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At least 487 records · Page 27Linked to original sources
PubMed1989

[Glucose analysis in general practice. An examination of 4 instruments designed for general practice and self-monitoring].

Several examinations have shown that the analysis of glucose in primary health care is of poor quality. The reason could be the quality of the instruments and/or the way the instruments are operated. We have examined Glucometer II, Glucochek SC, Reflolux II and Hypocount GA. These instruments were studied both in general practice and at Haukeland Hospital. The test results were compared with the routine used in the hospital laboratory. There were no major analytical differences between the instruments. All the instruments were found to have an analytical quality lower than what is recommended by the Norwegian Quality Control. The requested analytical quality for the instrument depends on the clinical needs. We would recommend that these glucose instruments be used to diagnose acute hypo/hyperglucemia and to some extent in control of diabetes. For a certain diagnosis of diabetes, the use of a more precise instrument is to be preferred. The need for a Quality Control program for glucose measurement in primary health care is emphasized.

Blood Glucose↗
PubMed1989

[Diagnosis and treatment in general practice. 4. General practitioners' knowledge of their patients].

The object of this work is to describe aspects of general practitioners' knowledge of their patients and to analyse the connection between this knowledge and certain activities involving the patients in the practice (examination in the practice, prescription of medicine, information and referral). Fifty-five practices with a clientele of 81,600 patients in the lower income group of the Danish National Health Insurance over the age of 15 years participated. A random sample of 1/30 of the insured persons were characterized by the practice prior to a period of observation of three months on the basis of the doctors' knowledge of the persons. During the period of observation, all practice-patient contacts were registered. The characteristics of the patients included: curation of attachment to the practice, degree of knowledge, previous problems etc. Contact data included information about diagnoses, symptoms, patient's wishes, prescriptions, referrals, information given and examinations in the practice. During the three months, a total of 1,974 episodes of medical care occurred. We did not find any connection between the duration of knowledge (as a measure of knowledge) and the number of abovementioned activities in the practice. This investigation, however, cannot exclude such a connection. Information is still required to illustrate the significance of the knowledge of the patients for the solution of their problems and, in particular, for the course of their health problems.

Denmark↗
PubMed1988

[Micronodular generalized familial angiomatosis (generalized essential telangiectasia): clinical cases; ultrastructural study].

Six patients of the same family present with micronodular and generalized familial angiomatosis. Four of them have been investigated. Their problem is purely esthetic; however an asymptomatic form of von Willebrand disease has been found in a female and one of her daughters. The light microscope reveals a network of dilated capillaries in the superficial dermis. Electron microscope investigation of the endothelium demonstrates on abundance of Weibel-Palade bodies, the presence of osmiophilic inclusions within clear vacuoles, the occurrence of long spacing collagen fibrils in the vicinity of endothelial and perithelial cells; furthermore, cytoplasmic projections within the lumen constitute the most dramatic and constant feature: there are many villosities, loops, coils, tufts and entanglements in all four cases.

Adolescent↗
PubMed1979

[Generalized periarthritis calcarea (generalized hydroxyapatite disease)].

The condition of generalized periarthritis calcarea (hydroxyapatite deposition disease) is characterised by multiple periarticular calcification which can be localised around practically any joint and also in proximity to the spine. This calcification consists of hydroxyapatite crystals which are responsible for the episodes of acute, subacute or chronic periarticular or articular inflammation so typical of the condition. Because of this one can classify periarthritis calcarea along with gout and chondrocalcinosis in the group of crystal deposition diseases. The actual cause of the calcification remains unknown but it is probable that, along with hereditary factors, disturbances in metabolism play an important role. The diagnosis of generalised periarthritis is made from the characteristic X-ray picture in conjunction with the clinical findings and, on occasion, the demonstration of hydroxyapatite crystals in the affected tissues. In the differential diagnosis gout, chondrocalcinosis, various inflammatory rheumatic conditions and septic arthritis must be excluded and various calcification processes, particularly interstitial calcinosis and lipocal cinogranulomatosis, must also be considered. Since the etiology of the calcification remains unknown to specific treatment is available. Symptomatic treatment with colchicine is mostly inadequate which is why one often has recourse to the use of non-steroid anti-inflammatory drugs and corticosteroids.

Calcinosis↗
PubMed1981

Continuing education in general practice. 1. Attitudes of general practitioners.

As part of a Queensland survey, we made an assessment of the attitudes of general practitioners to continuing education. We analysed responses for age, sex, type and geographical location of practice. Almost all the respondents (99%) agreed that commitment to CME is lifelong. Most of them did not feel that there is too much concern with keeping up-to-date. Recognition of their own educational needs is a problem for a sizeable minority. Most feel that GP skills can be taught through CME courses, which should focus on patient management. Informal communication with colleagues is a useful mode of learning. Although exactly half the doctors felt that CME should be mandatory, a greater proportion of younger doctors were in favour.

Adult↗
PubMed1997

[General practice quality circles in the large city. Participation by Hamburg general physicians].

