Oral candidiasis as a consequence of the systemic disease or its drug therapy

The emergence, development and treatment of systemic diseases could go along with activation of saprophytic fungal flora, including in the oral mucosa. In such cases, the patients complain of discomfort and soreness in response to irritants. Local treatment is used for mild forms. Generalized candidiasis requires prescribing systemic therapy, which is provided by the general practitioner (primary care physician). The dentist provides topical treatment.

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Indications for paediatric tonsillectomy GP versus Consultant perspective

The Journal of Laryngology & Otology ◽

10.1017/s0022215100126088 ◽

1994 ◽

Vol 108 (2) ◽

pp. 131-134 ◽

Cited By ~ 12

Author(s):

M. J. Donnelly ◽

M. S. Quraishi ◽

D. P. McShane

Keyword(s):

Primary Care ◽

General Practitioner ◽

Primary Care Physician ◽

General Practitioners ◽

Questionnaire Survey ◽

Care Physician ◽

The Past ◽

Ear Infections ◽

Glue Ear

AbstractTonsillectomy is a commonly performed operation in children. Although the justification for this procedure has been debatable in the past, more rigorous criteria in defining the need for tonsillectomies are becoming established. The role of the primary care physician in the management of tonsillar disease in children is important as the decision to refer a child for tonsillectomy is made by the general practitioner. A questionnaire survey of 400 general practitioners (GPs) and 31 consultant ENT surgeons was carried out to establish the important criteria used in deciding the need for paediatric tonsillectomy. We found that in general there was a good correlation between GP and Consultant indications for tonsillectomy. However there were two important areas of difference, while most of the GPs felt that recurrent ear infections and ‘glue ear’ were important indications for tonsillectomy, Consultants did not. Therefore we must be aware of the current recommendations for tonsillectomy and inform present and future GPs.

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Pharmaceuticals in treatment of oral mucosal manifestations of manifestations of various diseases on the oral mucosa

Clinical review for general practice ◽

10.47407/kr2021.2.7.00090 ◽

2021 ◽

Vol 2 (7) ◽

pp. 56-62

Author(s):

Irina Lutskaya ◽

Keyword(s):

Primary Care ◽

General Practitioner ◽

Primary Care Physician ◽

Oral Mucosa ◽

Functional State ◽

Dental Care ◽

Treatment Efficacy ◽

Clinical Manifestations ◽

Care Physician ◽

Symptomatic Therapy

The paper reports principles for etiotropic and symptomatic therapy of oral mucosal diseases. The options for dental care tactics selection by the general practitioner, the primary care physician, based on the clinical manifestations are discussed using certain nosological entities as examples. It has been shown that general functional state of the organism plays a vital part in achieving treatment efficacy.

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Oncological alertness in patients at outpatient therapeutic stage

Medical alphabet ◽

10.33667/2078-5631-2021-7-41-45 ◽

2021 ◽

pp. 41-45

Author(s):

A. S. Sycheva ◽

A. L. Vertkin ◽

A. L. Kebina

Keyword(s):

Primary Care ◽

General Practitioner ◽

Primary Care Physicians ◽

Detection Rate ◽

Care Physician ◽

Malignant Neoplasms ◽

Main Task ◽

Oncological Diseases ◽

Advanced Stages ◽

Specialized Institution

Objective. Increasing the detection rate of oncological diseases in the early stages using questionnaires.Materials and methods. The study involved 25,467 patients who came to an appointment with a general practitioner / general practitioner for any request. During the study, primary care physicians, regardless of the purpose of the visit, purposefully asked questions regarding the risks of malignant neoplasms.Results. The detection rate of oncological diseases was 60.4% in the first half of 2018 against 56.3% in the same period of 2017. In accordance with specific localizations, the following results were obtained: detection of stomach cancer increased by 3%, colon cancer by 2%, malignant neoplasms of the trachea, bronchi and lungs increased by 6%, and the mammary gland, cervix and prostate increased by 1%, 8%, and 2%, respectively.Conclusions. The presence of a clear stereotype of oncological alertness in the primary care physician may contribute to a decrease in the number of advanced stages of tumors due to the initiation of specialized treatment at earlier stages. In such a situation, the main task of the therapist and general practitioner is to identify suspicious symptoms of malignant neoplasms using an algorithmized approach and refer the patient to a specialized institution.

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The principles of oncological alertness at the outpatient therapeutic stage

Лечащий врач ◽

10.51793/os.2021.24.8.008 ◽

2021 ◽

Author(s):

А.С. Сычёва ◽

А.Л. Кебина ◽

А.В. Носова ◽

А.Л. Вёрткин

Keyword(s):

