Journal of family medicine and disease prevention最新文献

{"title":"A Minus That Makes the Difference","authors":"G. Vitale, S. Vitale, P. Pierini, C. Visconti","doi":"10.23937/2469-5793/1510108","DOIUrl":"https://doi.org/10.23937/2469-5793/1510108","url":null,"abstract":"Background: Acute Coronary Syndromes include a wide variety of clinical scenarios. Coronary Angiography (CA) is a low-resolution imaging technique and its inability to provide a satisfactory tissue characterization of culprit lesions could be a concern in some cases. Optical Coherence Tomography (OCT) is an emergent intravascular high-resolution imaging modality which could be complementary to CA in challenging cases. We report a case of a young man in whom OCT had been determinant to understand the pathology of culprit lesion and to formulate a tailored therapy. Case presentation: We report a case of a 28-years-old man, presenting to the emergency department and complaining of acute chest pain lasting about 30 minutes. Cardiovascular risk factors were cigarette smoking and familial history of Coronary Artery Disease. At admission both EKG and echocardiogram were unremarkable; a mild positivization of high sensitive troponine T was detected. The next day CA was performed showing a “minus” image in the proximal Left Anterior Descendent Artery (LAD), highly suspicious for a pedunculated, non-stenosing, adherent wall thrombus which prompted adequate antithrombotic and anticoagulant therapy. At control angiography we performed an OCT study which showed a thin-capped eccentric vulnerable plaque. We therefore decided to implant a bioresorbable scaffold on the proximal LAD. Subsequent thrombophilia screening showed severe hyperhomocysteinemia and homozygous C677T Methylenetetrahydrofolate Reductase mutation. The patient was discharged home 2 days later on aspirin, ticagrelor, folic acid and vitamins B6 and B12. At 6-month follow-up, a new OCT image acquisition showed satisfactory apposition of the bioresorbable scaffold. Conclusions: OCT is a promising high-resolution intravascular imaging modality able to provide a comprehensive tissue characterization of unstable coronary plaques. OCT should be used as a complementary technique in challenging clinical scenarios.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43515126","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":"Quality Care and the Soul of the Physician","authors":"S. Muse","doi":"10.23937/2469-5793/1510102","DOIUrl":"https://doi.org/10.23937/2469-5793/1510102","url":null,"abstract":"Quality care for the patient is the source of vocational satisfaction and also a measure of physician well-being. Both are impacted positively by the spiritual life of physicians which contributes significantly to resiliency in the midst of current stresses in medical care. Additionally, a majority of patients identify spiritually integrated care as desirable in their physician’s treatment. The author examines qualities of vulnerability, humility and compassion integral to the person of the physician who offers quality care to patients and which is prophylactic to higher risk of suicide among medical practitioners compared to other professionals. The original intent of the Hippocratic oath and the desire for a genuinely humane healing partnership has been under siege for some time now. Since Henry Ford introduced the mass assembly line, business has sought increasing efficiency in production with the consequence of increasing depersonalization of the healing relationship. The advent of computers and health care management as a business has reconfigured physicians to more and more cumbersome record-keeping ‘providers’ who in some cases are under pressure to see a new patient every 8-12 minutes. Short Note","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41857034","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":"Inter-Arm Blood Pressure Difference in a Typical University Family Medicine Clinic","authors":"Do Kent H, Raiciulescu Sorana, Leggit Jeffrey C","doi":"10.23937/2469-5793/1510101","DOIUrl":"https://doi.org/10.23937/2469-5793/1510101","url":null,"abstract":"","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45181957","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":"Simple Protocol to Initiate and Intensify Insulin in Primary Care","authors":"M. Faris","doi":"10.23937/2469-5793/1510097","DOIUrl":"https://doi.org/10.23937/2469-5793/1510097","url":null,"abstract":"Citation: Matloub F (2019) Simple Protocol to Initiate and Intensify Insulin in Primary Care. J Fam Med Dis Prev 5:097. doi.org/10.23937/2469-5793/1510097 Accepted: January 19, 2019; Published: January 21, 2019 Copyright: © 2019 Matloub F. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49213969","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":"Miraculous Properties of Camel Milk and Perspective of Modern Science","authors":"Yaseen Galali, Al-Dmoor Hanee M","doi":"10.23937/2469-5793/1510095","DOIUrl":"https://doi.org/10.23937/2469-5793/1510095","url":null,"abstract":"Camel has been mentioned in Quran in different places and described a miracle of almighty God. Also, prophet Muhammad (PBUH) has recommend camel in his speech (hadith). The prophet (PBUH) has recommended camel milk for some diseases such as skin disease as remedy. Camel plays in important livestock which produced milk longer than any other ruminant under harsh condition of desert ecosystem. Camel milk is different from other ruminant milk different ways. Camel milk is rich in vitamin C and protective proteins such as lactoferrin, lactoperoxidase, immunoglobulins and lysozyme. Camel milk lacks β-lactoglobulin and used as an option for the individuals intolerant to lactose of cow’s milk. Camel milk is extraordinary in terms of antioxidative agents, antibacterial, antiviral, antifungal, anti-hepatitis, anti-arthritis, treatment for paratuberculosis, preventing aging, remedy for autoimmune diseases and cosmetics. Insulin in camel milk is safe and efficacious in improving long-term glycemic control in diabetic patient. Camel milk reduces autism symptoms in children. Lactoferrin has ability to inhibit the proliferation of cancer cell. Camel milk is rich in magnesium and zinc thus could act as antiulcer. Therefore, this review focuses on the composition of camel milk and miraculous and medicinal aspect of camel milk in treating some diseases.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45733712","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":"Stigma Related to Fear and Shame Restricts Access to HIV Testing and Treatment in Tanzania","authors":"W. Danielle A, Johnson Kyle L, Moore Jacen S","doi":"10.23937/2469-5793/1510099","DOIUrl":"https://doi.org/10.23937/2469-5793/1510099","url":null,"abstract":"Background: Tanzania is one of 15 nations that share 75% of the HIV burden in sub-Saharan Africa, with a national prevalence of 5.3% and prevalence rates as high as 30% in special populations. Knowledge about HIV infection, testing, and treatment is low, especially in younger populations, suggesting a need for effective HIV educational programs. We sought to understand the impact of HIV-related stigma and gender roles in HIV education and knowledge in educational programs and explored methodologies that effectively incorporate culturally competent approaches to reduce stigma in HIV education programs. Methods: Literature searches were conducted in multiple databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Complete, and the U.S. National Library of Medicine through the National Institutes of Health (Medline/PubMed). The search terms were structured to include all text of each article rather than restricting the search to titles or keywords. While these search criteria resulted in identification of 45 peer-reviewed articles, the inclusion criteria (HIV prevention, community education, HIV knowledge and stigma) led to the exclusion of all except 20 articles. Their findings are described here. Results: Attitudes of blame, fear of people on antiretroviral therapy spreading the disease, and an acceptance of a positive HIV status as punishment for sin were identified as barriers to testing. Cultural norms/perceptions and gender power dynamics were key components in creating culturally competent models that empower women to be tested and disclose their status. Community-level awareness and increased opportunities to interact with people living with HIV/AIDS were used successfully to reduce stigma among younger populations. Conclusions: Community-based programs partnered with religious organizations were effective in disseminating HIV education and can be used as a strategy for reducing shame-based stigma based upon misconceptions and popular beliefs. Stigma can also be reduced by increasing HIV knowledge with an appropriate sociocultural framework. We propose targeting community and religious leaders using train-the-trainer models as a means to improve HIV education and reduce stigma, especially within high-risk","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43658063","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":"Genetic Counseling, Polymorphisms and Breast Cancer","authors":"Silva Kleber Santiago Freitas e","doi":"10.23937/2469-5793/1510098","DOIUrl":"https://doi.org/10.23937/2469-5793/1510098","url":null,"abstract":"Breast cancer, a highly penetrant hereditary disorder, is the most common cancer in women worldwide. Approximately 10% of breast cancer cases are hereditary and 15% of