Pub Date : 2024-04-17DOI: 10.26420/jfammed.2024.1359
Maloney Me, Miller Tj
Skin cancer is the most prevalent cancer in the United States, affecting approximately 20% of Americans, with rates increasing annually [1]. By 2040, malignant melanoma is projected to be the second leading cancer [2]. While the majority of skin cancers have low morbidity and mortality, malignant melanoma causes significant morbidity and mortality, accounting for 80% of skin cancer related deaths [3]. Because early-stage melanomas have improved outcomes, early detection and treatment is imperative. However, the 2023 United States Preventative Task Force (USPTF) called for more research in order to determine skin cancer screening recommendations and made a grade B recommendation for counseling 6-month to 24-year-olds regarding minimizing exposure to Ultraviolet (UV) radiation with fair skin to prevent skin cancer [4].
{"title":"Improving Skin Cancer and Sun Protective Counseling: Exploring Level of Knowledge and Risk Among Rural Patients","authors":"Maloney Me, Miller Tj","doi":"10.26420/jfammed.2024.1359","DOIUrl":"https://doi.org/10.26420/jfammed.2024.1359","url":null,"abstract":"Skin cancer is the most prevalent cancer in the United States, affecting approximately 20% of Americans, with rates increasing annually [1]. By 2040, malignant melanoma is projected to be the second leading cancer [2]. While the majority of skin cancers have low morbidity and mortality, malignant melanoma causes significant morbidity and mortality, accounting for 80% of skin cancer related deaths [3]. Because early-stage melanomas have improved outcomes, early detection and treatment is imperative. However, the 2023 United States Preventative Task Force (USPTF) called for more research in order to determine skin cancer screening recommendations and made a grade B recommendation for counseling 6-month to 24-year-olds regarding minimizing exposure to Ultraviolet (UV) radiation with fair skin to prevent skin cancer [4].","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"101 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-20DOI: 10.26420/jfammed.2024.1347
Victor Ajluni
Suicide represents a significant public health challenge with far-reaching consequences. It stands as one of the leading causes of death across the globe, with a complex web of factors contributing to this dire outcome. According to the World Health Organization, an estimated 800,000 individuals succumb to suicide annually, translating to one person every 40 seconds [1]. The ramifications of suicide are profound, extending beyond the individual to touch families, friends, and communities, leaving behind enduring psychological, social, and economic impacts.
{"title":"Primary Care as the Frontline: Strategies and Communication in Suicide Prevention","authors":"Victor Ajluni","doi":"10.26420/jfammed.2024.1347","DOIUrl":"https://doi.org/10.26420/jfammed.2024.1347","url":null,"abstract":"Suicide represents a significant public health challenge with far-reaching consequences. It stands as one of the leading causes of death across the globe, with a complex web of factors contributing to this dire outcome. According to the World Health Organization, an estimated 800,000 individuals succumb to suicide annually, translating to one person every 40 seconds [1]. The ramifications of suicide are profound, extending beyond the individual to touch families, friends, and communities, leaving behind enduring psychological, social, and economic impacts.","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"38 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To explore how we can make Health Care Providers (HCP) more conscious of their gaze and to encourage HCPs to make more eye contact with their patients, making them better suited to promote meaningful lives for them, thus strengthening the patient-provider relationship. Methods: Mixed quantitative and qualitative descriptive experimental design with narrative data analysis. 40 participants (23 HCPs and 17 chronic pain patients) viewed standardized videos depicting a patient-provider interaction in which the HCP did not look at the patient. Self-assessments and reflections were obtained. Results: Most HCPs recognized the clinical approach in the videos as cold, whereas 41% of patients recognized it as “normal”. When looking into patient’s eyes, 44% of HCPs were unable to identify the patients’ emotions, nor their own feelings. Powerlessness and vulnerability were emotions often felt by the HCP. Patients and HCPs agree that better addressing meaningful activities in a patient’s life, as well as looking at the patient more, would positively impact patient outcomes and pain management. At the one-month follow-up, 74% of HCPs had increased the amount of eye-contact made during their encounters and paid more attention to the relational aspect of their care. Conclusion: We succeeded in making HCPs more aware of the gaze they hold onto their patients, thus encouraging them to change their actions. We attributed the lack of eye contact and lack of focus on meaningful activities to a sense of vulnerability felt by HCPs. We believe that non-verbal communications skills should be more overtly taught in medical school.
