provide dual visual/textual information on HIV testing that will be helpful to improve the patient’s knowledge. This patient information leaflet secures the HIV test in leaflet format rather than verbal counseling. This patient information leaflet will be helpful in describing the patient’s characteristics by written information and the final document would be prepared for analysis of biological and clinical features in a target population study. To identify, recommend and implement of this patient information leaflet is the best practices of this type of patient information design. Acquired immuno-deficiency syndrome is a highly chronic disease caused by human immunodeficiency virus. The patient follow-up antiretroviral therapy treatment during acquiring the AIDS leads to treatment failure is the cause of the emergence of drug resistance. The human immuno-deficiency virus-infected person management requires the depth collection history, physical examination, laboratory testing etc. Such kind of information is required to develop a patient information leaflet to follow up the clinical features of HIV patients during each visit. This patient information leaflet is divided into four parts. In part-1 contains the social features, risk factors opportunistic infections, various signs and symptoms of HIV infection. In part-2 contains the CD4 counts, part-3 contains patient follow- up visits during ART, part-4 contains the biochemical features of the HIV-infected patients. The patient information leaflet is required based on knowledge, attitudes and practices on data collection during focus on human immuno-deficiency virus study.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"6 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43434939","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":"Hematuria in paediatrics","authors":"Maya Mouzannar","doi":"10.4172/2329-9126.1000359","DOIUrl":"https://doi.org/10.4172/2329-9126.1000359","url":null,"abstract":"A 10 year-old boy presented to the pediatric clinic with gross hematuria, tea-colored urine dating from 4 days before consulting, mild pelvic abdominal pain, decreased appetite and history of 2 days of fever prior, no nausea, no vomiting. Upon reviewing the past medical history over the previous weeks: patient noted that 15 days prior to consulting, he complained of sore throat with enlarged tonsils, no antibiotic was taken. On physical exam, patient has a blood pressure of 115/79, bilateral flank abdominal tenderness, no edema.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"6 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70285103","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}