Cancer, familial cancer and genomics: A primary care perspective

2020 ◽  
pp. 175573802097183
Author(s):  
Judith Hayward ◽  
Anju Kulkarni ◽  
Imran Rafi
Keyword(s):  
Primary Care ◽  
Cancer Risk ◽  
Familial Cancer ◽  
Diagnosis And Treatment ◽  
Inherited Cancer ◽  
Screening And Surveillance ◽  
History Of ◽  
Risk Reduction Measures ◽  
Primary Care Practitioners

Advances in genomics have vastly increased our understanding of inherited cancer risk and underlying cancer predisposition syndromes, thereby underpinning a revolution in the diagnosis and treatment of cancer itself. Concern regarding family history of cancer is a common presentation within primary care. This article provides an overview of the role of primary care practitioners in the clinical identification and management of inherited cancer risk within primary care including risk assessment, screening and surveillance. The article will consider management issues, including access to genomic testing and advice on risk-reduction measures. The role of genomics in cancer diagnosis and treatment and future applications will be outlined.

Quantitating familial cancer risk: a resource for clinical oncologists.

1994 ◽  
Vol 12 (8) ◽  
pp. 1724-1736 ◽  
Author(s):  
K Offit ◽  
K Brown
Keyword(s):  
Genetic Counseling ◽  
Cancer Risk ◽  
Familial Cancer ◽  
Cancer Genetic Counseling ◽  
Cancer Genetic ◽  
Ethical Considerations ◽  
Risk Estimates ◽  
Clinical Counseling ◽  
History Of

PURPOSE Because a family history of cancer constitutes an important risk factor, estimation and communication of cancer risk can facilitate efforts toward early detection and prevention. This review provides a resource for health professionals called to draw upon a multidisciplinary literature to provide quantitative risk estimates to families with cancer. DESIGN Descriptive population-derived, epidemiologic, genetic, genetic epidemiologic, and molecular studies are critically reviewed in the context of cancer genetic counseling. RESULTS Data are presented that document the increased lifetime relative risk to relatives of individuals with cancers of the breast, ovary, colon, prostate, or other sites. In general, risk ratios are poorly suited for clinical counseling. Age-specific absolute risks are presented for first-degree relatives of individuals affected by cancers of the breast, ovary, and colon. The derivation of Mendelian and Bayesian risk estimates in the setting of well-defined cancer family syndromes, and the growing role of DNA testing in more accurately assessing these risks, are discussed. Such carrier testing requires careful psychologic and ethical considerations. CONCLUSION Multidisciplinary cancer genetic counseling is an emerging resource available to physicians who care for families with common adult malignancies.

Otitis externa: the role of the veterinary nurse

2021 ◽  
Vol 12 (7) ◽  
pp. 306-310
Author(s):  
Sue Paterson
Keyword(s):  
Primary Care ◽  
Otitis Externa ◽  
Diagnosis And Treatment ◽  
External Ear ◽  
Ear Canal ◽  
Veterinary Practice ◽  
External Ear Canal ◽  
Veterinary Surgeon

Otitis externa is a common problem in primary care veterinary practice. While the diagnosis and treatment of disease is the responsibility of the attending veterinary surgeon, the veterinary nurse, as an integral part of the veterinary surgeon-led team, plays an important role in the investigation and management of disease. Veterinary nurses are more than capable of assessing the external ear canal both macroscopically and cytologically to help the veterinary surgeon to make a diagnosis. Client facing nurse communications can help with the administration of therapy, provide owner support during treatment to increase compliance and help with follow-up assessments.

scholarly journals The Role of the Primary-Care Physician in Treating Relapses in Multiple Sclerosis Patients

2009 ◽  
Vol 11 (3) ◽  
pp. 122-126 ◽  
Author(s):  
Sarah A. Morrow ◽  
Marcelo Kremenchutzky
Keyword(s):  
Multiple Sclerosis ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Tertiary Care ◽  
Care Physician ◽  
Diagnosis And Treatment ◽  
High Prevalence ◽  
Tertiary Care Centers ◽  
Multiple Sclerosis Patients

Multiple sclerosis (MS) is a common disabling neurologic disease with an overall prevalence in Canada of 240 in 100,000. Multiple sclerosis clinics are located at tertiary-care centers that may be difficult for a patient to access during an acute relapse. Many relapses are evaluated by primary-care physicians in private clinics or emergency departments, but these physicians' familiarity with MS is not known. Therefore, a survey was undertaken to determine the knowledge and experience of primary-care physicians regarding the diagnosis and treatment of MS relapses. A total of 1282 licensed primary-care physicians in the catchment area of the London (Ontario, Canada) Multiple Sclerosis Clinic were identified and mailed a two-page anonymous survey. A total of 237 (18.5%) responses were obtained, but only 216 (16.8%) of these respondents were still in active practice. Of these 216 physicians, only 9% reported having no MS patients in their practice, while 70% had one to five patients, 16.7% had six to ten, and 1.9% had more than ten (3.7% did not respond to this question). Corticosteroids were recognized as an MS treatment by 49.5% of the respondents, but only 43.1% identified them as a treatment for acute relapses. In addition, 31% did not know how to diagnose a relapse, and only 37% identified new signs or symptoms of neurologic dysfunction as indicating a potential relapse. Despite the high prevalence of MS in Canada, primary-care physicians require more education and support from specialists in MS care regarding the diagnosis and treatment of MS relapses.

