The spectrum of disorders associated with adult rheumatic and musculoskeletal diseases

2018 ◽  
pp. 205-240
Author(s):  
Gavin Clunie ◽  
Nick Wilkinson ◽  
Elena Nikiphorou ◽  
Deepak R. Jadon
Keyword(s):  
General Practitioners ◽  
Musculoskeletal Diseases ◽  
Real Life ◽  
General Medicine ◽  
Differential Diagnoses ◽  
Medical Comorbidities ◽  
Adult Disease ◽  
Adults And Children ◽  
Rheumatological Disease ◽  
Rheumatic Conditions

The Oxford Handbook of Rheumatology, 4th edition, takes the reader through a pragmatic and realistic way of assessing musculoskeletal and rheumatological disease presentation in its first four chapters. The text reflects real life, with differential diagnoses suggested as information becomes available through the details from history, then examination, then investigations. The chapters focus on patterns of, and focal regional, symptoms in adults and children. In this chapter, the book considers musculoskeletal and rheumatic conditions which occur in, or are closely associated with, other conditions of the skin, eye, heart, lung, kidney, and in hormonal, neurological, and gastrointestinal systems. Such an approach should help general practitioners and rheumatology trainees caring for their patients across their medical comorbidities and in general medicine. There is also a section on musculoskeletal–rheumatological features in patients with neoplasia. The chapter focuses primarily on adult disease.

Oxford Cases in Medicine and Surgery

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Chest Pain ◽  
Case History ◽  
Clinical Medicine ◽  
Real Life ◽  
General Medicine ◽  
Diagnostic Approach ◽  
History Taking ◽  
Presenting Symptoms ◽  
Essential Resource ◽  
Physiological Systems

Oxford Cases in Medicine and Surgery, second edition, teaches students a logical step-by-step diagnostic approach to common patient presentations. This approach mirrors that used by successful clinicians on the wards, challenging students with questions at each stage of a case (history-taking, examination, investigation, management). In tackling these questions, students understand how to critically analyse information and learn to integrate their existing knowledge to a real-life scenario from start to finish. Each chapter focuses on a common presenting symptom (e.g. chest pain). By starting with a symptom, mirroring real life settings, students learn to draw on their knowledge of different physiological systems - for example, cardiology, respiratory, gastroenterology - at the same time. All the major presenting symptoms in general medicine and surgery are covered, together with a broad range of pathologies. This book is an essential resource for all medicine students, and provides a modern, well-rounded introduction to life on the wards. Ideal for those starting out in clinical medicine and an ideal refresher for those revising for OSCEs and finals.

Prescription of compression stockings in France in primary care

2013 ◽  
Vol 29 (6) ◽  
pp. 390-396
Author(s):  
J-P Benigni ◽  
X Ansolabehere ◽  
X Saudez ◽  
M Toussi ◽  
S Branchoux ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Retrospective Analysis ◽  
General Practitioners ◽  
Real Life ◽  
Venous Disease ◽  
Compression Stocking ◽  
Actual Situation ◽  
Compression Stockings ◽  
One Year

Objectives Recent French data describing real-life compression stocking use are lacking. This study aimed to describe the actual situation for patients who were prescribed compression stockings by their general practitioner and to assess annual treatment costs from a societal perspective. Methods A retrospective analysis using Disease Analyzer database data from 6349 adults with at least one compression stocking prescription between July 2009 and June 2010. Results Mean patient age was 58 years, and 72.3% of patients were women. Seven out of 10 patients received only a single compression stocking prescription over one year. The estimated mean annual per patient cost was 152.2 ± 100.7 Euros. Conclusion Most patients received only a single compression stocking prescription during one year. General practitioners prescribing compression stockings more often may have a better understanding of venous disease and may manage their patients differently. Although more expensive, this approach may be one which should be accepted more widely.

Real-Life Management of Children and Adolescents with Chronic Myeloid Leukemia: The Italian Experience

2018 ◽  
Vol 140 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Fiorina Giona ◽  
Michelina Santopietro ◽  
Giuseppe Menna ◽  
Maria Caterina Putti ◽  
Concetta Micalizzi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Real Life ◽  
Chronic Phase ◽  
Optimal Management ◽  
Molecular Monitoring ◽  
Italian Experience ◽  
Adults And Children

