scholarly journals Follow-up and Treatment of an Orf Case Diagnosed at a Family Health Center

Author(s):  
Levent Çevik ◽  
Murat Öztürk

Orf is a zoonotic disease transmitted by contact from small ruminants, which is also common in our country, and its causative agent is parapoxvirus. It usually occurs as lesions characterized by nodules on the fingers, and although it is a self-limiting disease that heals without treatment, it can be confused with other zoonotic diseases and cause complications as a result of unnecessary interventions. For this reason, it is important for primary care physicians to recognize orf disease, which does not require a specific treatment, and to distinguish it from other zoonotic skin diseases. In this study, in a 56-year-old male patient who applied to the family health center, after vaccination of ovine animals; A case of orf diagnosed by history and physical examination and treated with symptomatic methods is presented.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M.-C. Audétat ◽  
S. Cairo Notari ◽  
J. Sader ◽  
C. Ritz ◽  
T. Fassier ◽  
...  

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.


2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Tarika Srinivasan ◽  
Erica J. Sutton ◽  
Annika T. Beck ◽  
Idali Cuellar ◽  
Valentina Hernandez ◽  
...  

Introduction: Minority communities have had limited access to advances in genomic medicine. Mayo Clinic and Mountain Park Health Center, a Federally Qualified Health Center in Phoenix, Arizona, partnered to assess the feasibility of offering genomic screening to Latino patients receiving care at a community-based health center. We examined primary care provider (PCP) experiences reporting genomic screening results and integrating those results into patient care. Methods: We conducted open-ended, semi-structured interviews with PCPs and other members of the health care team charged with supporting patients who received positive genomic screening results. Interviews were recorded, transcribed, and analyzed thematically. Results: Of the 500 patients who pursued genomic screening, 10 received results indicating a genetic variant that warranted clinical management. PCPs felt genomic screening was valuable to patients and their families, and that genomic research should strive to include underrepresented minorities. Providers identified multiple challenges integrating genomic sequencing into patient care, including difficulties maintaining patient contact over time; arranging follow-up medical care; and managing results in an environment with limited genetics expertise. Providers also reflected on the ethics of offering genomic sequencing to patients who may not be able to pursue diagnostic testing or follow-up care due to financial constraints. Conclusions: Our results highlight the potential benefits and challenges of bringing advances in precision medicine to community-based health centers serving under-resourced populations. By proactively considering patient support needs, and identifying financial assistance programs and patient-referral mechanisms to support patients who may need specialized medical care, PCPs and other health care providers can help to ensure that precision medicine lives up to its full potential as a tool for improving patient care.


2015 ◽  
Vol 23 (4) ◽  
pp. 611-619 ◽  
Author(s):  
Maicon Henrique Lentsck ◽  
Thais Aidar de Freitas Mathias

AbstractObjective: to verify the correlation between the rates of hospitalization for primary care-sensitive cardiovascular diseases and the coverage by the Family Health Strategy of residents of the State of Paraná, by regional health divisions, from 2000 to 2011.Method: ecological study developed from data of the Hospital Information System of the Brazilian Unified Health System (SUS) and the Department of Primary Care of the Ministry of Health. The rates of hospitalization for cardiovascular diseases were correlated with the annual coverage by the Family Health Strategy using Pearson's and Spearman's correlation coefficients.Result: there was a strong and negative correlation in the State of Paraná (r=-0.91; p <0.001) and in most regional health divisions, with the highest correlations observed in the Metropolitan and Toledo (r =-0.93; p<0.001) and Paranaguá (r=-0.92, p<0.001) regional health divisions.Conclusion: the results suggest that the increase in the coverage by the Family Health Strategy was an important factor for decrease in the hospitalizations for cardiovascular conditions among residents of the State of Paraná and in most regional health divisions. Other studies should be performed to analyze the factors and causes in regional health divisions where there was no correlation with increase in the Family Health Strategy.


2015 ◽  
Vol 44 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Henri Menezes Kobayashi ◽  
Antonio Carlos Pereira ◽  
Marcelo de Castro Meneghim ◽  
Rívea Inês Ferreira ◽  
Glaucia Maria Bovi Ambrosano

Introduction One of the main problems of the public health services, in which the family oral health team is included, is access by users to dental treatment in primary care, with particular reference to caries disease. Objective The aim of this study was to evaluate the relationship between family risk, for prioritization of home visits and oral health conditions, with a view to providing evidence about the first indicator for organizing the demand for oral health in the Family Health Strategy (FHS). Method The application of family health is based on Form A of the primary care information database SIAB ("Sistema de Informação de Atenção Básica"), used for registering families with the FHS. Eleven dentists examined the oral health conditions of 1165 persons (608 from 12 to 19 years; and 557 from 35 to 44 years of age), classifying them into six codes from A to F. Multinomial logistic regression was used (α=0.05) to analyze the association between family risk variables and oral health situation. Result There was significant association between family risk and presence of caries disease with treatment needs (OR: 2.08, p<0.0001). Conclusion Persons who have family risk would have twice as much chance of presenting caries disease in comparison with those without risk, corroborating the relevance of this element in organizing the demand for oral health.


2017 ◽  
Vol 27 (suppl_3) ◽  
Author(s):  
R Thomas ◽  
MR Gualano ◽  
F Bert ◽  
V Adige ◽  
G Scozzari ◽  
...  