{"title":"Look and Listen: How the Coldness of Health Care Providers is Modifiable","authors":"Lafrenaye Sylvie, Depani Isabella, Vignone Amanda, Guay Hélène, Labbé Ismael, Léonard Guillaume","doi":"10.26420/jfammed.2023.1339","DOIUrl":"https://doi.org/10.26420/jfammed.2023.1339","url":null,"abstract":"Purpose: To explore how we can make Health Care Providers (HCP) more conscious of their gaze and to encourage HCPs to make more eye contact with their patients, making them better suited to promote meaningful lives for them, thus strengthening the patient-provider relationship. Methods: Mixed quantitative and qualitative descriptive experimental design with narrative data analysis. 40 participants (23 HCPs and 17 chronic pain patients) viewed standardized videos depicting a patient-provider interaction in which the HCP did not look at the patient. Self-assessments and reflections were obtained. Results: Most HCPs recognized the clinical approach in the videos as cold, whereas 41% of patients recognized it as “normal”. When looking into patient’s eyes, 44% of HCPs were unable to identify the patients’ emotions, nor their own feelings. Powerlessness and vulnerability were emotions often felt by the HCP. Patients and HCPs agree that better addressing meaningful activities in a patient’s life, as well as looking at the patient more, would positively impact patient outcomes and pain management. At the one-month follow-up, 74% of HCPs had increased the amount of eye-contact made during their encounters and paid more attention to the relational aspect of their care. Conclusion: We succeeded in making HCPs more aware of the gaze they hold onto their patients, thus encouraging them to change their actions. We attributed the lack of eye contact and lack of focus on meaningful activities to a sense of vulnerability felt by HCPs. We believe that non-verbal communications skills should be more overtly taught in medical school.","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139290948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.26420/jfammed.2023.1338
Soliman M, Voelckers A
Wellens syndrome is an Electrocardiographic (ECG) pattern that is associated critical stenosis of the Left Anterior Descending (LAD) artery. It manifests as either biphasic T waves in V2-V3 (type A) or deeply negative T waves in V2-V4 (type B). These T-wave abnormalities are persistent and can endure for hours to weeks. Patients with Wellens syndrome often lack chest pain and typically display normal or slightly elevated cardiac enzyme levels. It is critical for clinicians working in both outpatient and inpatient clinical settings to understand and recognize these ECG changes and its association with critical LAD obstruction and significant risk of anterior wall myocardial infarction. In this case report, we present a unique case of Wellens syndrome type B in an asymptomatic 83-year-old male patient initially assessed and evaluated in an outpatient family practice clinical setting.