scholarly journals The Role of Screening in Depression Diagnosis and Treatment in a Representative Sample of US Primary Care Visits

2019 ◽  
Vol 35 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Hillary Samples ◽  
Elizabeth A. Stuart ◽  
Brendan Saloner ◽  
Colleen L. Barry ◽  
Ramin Mojtabai
Keyword(s):  
Primary Care ◽  
Representative Sample ◽  
Diagnosis And Treatment ◽  
Depression Diagnosis

scholarly journals Hepatitis B Vaccination and Screening Awareness in Primary Care Practitioners

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Adnan Said ◽  
Janice H. Jou
Keyword(s):  
Primary Care ◽  
Hepatitis B ◽  
Sexual Transmission ◽  
Risk Groups ◽  
Healthy People ◽  
Hepatitis B Vaccination ◽  
Attitudes And Practices ◽  
Barriers To Screening ◽  
History Of ◽  
Primary Care Practitioners

Introduction. The goals of Healthy People US 2020 have called for increased screening and vaccination of high-risk groups for Hepatitis B (HBV). Methods. We performed a survey of 400 randomly chosen primary care practitioners (PCPs) in Wisconsin to assess their knowledge, attitudes, and practices regarding screening and vaccination for HBV. Results. Screening rates of patients at risk of sexual transmission were low, with 61% of respondents stating that they screen patients who had more than 1 sex partner in 6 months and 86% screening patients with a history of sex with prostitutes. Screening rate for persons with a history of intravenous drug use was 94%. Children of immigrants were screened by 65%, persons on hemodialysis by 73%, and prison inmates by 69%. Screening increased with provider experience with HBV. Deficiencies in vaccination rates mirrored screening practices. Major barriers to screening were cost, someone else’s responsibility, time constraints, or lack of knowledge. Conclusions. Without improved education and practices of PCPs about HBV screening and vaccination, the goals of healthy people 2020 regarding HBV will not be met. Barriers to screening and vaccination need to be addressed. Cost-effectiveness of alternative strategies such as universal vaccination under the age of 50 should be explored.

scholarly journals Effectiveness of interventions to identify and manage patients with familial cancer risk in primary care: a systematic review

2019 ◽  
Vol 11 (1) ◽  
pp. 73-83
Author(s):  
Siang Ing Lee ◽  
Mitesh Patel ◽  
Brittany Dutton ◽  
Stephen Weng ◽  
Jocelyn Luveta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Cancer Risk ◽  
Familial Cancer ◽  
Familial Cancer Risk

scholarly journals The Role of Parental and Grandparental Epigenetic Alterations in Familial Cancer Risk

2008 ◽  
Vol 68 (22) ◽  
pp. 9116-9121 ◽  
Author(s):  
Jessica L. Fleming ◽  
Tim H-M. Huang ◽  
Amanda Ewart Toland
Keyword(s):  
Cancer Risk ◽  
Familial Cancer ◽  
Epigenetic Alterations ◽  
Familial Cancer Risk

Role of tympanic neurectomy in otalgia

1990 ◽  
Vol 104 (2) ◽  
pp. 114-117 ◽  
Author(s):  
J. A. Cook ◽  
R. M. Irving
Keyword(s):  
Local Anaesthesia ◽  
Accurate Diagnosis ◽  
Diagnosis And Treatment ◽  
Glossopharyngeal Neuralgia ◽  
Specific Reference ◽  
Selective Stimulation ◽  
History Of ◽  
Stimulation Of

AbstractTympanic neurectomy was first described 44 years ago. Although its indications have subsequently increased, it has not become a popular procedure. This paper concentrates on its use in treating otalgia. The history of tympanic neurectomy, the anatomy of the tympanic plexus and the aetiology of otalgia with specific reference to the tympanic plexus are discussed and a case of bilateral otalgia due to glossopharyngeal neuralgia successfully treated by staged, bilateral tympanic neurectomy reported. It is suggested tympanotomy performed under local anaesthesia with selective stimulation of the intra-tympanic nerves may lead to accurate diagnosis and treatment of the various forms of neuralgic otalgia.

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