Quality circles (peer review) will play an increasing and important role in ambulatory care when they are based on voluntary participation and in a setting of open discussion. Goal is the further qualification of physicians by critical reflections on their practice based on learning processes and the experiences of the participants. Reported are experiences from the unit for primary care and health service research of the Hamburg University on implementing quality circles. Engagement in quality assurance may be helpful in the shaping and professionalisation of general practice.

Attitude of Health Personnel↗
PubMed1997

[The updated guideline 'Gastric complaints' of the Dutch College of General Practitioners; a reaction from a general practitioner].

Three working diagnoses in gastric complaints are presented: aspecific gastric complaints, ulcer complaints, reflux complaints; these assist the general practitioner in formulating the initial diagnostic and pharmacological interventions and in evaluating the effects of therapy. The guidelines state that eradication treatment of Helicobacter pylori is indicated only in gastritis caused by H. pylori, grade IV bulbitis, a duodenal bulb malformation or peptic ulcers.

Gastritis↗
PubMedDate not supplied

General and oral manifestations of human immunodeficiency virus infection: a general overview with guidelines for infection control in the dental practice.

The human immunodeficiency virus (HIV-1), responsible for the acquired immunodeficiency syndrome, has in the span of a decade become an epidemic of global proportions. Oral lesions, head and neck diseases are often the first manifestations of HIV-1 infection and AIDS. It is essential for all dentists to familiarize themselves with the oral manifestations of HIV-infection as well as the dental management of such manifestations. In addition to all health care, professionals should become acquainted with the "universal precautions" recommended by the Centers for Disease Control, in order to protect themselves, their staff, and their patients to minimize, if not totally eliminate, any risk of infectious disease transmission in the health care setting. This paper presents a general overview of the human immunodeficiency virus; oral manifestations of HIV-infection; "universal precautions" and guidelines for the control of infection in the dental practice.

HIV Infections↗
PubMed1997

Communication about risk--dilemmas for general practitioners. The Department of General Practice Working Group, University of Wales College of Medicine.

Measures of risk frequently contribute to our understanding, prevention, or treatment of disease, but it is important that general practitioners (GPs) explain clinical risks effectively to patients to ensure they are not misunderstood, as risk information can assist in decision-making processes and encourage behavioural change. However, the interpretation of risks by patients and doctors varies. It is argued that problems arise because communication about risk is usually framed in terms of the language of chance or probability. In this paper, we describe how probability theory developed, and suggest that attempts to communicate empirical risk processes in probabilistic language are bound to produce dilemmas. We explore how the theory relates to clinical practice and identify key issues that doctors must address in discussing risk with individual patients.

Communication↗
PubMed1998

The role of the general practitioner in postnatal care: a survey from Australian general practice.

BACKGROUND: Despite the practice of routine postnatal check-ups, many women experience problems in the months after childbirth. General practitioners (GPs) are involved in routine postnatal care, yet little research has been undertaken to explore this role. AIM: To report the views of Australian GPs as to what physical examination and discussion should take place at the routine six week postnatal check-up and to determine the influence of gender on the approach to the check-up. METHOD: Postal survey of 1104 Australian GPs, yielding an eligible sample of 1022. RESULTS: A total of 715/1022 (70%) usable surveys returned. Over 65% of GPs recommend routine examination of the abdomen, blood pressure, perineum, vagina, pelvic floor, and breasts at the six week check-up. Fewer than a half the sample believed that physical problems (urine and bowel symptoms, back problems), sexual issues, relationship and parenting issues should be routinely discussed. After controlling for age, practice location, obstetric practice, and qualifications, the sex of the GP remains an important factor influencing the GP's approach to postnatal care. Female GPs are three times more likely to believe that maternal feelings should be discussed routinely and about twice as likely to believe that infant sleeping/behaviour, maternal sleeping/diet/tiredness, coping with other children, relationship with partner, and household work should form part of the routine discussion with all recent mothers. CONCLUSIONS: Sex of practitioner and older age (60 years or more) are the two most important influences on a GP's approach to postnatal care. This study indicates a need for GPs to shift their focus from routine examination to indicated examination to allow more time to discuss common postnatal problems.

Adult↗
PubMed1998

[Summary of the guideline 'Hearing impairement' from the Dutch College of General Practitioners. The Dutch College of General Practitioners].

Hardness of hearing is a growing problem; toward the year 2000 there will be 1.5 to 2 million persons with hardness of hearing in the Netherlands. The Dutch College of General Practitioners has published a guideline 'Slechthorendheid' [hardness of hearing] with instructions for the diagnosis and treatment of patients with hardness of hearing in primary care. Many patients with hardness of hearing do not visit the GP (e.g. mentally handicapped). The whispered speech test or screening audiometry plays an important part in the diagnosis. In case a hearing loss > or = 30 dB is detected consultation of or referral to an ENT specialist is an option. In most cases a plug of earwax is the cause of the hardness of hearing.

Adolescent↗