韦伦斯综合征是一种心电图（ECG）模式，与左前降支（LAD）动脉的临界狭窄有关。它表现为 V2-V3 双相 T 波（A 型）或 V2-V4 深负性 T 波（B 型）。这些 T 波异常是持续性的，可持续数小时至数周。Wellens 综合征患者通常没有胸痛，心肌酶水平通常正常或略有升高。对于在门诊和住院临床环境中工作的临床医生来说，了解和识别这些心电图变化及其与重度 LAD 梗阻和前壁心肌梗死重大风险的关联至关重要。在本病例报告中，我们介绍了一例独特的韦伦斯综合征 B 型病例，患者是一名无症状的 83 岁男性，最初是在门诊家庭医生的临床环境中接受评估的。
{"title":"Recognizing Wellens Syndrome in a Family Practice Setting","authors":"Soliman M, Voelckers A","doi":"10.26420/jfammed.2023.1338","DOIUrl":"https://doi.org/10.26420/jfammed.2023.1338","url":null,"abstract":"Wellens syndrome is an Electrocardiographic (ECG) pattern that is associated critical stenosis of the Left Anterior Descending (LAD) artery. It manifests as either biphasic T waves in V2-V3 (type A) or deeply negative T waves in V2-V4 (type B). These T-wave abnormalities are persistent and can endure for hours to weeks. Patients with Wellens syndrome often lack chest pain and typically display normal or slightly elevated cardiac enzyme levels. It is critical for clinicians working in both outpatient and inpatient clinical settings to understand and recognize these ECG changes and its association with critical LAD obstruction and significant risk of anterior wall myocardial infarction. In this case report, we present a unique case of Wellens syndrome type B in an asymptomatic 83-year-old male patient initially assessed and evaluated in an outpatient family practice clinical setting.","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.26420/jfammed.2023.1337
Zhiheng Zhou, Jinghua He, Shenqing Zhou, Xianhui Chen, Yang Zhang, Shuangxi Wang, Jiangzhong Deng, Jiang Wu, Tianyuan Feng, Jiaji Wang
Since 1997, China has been carrying out general practice education and has promulgated and implemented the “General Practitioner System”, conducting general practice job transfer training and “5+3” standardized training. However, the continuing education of general practitioners in China was the weakest. This study looked insights in the barrier of continuing education for General Practitioners in China: There was no unified mode and standard for continuing education for general practitioners, lacked of management system covering the entire practice cycle of general practitioners, the focus of post graduation training was unclear, the overall level of the teaching staff was not high, and the enthusiasm of general practitioners to participate in continuing education was poor. In response to these issues, the authors constructed and implemented a full cycle general practitioner continuing education model guided by job competence. Based on summarizing the 10 core job competencies of general practitioners, they constructed a general practitioner training faculty, established general practitioner related systems (continuing education system, practice management system, and professional title promotion system), designed training courses, and conducted hierarchical training, We organized multi-path scientific research training and conducted comprehensive quality management for the continuing education of general practitioners, achieving satisfactory results. Our raining model provided a useful reference for the current continuing education of general practitioners in China and is worth promoting and applying.
{"title":"Current Insights in The Barrier of Continuing Education for General Practitioners in China and Construction of A Novel Raining Model","authors":"Zhiheng Zhou, Jinghua He, Shenqing Zhou, Xianhui Chen, Yang Zhang, Shuangxi Wang, Jiangzhong Deng, Jiang Wu, Tianyuan Feng, Jiaji Wang","doi":"10.26420/jfammed.2023.1337","DOIUrl":"https://doi.org/10.26420/jfammed.2023.1337","url":null,"abstract":"Since 1997, China has been carrying out general practice education and has promulgated and implemented the “General Practitioner System”, conducting general practice job transfer training and “5+3” standardized training. However, the continuing education of general practitioners in China was the weakest. This study looked insights in the barrier of continuing education for General Practitioners in China: There was no unified mode and standard for continuing education for general practitioners, lacked of management system covering the entire practice cycle of general practitioners, the focus of post graduation training was unclear, the overall level of the teaching staff was not high, and the enthusiasm of general practitioners to participate in continuing education was poor. In response to these issues, the authors