Psico-USF ◽  
2019 ◽  
Vol 24 (4) ◽  
pp. 661-671
Author(s):  
Meyrielle Belotti ◽  
Alexandra Iglesias ◽  
Luziane Zacché Avellar

Abstract The article aims to analyze the conceptions conferred by the health professionals that compose the Expanded Nuclei of Family Health (NASF) on their work assignments. This is a qualitative research, in which was used, for the data collection, eight focus groups, with a total of 43 participants. The data were submitted to content analysis. The results outlined the following categories: integrating NASF work with the Family Health Teams (ESF); developing specialized care; promoting intersectionality; contributing to the promotion of teamwork in Primary Care (AB) and strengthening AB. The study indicates the importance of a better understanding of the functions of the NASF, so that it does not restrict the opportunity to perform specialized care in AB. It is pointed out, the need for adjustments in the work processes of the ESF, in order to enable the shared work in the AB.


2020 ◽  
Vol 43 (2) ◽  
pp. E14-23
Author(s):  
Sophie Marcoux, MD, PhD Marcoux ◽  
Caroline Laverdière

Purpose: The majority of childhood cancer survivors suffer from late adverse effects after the completion of treatment. The prospect of most survivors reaching middle-age is a relatively new phenomenon, and the ways by which current and future primary care physicians (PCPs) will address this novel public health challenge are uncertain. Methods: A survey assessing knowledge level and information delivery preferences regarding long-term follow-up guidelines for adult patients having survived a childhood cancer was distributed by e-mail through the Quebec (Canada) national associations of PCPs and residents (n=238). Results: Participants reported an estimated average of 2.9 ± 1.9 cancer survivors in their yearly caseload, and only 35.3% recalled having provided services to at least one survivor in the last year. Most participants indicated ignoring validated follow-up guidelines for these patients (average score 1.66 on a Likert scale from “1—totally disagreeing” to “5—totally agreeing”). Scarce access to personalized follow-up guidelines and lack of clinical exposure to cancer survivors were identified as main obstacles in providing optimal care to these patients (respective averages of 1.66 and 1.84 on a Likert scale from “1— is a major obstacle” to “5—is not an obstacle at all”). Conclusion: The PCPs and residents rarely provide care for childhood cancer adult survivors. On an individual basis, there is a clear need for increased awareness, education and collaboration regarding long-term care of childhood cancer adult survivors during medical training. On a more global basis, structural, organizational and cultural changes are also needed to ensure adequate care transition.


PEDIATRICS ◽  
1981 ◽  
Vol 67 (6) ◽  
pp. 833-837
Author(s):  
Faye H. Strayer ◽  
Carol C. Fethke ◽  
Thomas Kisker ◽  
Nancy G. Dekrey

Four years' experiences of 69 primary care physicians who delivered more than 70% of the chemotherapy to 174 children with cancer were assessed. Five academic pediatric oncologists were responsible for diagnosis, assignment to a clinical trial protocol, and overall management. The academicians saw the patients at diagnosis and at regularly scheduled intervals but provided care for less than 30% of the outpatient visits. Factors examined included: (1) why the primary care physicians agreed to participate in the care of these patients, (2) how they thought their participation affected the patient and the patient's family, (3) how participation affected their personal and professional development, (4) how participation affected their practice, (5) what their perceptions were concerning the merits of traditional specialist management, and (6) their overall evaluation of the Iowa shared-management program. The initial agreement by primary care physicians to participate in shared management was related to their perception that it would improve the overall care of their patients. The physicians agreed that the program saved the family time and money, was of educational value, personally satisfying, and not economically detrimental to their practice. They did not identify areas where specialist management had clear advantages over shared management and none reported dissatisfaction with this management program.


Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 495 ◽  
Author(s):  
Derek Chan ◽  
David Gracey ◽  
Michael Bailey ◽  
Deborah Richards ◽  
Brad Dalton

Background Cardiovascular disease (CVD) is common in HIV infection. With no specific Australian guidelines for the screening and management of CVD in HIV-infected patients, best clinical practice is based on data from the general population. We evaluated adherence to these recommendations by primary care physicians who treat HIV-infected patients. Methods: Primary care physicians with a special interest in HIV infection were asked to complete details for at least 10 consecutive patient encounters using structured online forms. This included management practices pertaining to blood pressure (BP), blood glucose, electrocardiogram, lipid profile and CVD risk calculations. We assessed overall adherence to screening and follow-up recommendations as suggested by national and international guidelines. Results: Between May 2009 and March 2010, 43 physicians from 25 centres completed reporting for 530 HIV-infected patients, of whom 93% were male, 25% were aged 41–50 years and 83% were treated with antiretrovirals. Risk factors for CVD were common and included smoking (38%), hyperlipidaemia (16%) and hypertension (28%). In men aged >40 years and women aged >50 years without evidence of ischaemic heart disease, only 14% received a CVD risk assessment. Lipid and BP assessments were performed in 87% and 88% of patients, respectively. Conclusions: This Australian audit provides unique information on the characteristics and management of HIV and CVD in clinical practice. We have found a high burden of risk for CVD in HIV-infected Australians, but current screening and management practices in these patients fall short of contemporary guidelines.


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