Background: To date, no data on the adherence to specific guidelines for children with chronic myeloid leukemia (CML) in chronic phase (CP) have been reported. Methods: Since 2001, guidelines for treatment with imatinib mesylate (IM) and monitoring in patients younger than 18 years with CP-CML have been shared with 9 pediatric referral centers (P centers) and 4 reference centers for adults and children/adolescents (AP centers) in Italy. In this study, the adherence to these guidelines was analyzed. Results: Thirty-four patients with a median age of 11.4 years and 23 patients with a median age of 11.0 years were managed at 9 P and at 4 AP centers, respectively. Evaluations of bone marrow (BM) and/or peripheral blood (PB) were available for more than 90% of evaluable patients. Cytogenetics and molecular monitoring of PB were more consistently performed in AP centers, whereas molecular analysis of BM was carried out more frequently in P centers. Before 2009, some patients who responded to IM underwent a transplantation, contrary to the guidelines’ recommendations. Conclusions: Our experience shows that having specific guidelines is an important tool for an optimal management of childhood CP-CML, together with exchange of knowledge and proactive discussions within the network.

Skin

2013 ◽  
pp. 127-139
Author(s):  
Christopher Griffiths ◽  
Amy Foulkes
Keyword(s):  
Quality Of Life ◽  
Skin Disease ◽  
Drug Toxicity ◽  
Holistic Approach ◽  
Differential Diagnoses ◽  
Joint Disease ◽  
Accurate Description ◽  
Shared Knowledge ◽  
Rheumatological Disease

Optimal rheumatological care involves a holistic approach to the patient. As rheumatologists frequently see dermatological manifestations of rheumatological disease, as well as cutaneous signs of drug toxicity, knowledge of how to approach the diagnosis and management of the patient with skin disease is essential. With many successful examples of joint rheumatology/dermatology clinics, the subsequent shared knowledge and management will improve the quality of life of patients with combined skin and joint disease. This chapter includes basic skin anatomy and morphological definitions, which facilitate accurate description of skin disease. Common differential diagnoses and common dermatological manifestations of rheumatological disease are discussed with appropriate options for management.

Older Australians' Expectations of their Interactions with their GPs

2005 ◽  
Vol 11 (3) ◽  
pp. 38 ◽  
Author(s):  
Simone Pettigrew ◽  
Katherine Mizerski ◽  
Robert Donovan
Keyword(s):  
Older People ◽  
Focus Groups ◽  
Medical History ◽  
General Practitioners ◽  
Information Flow ◽  
Older Patients ◽  
Telephone Survey ◽  
General Medicine ◽  
Personal Relevance ◽  
New Developments

This article reports the findings of a study into older Australians' expectations when interacting with their general practitioners (GPs). Six focus groups and a national telephone survey (n=505) were conducted to identify those aspects of interactions with GPs considered to be the most important and relevant to older people. The results indicate that the three most important issues relate to ability of GPs to: (1) provide prompt referrals to specialists and ensure an ongoing information flow between GPs and specialists (2) remain abreast of new developments in geriatric and general medicine, and (3) demonstrate a familiarity with the patient's medical history. These issues were considered important to older patients in general and to be of personal relevance to the large majority of those sampled.

scholarly journals Investigation and Analysis of Standardized Training for Residents of General Practitioners of Gansu Province in China

2020 ◽  
Author(s):  
Hui Cai ◽  
Hongjing Wang ◽  
Jin He ◽  
Dongzhi Zhang ◽  
Yue Wu ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
General Medicine ◽  
Gansu Province ◽  
Common Disease ◽  
Family Doctors ◽  
Primary Health ◽  
Health Care Institutions ◽  
Primary Health Care Institutions

Abstract Background: China’s standardized training for residents of General Practitioners (GPs) is aimed at providing the postgraduate training for family doctors who will serve the primary health care institutions. The aim of this paper is to investigate the standardized training situation, satisfaction with standardized training, work situation, intention, satisfaction and attitude of GPs who have finished standardized training. Methods: This study was undertaken in 6 training hospitals in Gansu province using a questionnaire with 45 questions. Results: Approximately 275 residents of GPs were enrolled. Finally, 263 residents completed the questionnaire (95.64% response rate), including 133 females (50.57%) and 130 males (49.43%) with an average age of 28 years (standard deviation, 1.93 years; range, 25-36 years). Additionally, 56.65% were single and 43.35% were married. Of all subjects, 92.40% residents had obtained certification of standardized training for residents of GPs and only 39.54% residents were satisfied with monthly income during training. There were 171 oriented rural medical graduates, of whom, only 42.69% expressed the willing to continue working in the primary health care institutions after the serve time (6 years) expired. Around 86.31% of residents of GPs who had finished standardized training got jobs with more than half serving in the primary health care institutions. For medical institutions and sanitary bureau were clear about general medicine policies, only 29.96% subjects registered as GPs. Among the residents in general practice department, 68.42% were engaged in the diagnosis and treatment of common disease and frequently-occurring diseases as well as referral of patients. The percentage of residents who were satisfied with the job and income were 30.40% and 14.98%, respectively. Conclusion: Standardized training for residents of GPs in China is gradually improving. In order to cultivate more GPs and increase their willing to serve in the primary health care institutions, it is necessary to formulate and execute better policy of GPs, publize general medicine and improve the training quality.