Primary Care ◽

General Practitioner ◽

Primary Care Physicians ◽

Detection Rate ◽

Care Physician ◽

Malignant Neoplasms ◽

Main Task ◽

Oncological Diseases ◽

Advanced Stages ◽

Specialized Institution

Цель данной работы состоит в увеличении выявления ранних стадий онкологических заболеваний с помощью анкетирования на амбулаторном этапе. В исследование включены 25 467 пациентов, обратившихся к терапевту или врачу общей практики по любому поводу. Врачи первичного звена вне зависимости от цели посещения проводили структурированное анкетирование по вопросам рисков развития злокачественных новообразований. Частота выявления онкологических заболеваний возросла до 60,4% за первое полугодие 2018 г. против 56,3% за аналогичный период 2017 г. Выявляемость рака желудка выросла на 3%, ободочной кишки – на 2%, злокачественных новообразований трахеи, бронхов и легких – на 6%, опухолей молочной железы, шейки матки и предстательной железы на 1%, 8% и 2% соответственно. Формирование четкого стереотипа онкологической настороженности у врача первичного амбулаторного звена способствует раннему выявлению и снижению частоты продвинутых стадий опухолей и более раннему началу специализированного лечения. Выявление подозрительной на злокачественные новообразования симптоматики с использованием алгоритмизированного подхода с последующим направлением пациента в специализированное учреждение должно улучшить результаты лечения. Objective of the study is an increasing the detection rate of oncological diseases in the early stages using questionnaires. The study involved 25,467 patients who came to an appointment with a general practitioner/general practitioner for any request. During the study, primary care physicians, regardless of the purpose of the visit, purposefully asked questions regarding the risks of malignant neoplasms. The detection rate of oncological diseases was 60,4% in the first half of 2018 against 56,3% in the same period of 2017. In accordance with specific localizations, the following results were obtained: detection of stomach cancer increased by 3%, colon cancer by 2%, malignant neoplasms of the trachea, bronchi and lungs increased by 6%, and the mammary gland, cervix and prostate increased by 1%, 8%, and 2%, respectively. The presence of a clear stereotype of oncological alertness in the primary care physician may contribute to a decrease in the number of advanced stages of tumors due to the initiation of specialized treatment at earlier stages. In such a situation, the main task of the therapist and general practitioner is to identify suspicious symptoms of malignant neoplasms using an algorithmized approach and refer the patient to a specialized institution.

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Capture the fracture by SMS

Osteologie/Osteology ◽

10.1055/s-0037-1619024 ◽

2016 ◽

Vol 25 (04) ◽

pp. 283-286

Author(s):

G. Freystaetter ◽

A. Platz ◽

C. Meier ◽

H.-U. Mellinghoff ◽

R. Theiler

Keyword(s):

Primary Care ◽

Drug Therapy ◽

Observational Study ◽

Elderly Patients ◽

Care Physician ◽

Reminder System ◽

Sms Reminder ◽

Osteoporosis Fracture ◽

Improve Patient ◽

Osteoporosis Drug

SummaryIn this observational study a SMS reminder system was tested to improve patient adher- ence to osteoporosis drug therapy. 399 of 1323 osteoporosis fracture patients could be documented. 66 % of patients who received a SMS recommendation arranged an ap- pointment with their primary care physician. A large proportion of the physicians followed these recommendations. As more elderly patients declined to participate, the SMS tool seems to be useful in younger seniors (< 70 years).

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Impact of chemotherapy and radiation therapy on local control and survival of metastatic breast cancer to the brain: Single-institution review of 792 cases.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.26_suppl.146 ◽

2014 ◽

Vol 32 (26_suppl) ◽

pp. 146-146

Author(s):

Diogo Bugano Diniz Gomes ◽

Rita Elias Deeba ◽

Vicente Valero ◽

Stacy L. Moulder ◽

Banu Arun ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Local Control ◽

Systemic Therapy ◽

Systemic Disease ◽

Local Treatment ◽

Metastatic Breast ◽

Treatment Modalities ◽

Time To Progression ◽

The Brain

146 Background: There are various treatment modalities for metastatic breast cancer to the brain (MBC-b), with wide variation of reported outcomes. Methods: There were 1,513 patients (pts) with MBC-b treated at MD Anderson Cancer Center October 2009-December 2012. We reviewed medical records of the first consecutive 1015 and included 792 with confirmed brain metastases (BM). A Cox multivariate model was used to identify the effect of treatment on time-to-progression in the brain (TTP-b) and overall survival (OS). Results: Disease subtypes: ER+/HER2- (27%); ER+/HER2+ (16%); ER-/HER2+ (18%); ER-/HER2- (29%), missing (10%). Number of BM: 1 (20%), >1 (73%), missing (7%). Local treatment: metastasectomy (S) (13%), radio-surgery (SRS) (12%), whole-brain radiation (WBRT) (57%), combination of S/SRS with WBRT (11%), no treatment (7%). Systemic treatment: Any (64%), HER2 directed (24%). Median OS was 11.33 months(m) (4.4-25.8). Clinical characteristics associated with OS in multivariate analysis: ER+, HER2+, age < 60, ECOG 0-1, single BM, controlled systemic disease at time of BM and <3 treatment lines before BM. After correction for covariates, use of systemic therapy was associated with longer OS (HR 0.35 CI 0.20-0.60, p < 0.001) regardless of subgroup: HER2+ (19.9 vs 3.5m), ER+/HER2- (12.7 vs 2.2m), ER-/HER- (10.5 vs 2.3m). In pts receiving trastuzumab at diagnosis of BM, continuation of HER2 therapy increased OS (HR 0.44 CI 0.25-0.77, p = 0.004) regardless of agent used (lapatinib vs trastuzumab p=0.7). OS was the same for S and SRS (p=0.7) and either one increased OS (HR 0.41 CI 0.21-0.79 p=0.008). WBRT prolonged OS in multiple BM (HR 0.61 CI 0.38-0.96); Median TTP-b was 11.07m (5-24). WBRT added to S/SRS had longer TTP-b than either modality alone (17.6m vs 10.4m HR 0.56 CI 0.37-0.85 p=0.006). Use of systemic therapy after diagnosis of BM increased TTP-b (11.8 vs 5.1m HR 0.55 CI 0.33-0.92 p = 0.024), but there was no difference between agents used (lapatininib vs trastuzumab p=0.79; capecitabine vs others p= 0.96). Conclusions: WBRT improved local control when done after S/SRS. The use of chemotherapy after local therapy improved time to progression in the brain and survival.

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