patients with invasive breast cancer have a first-degree relative with the same disorder. Genetic counseling has become an important tool of the health care system providing information and support to families at risk of a genetic disorder. Oncology research teams have designed breast cancer screening guidelines for highrisk patients. Along the past decade, several genes have been identified as genetically related to breast cancer inheritance. BRCA1 and BRCA2 are considered the most important genes related to inheritance predisposition of breast cancer, along with PTEN and TP53 [1]. The BRCA1 and BRCA2 structures are different but their functions are interconnected and related to DNA repair. The susceptibility of breast cancer for patients with the BRCA1 mutation is up to 87% for older women. Another gene, TP53, codes for a protein that acts as the guardian of the genome, binds to DNA in order to perform transcriptional regulatory functions, regulation of the cell cycle and apoptosis among other functions. According to genetic counseling and epidemiologic studies, the risk of developing cancer for patients with TP53 polymorphisms is 90%. Regarding the gene PTEN, germline mutations increases the risk of breast cancer and about 80% of patients with breast cancer carry germline mutations in the gene. PTEN is an oncogene and codes for a protein with phosphatase activity, related to the regulation of cell cycle, controlling cells growth and able to promote cell cycle arrest. Currently, genetic counseling endeavor to identify patients at risk of genetic anomalies, study family history and inheritance patterns, calculate risks of recurrence, and provide information regarding testing and treatment procedures. Therefore, breast cancer patients and their families are presented with possibilities of screening for BRCA1, BRCA2, TP53, and PTEN mutations, and preventive care such as chemoprevention and prophylactic surgery.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46893916","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":"Stigma Remains a Significant Barrier to HIV Knowledge and Treatment in Zambia","authors":"W. Danielle A, Johnson Kyle L, Moore Jacen S","doi":"10.23937/2469-5793/1510096","DOIUrl":"https://doi.org/10.23937/2469-5793/1510096","url":null,"abstract":"Background: Despite high HIV prevalence in Zambia, which lies within the heart of sub-Saharan Africa, early implementation of public policy and programs to effectively manage the burden of disease has insured consistently high testing rates. Zambian strategies to combat the HIV/AIDS crisis employ governmental support for HIV testing and public education and can serve as models for neighboring countries to advance the development of effective testing and treatment initiatives. Although these testing programs have proven highly successful, stigma and gaps in public knowledge continue to hamper access to treatment. Through this review of the current literature, we sought to better understand HIV-specific educational programs, the impact of HIV-related stigma, and the cultural components that influence patient care. Methods: Literature searches were conducted in multiple databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Complete, and the U.S. National Library of Medicine through the National Institutes of Health (Medline/PubMed). The search terms were structured to include all text of each article rather than restricting the search to titles or keywords. While these search criteria resulted in identification of 38 peer-reviewed articles, the inclusion criteria (HIV prevention, community education, HIV knowledge and stigma) led to the exclusion of all except 22 articles. Their findings are described here. Results: Individuals who reported negative experiences with health workers perceived HIV-related stigma was common. The fear of involuntary status disclosure while filling prescriptions for anti-retroviral medications led to higher levels of perceived stigma and treatment refusal. Observation of stigma and bullying experienced by people living with HIV/AIDS in the educational system increased fear in both teachers and students. Conclusions: Cultural and religious considerations were found to be important in stigma reduction. In sum, collaboration with key community leaders, church elders, and politicians were seen as vital in strengthening HIV programs. We propose using train-the-trainer models to empower teachers, particularly women, to become HIV educators and reduce stigma.