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

{"title":"Improvement of Post Anoxic Myoclonus with Valproic Acid and Add on Levetiracetam Therapy","authors":"A. Sarangi","doi":"10.4172/2329-9126.1000344","DOIUrl":"https://doi.org/10.4172/2329-9126.1000344","url":null,"abstract":"Myoclonus may be defined as sudden muscle contractions that are brief, involuntary, and shock-like. There are many conditions that can lead to myoclonus including spinal cord injury, stroke and as a side effect of certain drugs. Post hypoxic myoclonus is a recognized entity that develops post successful resuscitation of cardiac arrest and this is known in the literature as Lance Adams Syndrome. Often myoclonus is confused with an underlying seizure disorder. Myoclonic status epilepticus at any time after return of spontaneous circulation (ROSC) is even considered to reliably indicate a poor prognosis. Different treatments have been attempted to manage post hypoxic myoclonus including valproic acid and clonazepam and even Bilateral Pallidal Deep Brain Stimulation. The authors would like to present a case report of a 59-years-old male with chronic post hypoxic myoclonus who was successful treated with a combination medication regime of valproic acid and levetiracetam.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46652833","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":"Influence of Diabetes and Hemodialysis Against Nerve Conduction Studies","authors":"Y. Kato, H. Bando, Tomomi Fujikawa, Miyuki Narutaki, Masami Yamamoto, H. Kakutani, Yuji Shirai, K. Ishikura, Kazuhiro Kusunoki, S. Tanaka, T. Kawata, S. Kanazawa, Sayuri Matsuzaki, M. Bando, S. Waka","doi":"10.4172/2329-9126.1000343","DOIUrl":"https://doi.org/10.4172/2329-9126.1000343","url":null,"abstract":"Background: Diabetic peripheral neuropathy (DPN) has been prevalent and discussed, and nerve conduction studies (NCS) has been continued. We have checked NCS using recently introduced useful DPN-Check device. Subjects and Methods: The subjects were 66 patients (pts) classified into 4 groups according to existence of diabetes mellitus (DM) and hemodialysis (HD); Group1: DM (+), HD (+) in 15 pts, group 2: DM (-), HD (+) in 15 pts, group 3: DM (+), HD (-) in 20 pts, group 4: 16 healthy controls. Methods included measurements of sural nerve conduction velocity (SNCV) and sural nerve action potential (SNAP) using HDN-1000. Results: Average age in each group was 64.4 years to 72.6 years. SNCV value of 4 group in average was 37.1 m/sec, 46.3 m/sec, 49.3 m/sec, 53.2 m/sec, respectively, and value of group 1 was significantly lower than those of group 2,3,4 (p<0.01). Similarly, average SNAP was 4.1 μV, 8.7 μV, 8.0 μV, 21.6 μV, respectively, and group 1,2,3 were significantly lower than group 4 (p<0.01). There was significant correlation between SNCV and SNAP in all subjects (p<0.01). Significant correlations were shown between DM duration and SNCV, and DM duration and SNAP (p<0.01). Discussion and Conclusion: SNCV and SNAP were measured successfully and easily by HDN-1000, indicating clinical availability. Obtained data suggested that 1) SNCV is not significantly decreased due to only uremic neuropathy, 2) SNCV is significantly decreased in patients with both HD and DM, 3) SNAP is significantly decreased in patents with DM for years and 4) SNAP would be remarkably decreased when HD is in addition to DM. These results would become the basal data of future NCS for DM and HD.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49353015","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":"\"By The Way...\"Phenomenon: A Qualitative Study of the Additional Demands in Closing Moments of Medical Interview in Family Medicine","authors":"J. Turabián","doi":"10.4172/2329-9126.1000342","DOIUrl":"https://doi.org/10.4172/2329-9126.1000342","url":null,"abstract":"Objective: To identify and characterize, the additional demands (ADs) in the family medicine practice. Participants and Methods: A qualitative, observational, narrative study, to explore the demand that occur at the end of the visit, with the presentation of a new query motif that is added to the previous one, once this one is finished, from June to August, 2017, in a family medicine office in Toledo, Spain, was carried out, by recording the words used by the patient. From a randomly selected date we included all patients performing additional demand until data saturation. An analysis of the content of the demands collected of each patient included was carried out. The technique to control bias was methodological triangulation between the results obtained with the data that had been reported in the literature. Results: A total of 116 ADs were included, of which 85 (73%) were from female patients and 31 (27%) were from male patients. The age range was 14 to 91 years. The categories that were assessed as with very high or high importance were: 1) What seems to concern or interest the patient more in that moment or it seems to be the most important or the main reason for the doctor at that time, including the consultation on a chronic topic that presents itself as new; 2) What is related or insists in some way on the previous demand and expresses an action to act, or a fear of the previous demand; 3) to sleep or to “nerves”; 4) more than a demand is a story (usually psycho-social); and 5) demand for another family member present or absent in the consultation. The additional demand phrases that began with the conjunction “And ...” (In addition to) were the most frequent, followed by those that began with “And ... another thing ...”, “Ah!” or “Oh!” (An interjection used to express surprise), and “And since I’m here ... “or” By the way ...”