constructed and implemented a full cycle general practitioner continuing education model guided by job competence. Based on summarizing the 10 core job competencies of general practitioners, they constructed a general practitioner training faculty, established general practitioner related systems (continuing education system, practice management system, and professional title promotion system), designed training courses, and conducted hierarchical training, We organized multi-path scientific research training and conducted comprehensive quality management for the continuing education of general practitioners, achieving satisfactory results. Our raining model provided a useful reference for the current continuing education of general practitioners in China and is worth promoting and applying.","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139317888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-29DOI: 10.26420/jfammed.2023.1336
Esquivel-Brambila Pa, Ramírez-Málaga Ur, Basurto-Acevedo Ml, Ortiz-Mesina Ms
Background: In Type 2 Diabetes Mellitus, anemia affects tissue oxygenation and glycemic homeostasis, which promotes the premature onset of microvascular damage. Objective: To determine the association between the degree of anemia and microvascular complications in patients with type 2 diabetes mellitus. Methods: This is a cross-sectional, analytical study. Patients with diabetes mellitus and any complications were included. A review of electronic medical records of patients who met the selection criteria was conducted. The information was captured in a database previously structured in the SPSS statistical software and analyzed using inferential statistics. Results: With a total of 113 patients, with an average age of 62.23±10.3 years. Of the patients with Type 2 Diabetes Mellitus, 54.9% (62) presented with anemia. Of these, 46.9% (53) presented with Grade I, 5.3% (6) with Grade II, and 2.7% (3) with Grade III anemia, according to the World Health Organization. In terms of microvascular complications, only 5.3% (6) of those with diabetic retinopathy presented with anemia, the most frequent being Grade I. In the group of patients with diabetic neuropathy, Grade I was found in 19.5% (22), and with nephropathy it was 35.4% (40), with 30.1% (34) being Grade I.
背景：在 2 型糖尿病患者中，贫血会影响组织氧合和血糖平衡，从而促使微血管损伤过早发生。研究目的确定 2 型糖尿病患者贫血程度与微血管并发症之间的关系。方法：这是一项横断面分析性研究：这是一项横断面分析研究。研究对象包括患有糖尿病和任何并发症的患者。对符合选择标准的患者的电子病历进行了审查。这些信息被收集到事先用 SPSS 统计软件构建的数据库中，并使用推断统计法进行分析。结果共有 113 名患者，平均年龄（62.23±10.3）岁。在 2 型糖尿病患者中，54.9%（62 人）伴有贫血。其中，46.9%（53 人）为一级贫血，5.3%（6 人）为二级贫血，2.7%（3 人）为三级贫血。在微血管并发症方面，只有 5.3%（6 人）的糖尿病视网膜病变患者出现贫血，其中最常见的是 I 级贫血；在糖尿病神经病变患者中，19.5%（22 人）出现 I 级贫血；在肾病患者中，35.4%（40 人）出现 I 级贫血，其中 30.1%（34 人）为 I 级贫血。
{"title":"Anemia and Microvascular Complications in Type 2 Diabetes Mellitus","authors":"Esquivel-Brambila Pa, Ramírez-Málaga Ur, Basurto-Acevedo Ml, Ortiz-Mesina Ms","doi":"10.26420/jfammed.2023.1336","DOIUrl":"https://doi.org/10.26420/jfammed.2023.1336","url":null,"abstract":"Background: In Type 2 Diabetes Mellitus, anemia affects tissue oxygenation and glycemic homeostasis, which promotes the premature onset of microvascular damage. Objective: To determine the association between the degree of anemia and microvascular complications in patients with type 2 diabetes mellitus. Methods: This is a cross-sectional, analytical study. Patients with diabetes mellitus and any complications were included. A review of electronic medical records of patients who met the selection criteria was conducted. The information was captured in a database previously structured in the SPSS statistical software and analyzed using inferential statistics. Results: With a total of 113 patients, with an average age of 62.23±10.3 years. Of the patients with Type 2 Diabetes Mellitus, 54.9% (62) presented with anemia. Of these, 46.9% (53) presented with Grade I, 5.3% (6) with Grade II, and 2.7% (3) with Grade III anemia, according to the World Health Organization. In terms of microvascular complications, only 5.3% (6) of those with diabetic retinopathy presented with anemia, the most frequent being Grade I. In the group of patients with diabetic neuropathy, Grade I was found in 19.5% (22), and with nephropathy it was 35.4% (40), with 30.1% (34) being Grade I.","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-29DOI: 10.26420/jfammed.2023.1335
Jiaojiao Gu, Qing Kong, Huailin Gao