French general practitioners’ willingness to prescribe mHealth devices and apps: a quantitative study (Preprint)

2021 ◽  
Author(s):  
Claire Della Vecchia ◽  
Tanguy Leroy ◽  
Charlotte Bauquier ◽  
Myriam Pannard ◽  
Aline Sarradon-Eck ◽  
...  
Keyword(s):  
General Practitioners ◽  
Medical Practice ◽  
Randomized Clinical Trials ◽  
Training Programs ◽  
Care Pathway ◽  
General Medicine ◽  
Population Data ◽  
Professional Associations ◽  
Online Questionnaire ◽  
Healthy Behaviors

BACKGROUND The field of mHealth is in constant expansion. Integrating connected objects and applications for patient healthcare (COA) in clinical practice is a major and complex challenge. General practitioners (GP) are the essential link in a patient’s care pathway. As they are patients’ preferred healthcare intermediaries, GP have an important support role to play in patients’ transition to mHealth since they must be able to both guide and advise them. OBJECTIVE To identify the factors associated with the willingness of French GP to prescribe COA to their patients. METHODS The present study was part of the ApiApps project whose overall objective is to help remove barriers GP face when prescribing COA by developing a custom-built platform to aid them. It is funded by the National Research Agency (ANR-17-CE19-0027). The study included GP recruited from several academic department of general practice of several medical faculties in France (Lyon, Nice, Rouen) and also from mailing lists of academic GP, healthcare professional associations, and social and professional networks. Participants were asked to complete an online questionnaire which collected data on various sociodemographic variables, on indicators of their involvement in continued training programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, as well as indicators characterizing their patient population. Data on their representations and beliefs regarding COA were also collected. Finally, the questionnaire included items to measure specific indicators of GP acceptability of prescribing COA for the management of various pathologies. RESULTS Three quarters (74% (129/174)) of GP declared they were ready to prescribe OCA to their patients. In the multivariate analysis of 174 GP, involvement in continued education programs (OR = 6.17 [1.52-28.72]), ease of communication with their patients (OR = 1.45 [1.13-1.88]), GP-perceived benefits of COA for both patients and for their medical practice and GP-perceived drivers for COA implementation in their medical practice (same indicator) (OR = 1.04 [1.01-1.07]), as well as validation of COA through randomized clinical trials (OR = 1.02 [1.00-1.04]) were all associated with GP willingness to prescribe COA. In contrast, older GP (OR = 0.95 [0.91-0.98]), female GP (OR = 0.26 [0.09-0.69]) and those who perceived risks for the patient and/or for their medical practice (OR = 0.96 [0.94-0.99]) were less inclined to prescribe COA. CONCLUSIONS COA were generally seen by GP as useful in general medicine to complement other existing tools and respondents were for the most part favorable to prescribing them. However, the full integration of COA in general medicine will be conditioned by the need for conclusive certification, for transparency (reliable and precise data concerning COA methods of construction and clinical validation), for software aids to assist GP prescribe them, and for COA training programs.

scholarly journals Catatonia

2007 ◽  
Vol 13 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Sundararajan Rajagopal
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Clinical Features ◽  
Rating Scales ◽  
General Medicine ◽  
Differential Diagnoses ◽  
Extensive Range ◽  
Different Types ◽  
The Subject ◽  
Underlying Mechanisms ◽  
Key Aspects

Catatonia is an important phenomenon in both psychiatry and general medicine. This article provides an overview of the key aspects of catatonia, including clinical features, differential diagnoses, management and prognosis. The different types of catatonia, the position of catatonia in the psychiatric classificatory systems, use of catatonia rating scales and the association between catatonia and neuroleptic malignant syndrome are also covered. Abnormalities that have been hypothesised as being possible underlying mechanisms in catatonia are highlighted. The article aims to provide clinicians with a comprehensive update on the subject, with information derived from an extensive range of relevant references.

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