. Conclusions: Although some ADs seem to occur in a random manner and to be a superfluous request, most of them, however, can contain issues that most concern the patient or are rated as more important by the physician. ADs with some psychosocial content are the most frequent and important. But, its aspect of commonplace demands, make it difficult to take them into account. Family doctor never should underestimate any demand in closing moments of medical interview of the patient, especially if its content is partly psychosocial, since that may be the real and important motive that led him or her to the consultation. Therefore, a pragmatic, unstructured and strategic interview can be proposed: from where the doctor and the patient can go, in zigzag, “through the field instead of going the path”, taking advantage of the opportunities, as the appearance of ADs.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"2017 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41361963","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 Potential Role of Primary Care Personnel in the Prevention and Screening of Cancer","authors":"L. Dobrossy, A. Budai","doi":"10.4172/2329-9126.1000339","DOIUrl":"https://doi.org/10.4172/2329-9126.1000339","url":null,"abstract":"The reduction of incidence and mortality of cancer puts a heavy burden on all actors of the health care system. The primary care personnel who see their exclusive role as treating sick people must not be an exception. As a new task, they have to do their part in the prevention aiming at elimination of lifestyle-related risk factors, and in the efforts to detect and treat cancer as early as possible. This paper indicates how they can take part in these efforts, discusses the natural history of cancer, the methods of prevention and screening, and the benefits and potential harms of interventions. Its message is that the efforts which mostly but not exclusively are the tasks of public health could be successful only by the contribution, change of traditional mentality, active and initiative attitude of primary care personnel.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45177105","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":"Infectious Sacroiliitis: A Radiographic No Touch Lesion","authors":"A. Malhotra, R. Kalil, Ryan A. Jones, D. Schwartz, Asem Qadeer, Mingqian Huang, R. Abdullah","doi":"10.4172/2329-9126.1000336","DOIUrl":"https://doi.org/10.4172/2329-9126.1000336","url":null,"abstract":"Ashwin Malhotra1,2*, Ramsey Kalil1, Ryan Jones1,3, Danielle Schwartz1, Asem H Qadeer1, Mingqian Huang4 and Robert Abdullah5 1Department of Medicine, Stony Brook University Hospital, New York, USA 2Department of Neurology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, USA 3Department of Neurology, Stony Brook University Hospital, New York, USA 4Department of Radiology, Stony Brook University Hospital, New York, USA 5Department of Medicine, Stony Brook University Hospital, Health Sciences Tower, New York, USA","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-9126.1000336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43760475","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":"Factors Influencing Practice of Optimal Dietary Intake of Alcoholics under Rehabilitation in Asumbi-Homabay, Kenya","authors":"L. Mutuli, P. Bukhala, G. Nguka","doi":"10.4172/2329-9126.1000334","DOIUrl":"https://doi.org/10.4172/2329-9126.1000334","url":null,"abstract":"Background: Optimal dietary intake in alcohol rehabilitation is a pathway that reflects self-care, commitment to staying sober and is a vital adjunct in effective alcohol rehabilitation. \u0000Objective: This qualitative study sought to elicit facilitators and barriers that influence the practice of optimal dietary intake during the three months of alcohol rehabilitation. \u0000Methods: A question guide was utilized to solicit information through in-depth interviews from 15 alcoholics and 5 health professionals until saturation point. Constant comparative approach was used to analyze verbatim transcripts obtained from in-depth interviews. This analysis entailed three stages including open, axial and selective coding. \u0000Results: Recuperating alcoholics’ appreciated the health benefits of practicing optimal dietary intake in restoring their health, with health professionals being significantly supportive which translated into increased self-efficacy to practice of optimal dietary intake during alcohol rehabilitation. \u0000Conclusions: The rehabilitation centres should have nutritionists besides other health professionals who can offer individualized nutrition services needed by the recuperating alcoholics.