Background: Syndrome of Inappropriate secretion of Antidiuretic Hormone (SIADH) is a group of disorders in which free water excretion is impaired due to increased Arginine Vaso Pressin (AVP) secretion in the absence of renal or endocrine dysfunction, which in turn leads to hypotonic hyponatremia. In this case report, we describe the diagnostic process of a patient with SIADH and the treatment with integration of Western and Chinese medicine. Case Presentation: A 69-year-old man was admitted to our hospital for intermittent hand tremors. He was diagnosed with hyponatremia based on laboratory tests. However, after 2 weeks of sodium supplementation, his condition did not improve. Combined with Pituitary MRI, 24h urine sodium and other laboratory tests, he was diagnosed with SIADH. After taking oral tolvaptan and traditional Chinese medicine Rehmanniae Decoction of Six Ingredients granules, his symptoms were alleviated and the serum sodium normalized. Conclusion: SIADH could be as an etiology for hyponatremia that is difficult-to-correct, and traditional Chinese medicine may have some efficacy and advantages.
{"title":"A Case Report of an Effective Treatment for Syndrome of Inappropriate Secretion of Antidiuretic Hormone with Integration of Western Medicine and Traditional Chinese Medicine","authors":"Jiaojiao Gu, Qing Kong, Huailin Gao","doi":"10.26420/jfammed.2023.1335","DOIUrl":"https://doi.org/10.26420/jfammed.2023.1335","url":null,"abstract":"Background: Syndrome of Inappropriate secretion of Antidiuretic Hormone (SIADH) is a group of disorders in which free water excretion is impaired due to increased Arginine Vaso Pressin (AVP) secretion in the absence of renal or endocrine dysfunction, which in turn leads to hypotonic hyponatremia. In this case report, we describe the diagnostic process of a patient with SIADH and the treatment with integration of Western and Chinese medicine. Case Presentation: A 69-year-old man was admitted to our hospital for intermittent hand tremors. He was diagnosed with hyponatremia based on laboratory tests. However, after 2 weeks of sodium supplementation, his condition did not improve. Combined with Pituitary MRI, 24h urine sodium and other laboratory tests, he was diagnosed with SIADH. After taking oral tolvaptan and traditional Chinese medicine Rehmanniae Decoction of Six Ingredients granules, his symptoms were alleviated and the serum sodium normalized. Conclusion: SIADH could be as an etiology for hyponatremia that is difficult-to-correct, and traditional Chinese medicine may have some efficacy and advantages.","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"197 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-20DOI: 10.26420/jfammed.2023.1334
Mateu Serra Prat, Júlia Serra Colomer, Àngel Lavado, M. Cabré, E. Burdoy
Background: The COVID-19 pandemic severely affected the aged population and healthcare system functioning. Aim: To evaluate the impact of COVID-19 on mortality and health resource use in an aged population and to determine whether the impact differed according to frailty status. Methods: A population-based observational longitudinal study comparing pre-pandemic and pandemic variables was performed using data retrospectively collected from computerized clinical histories. The study population included all inhabitants aged =65 years corresponding to three primary care centres in Barcelona province (Spain). Data were collected on mortality, institutionalization, hospital admissions, emergency visits, outpatient visits, primary care visits, and day hospital sessions in the pre-pandemic (2018-2019) and pandemic (2020-2021) periods. Frailty status was established according to the Electronic Screening Index of Frailty (e-SIF). Results: 9315 individuals were included in the pre-pandemic cohort (75.4 years, 56% women) and 9774 in the pandemic cohort (73.3 years, 56% women). Compared with the pre-pandemic period, in the pandemic period, mortality overall increased by 21.7% (14.7% for non-frail and 33.0% for frail individuals); emergency visits, hospitalizations, and day hospital sessions decreased by 23.1%, 12.1%, and 3.7%, respectively, and primary care visits increased by 15.0%. Conclusions: For the population aged =65 years in the COVID-19 pandemic period, the mortality of frail individuals was greater than overall mortality for this population, and frailty prevalence overall decreased by 5%. In terms of resource use, use of hospital services decreased and of primary care services increased.