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45703196","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 Related to Disclosure and Nondisclosure of Dietary Supplements in Primary Care, Integrative Medicine, and Naturopathic Medicine.","authors":"Jennifer R Guzman,&nbsp;Debora A Paterniti,&nbsp;Yihang Liu,&nbsp;Derjung M Tarn","doi":"10.23937/2469-5793/1510109","DOIUrl":"https://doi.org/10.23937/2469-5793/1510109","url":null,"abstract":"<p><strong>Background: </strong>Patients infrequently disclose use of dietary supplements to providers. Little is known about factors that motivate patients to disclose supplement use. The study aimed to identify reported factors motivating patients' disclosure and nondisclosure of dietary supplement use and explore differences based on type of supplement and provider practice.</p><p><strong>Methods: </strong>Mixed methods study combining qualitative content analysis of semi-structured interviews with statistical analyses to assess differences in identified factors by provider practice type and supplement type. Seventy-eight English-speaking patients who reported taking 466 dietary supplements in the previous 30 days were recruited from primary care and Complementary and Alternative Medicine (CAM), and Integrative Medicine (IM) offices in Southern California.</p><p><strong>Results: </strong>We identified nine themes related to disclosure and nine related to nondisclosure of dietary supplement use. Major themes were features of the office visit, circumstances in patient health and medical care, and provider/patient characteristics. The most commonly raised theme promoting disclosure of supplement use was provider inquiry. Patients associate disclosure with having concerns about a supplement but also with annual physical exams and some routine topics of discussion, including self-care, lab results, and new medication prescriptions. Themes related to nondisclosure included lack of provider inquiry, features of the office visit, such as supplements being unrelated to the visit purpose, and patients' convictions that supplements are safe or not important to discuss. Themes did not vary by supplement type. Primary care patients were more likely than CAM/IM patients to attribute nondisclosure to convictions that supplements were beneficial, not worth mentioning, or equivalent to food (p ≤ 0.001).</p><p><strong>Conclusions: </strong>When providers fail to ask directly about dietary supplement use, disclosure is often an impromptu decision that is driven by the content of provider-patient interactions. Ensuring disclosure of dietary supplement use to prevent potential drug-supplement interactions or adverse health outcomes likely requires consistent, proactive provider queries about supplement use.</p>","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37638716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do the Psychosocial Factors Affect Blood Pressure in Patients with Hypertension? A Cross-Sectional Study","authors":"E. Emrah, S. Esra","doi":"10.23937/2469-5793/1510082","DOIUrl":"https://doi.org/10.23937/2469-5793/1510082","url":null,"abstract":"Background: Hypertension leads to complications such as myocardial infarction, stroke, and renal failure if not treated appropriately. Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral. The aim of this study is to find the relationship between blood pressure levels of patients with hypertension and sociodemographic characteristics, traumatic life events and depression status. Method: Our sample was 305 hypertensives visiting a family physician in Rize, a city in the Black Sea (Northern part) Region of Turkey. The study was completed between December 2017 to April 2018. Participants completed a sociodemographic questionnaire including questions for sociodemographic characteristics, lifestyle behaviors, psychiatric complaints traumatic life events, and blood pressure control. Depression status was assessed using The Hospital Anxiety and Depression Scale (HAD). Data as analyzed using the SPSS 21 statistical analysis program. Results: Of the participants, 54.0% (n = 165) had psychiatric complaints, 52.5% (n = 160) had traumatic life events, and 37.7% (n = 115) stated that they had controlled blood pressure. Blood pressure levels were significantly related with psychiatric complaints, life events, HAD-Anxiety (HAD-A) and HAD-Depression (HAD-D) scores (p = 0.001, p = 0.000, p = 0.001, p = 0.002, respectively). There was reverse relationship between blood pressure levels and monthly household income (p = 0.03). Conclusion: It is harder to have controlled blood pressure for hypertensives in the presence of traumatic life events, psychiatric complaints, higher HAD-A and HAD-D scores, compared to hypertensives with none of these. Psychosocial factors should be questioned in hypertensives when especially blood pressure cannot control.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44069305","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}