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":"5 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45933393","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":"Spinal Dural Arteriovenous Fistulae with Rapid Functional Deterioration: Clinical and Radiological Features","authors":"F. Jablawi, M. Mull","doi":"10.4172/2329-9126.1000331","DOIUrl":"https://doi.org/10.4172/2329-9126.1000331","url":null,"abstract":"Background: Spinal Dural Arteriovenous Fistulae (SDAVF) cause usually slowly progressive myelopathy. Specific descriptions of SDAVF with rapid functional deterioration are still lacking in the literature and are purpose of this study. \u0000Material and Methods: We retrospectively evaluated data of 59 SDAVF patients who were treated in our institution between 2006 and 2016. Based on clinical course, we dichotomized our cohort in two groups; a) patients with rapid functional deterioration within a period of 0-6 months, b) patients with slowly progressive functional deterioration within a period of more than 6 months. Motor disabilities were rated according to the modified Aminoff- Longue disability score (AL-score) as follows: 1) mild: AL-score 0-1, 2) moderate: AL-score 2-3, 3) severe: AL-score 4-5. Alterations of the perimedullar veins were rated subjectively as absent, mild or prominent. Follow-up analysis was performed via telephone survey. \u0000Results: Complete data of forty patients was eligible for this analysis. Thirteen and twenty-seven patients were included in group (a) and (b) respectively. The durations of symptom differed significantly between both groups (p=0.02). AL-scores showed no significant differences between both groups at time of diagnosis. However, patients group (a) presented more prominent perimedullar veins at time of diagnosis and better outcome at the last follow-up. \u0000Conclusion: Early diagnosis and treatment of SDAVF might decrease the risk of further irreversible damages of the spinal cord and result in a better outcome regardless of the functional condition at time of diagnosis. Further histopathological studies are acquired to improve our understanding of this rare but serious disease.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48414617","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":"For Decision-Making in Family Medicine Context is the Final Arbiter","authors":"J. Turabián","doi":"10.4172/2329-9126.1000E117","DOIUrl":"https://doi.org/10.4172/2329-9126.1000E117","url":null,"abstract":"There is a lack of knowledge about the diagnostic process in medical \u0000 experts, and there is no clear consensus regarding its systematization \u0000 in practice, teaching and evaluation. For the medical expert, clinical \u0000 reasoning has become an ingrained form of thinking and is done \u0000 \"without realizing\". The diagnostic process is a mental operation \u0000 through which pathology is identified and the disease is evaluated. But \u0000 the diagnosis is made by medical expert in a similar way as of the \u0000 painter when he manages to highlight a figure on a background, when \u0000 recognizing the edges by contrast, and so, only by observing colour in \u0000 its context can you begin to understand its nature. For the family \u0000 doctor, the same problem takes different forms according to its \u0000 background. There are different diagnoses of the same symptom \u0000 according to contexts. The professional intuition is sometimes \u0000 marvellous and sometimes flawed. To map the boundary conditions \u0000 that separate true intuitive skill from overconfident and biased \u0000 impressions it should be based in the contextual evidence. The way to \u0000 arrive at objective decisions is to contextualize. The complexity of \u0000 family medicine lies in the contextualization of medical care in each \u0000 patient.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43345714","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":"African American Childhood and Adolescent Obesity: Interventions with Group Therapy","authors":"A. Horton","doi":"10.4172/2329-9126.1000328","DOIUrl":"https://doi.org/10.4172/2329-9126.1000328","url":null,"abstract":"Obesity rates tend to be higher in Black children. Nationally, in 2012, 20.5% of African-American girls were obese compared to 15.6% of White girls and 19% of African-American boys were obese compared to 12.6% of white Boys. For youth from 2 years old to 19 years old, 8% of African-American children are considered severely obese, with the severe weight gain occurring most often between the third and eighth grades. African Americans are seriously eating themselves into the grave. This is a conversation often held with the late Dick Gregory, but I never agreed with his extremities on eating either. The key is to be healthy and balanced. The key is nutrition and it should be taught in schools, as to what foods are healthy and what foods are not. Many churches haves taken it upon themselves to teach good, healthy habits.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44929272","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 Ego Ideal and the Hidden Damage of Diagnosis and Treatment","authors":"S. Soreff","doi":"10.4172/2329-9126.1000e119","DOIUrl":"https://doi.org/10.4172/2329-9126.1000e119","url":null,"abstract":"Let me say at the outset the reason for being a medical doctor or any other healthcare providers to make an accurate diagnosis and organize a treatment plan based on that diagnosis. Furthermore, many, if not most patients, feel a sense of relief that their problem has both a name called a diagnosis and it can be treated. What is often not recognized by the physician is that very diagnosis and the treatment can damage the patients’ ego ideal.","PeriodicalId":90594,"journal":{"name":"Journal of general practice (Los Angeles, Calif.)","volume":" ","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2017-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45938246","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}