{"title":"Impact of the COVID-19 Pandemic on Mortality and Health Resource Use in an Aged Population and Differences According to Frailty Status","authors":"Mateu Serra Prat, Júlia Serra Colomer, Àngel Lavado, M. Cabré, E. Burdoy","doi":"10.26420/jfammed.2023.1334","DOIUrl":"https://doi.org/10.26420/jfammed.2023.1334","url":null,"abstract":"Background: The COVID-19 pandemic severely affected the aged population and healthcare system functioning. Aim: To evaluate the impact of COVID-19 on mortality and health resource use in an aged population and to determine whether the impact differed according to frailty status. Methods: A population-based observational longitudinal study comparing pre-pandemic and pandemic variables was performed using data retrospectively collected from computerized clinical histories. The study population included all inhabitants aged =65 years corresponding to three primary care centres in Barcelona province (Spain). Data were collected on mortality, institutionalization, hospital admissions, emergency visits, outpatient visits, primary care visits, and day hospital sessions in the pre-pandemic (2018-2019) and pandemic (2020-2021) periods. Frailty status was established according to the Electronic Screening Index of Frailty (e-SIF). Results: 9315 individuals were included in the pre-pandemic cohort (75.4 years, 56% women) and 9774 in the pandemic cohort (73.3 years, 56% women). Compared with the pre-pandemic period, in the pandemic period, mortality overall increased by 21.7% (14.7% for non-frail and 33.0% for frail individuals); emergency visits, hospitalizations, and day hospital sessions decreased by 23.1%, 12.1%, and 3.7%, respectively, and primary care visits increased by 15.0%. Conclusions: For the population aged =65 years in the COVID-19 pandemic period, the mortality of frail individuals was greater than overall mortality for this population, and frailty prevalence overall decreased by 5%. In terms of resource use, use of hospital services decreased and of primary care services increased.","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139369285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-19DOI: 10.26420/jfammed.2023.1333
Friedrich C Prischl, Erwin Rebhandl, Sonja Zehetmayer
Numerous studies have been carried out on determination of glycated haemoglobin to diagnose type 2 diabetes (T2D), among them the manuscript by Selvin et al [1]. They have led the American Diabetes Association (ADA) to recommend haemoglobin A1c (HbA1c) measurements to identify patients having diabetes in their 2010 position statement with a cut off of =6.5 % [2]. Nevertheless, there is some controversial discussion whether HbA1c should be the gold standard for diagnosis of T2D instead of fasting glucose or oral glucose tolerance testing with various arguments in favour of HbA1c [3].
{"title":"Early Identification of Type 2 Diabetes Using Glycated Haemoglobin in Primary Care Medical Offices as a Proof of Feasibility in Austria","authors":"Friedrich C Prischl, Erwin Rebhandl, Sonja Zehetmayer","doi":"10.26420/jfammed.2023.1333","DOIUrl":"https://doi.org/10.26420/jfammed.2023.1333","url":null,"abstract":"Numerous studies have been carried out on determination of glycated haemoglobin to diagnose type 2 diabetes (T2D), among them the manuscript by Selvin et al [1]. They have led the American Diabetes Association (ADA) to recommend haemoglobin A1c (HbA1c) measurements to identify patients having diabetes in their 2010 position statement with a cut off of =6.5 % [2]. Nevertheless, there is some controversial discussion whether HbA1c should be the gold standard for diagnosis of T2D instead of fasting glucose or oral glucose tolerance testing with various arguments in favour of HbA1c [3].","PeriodicalId":90896,"journal":{"name":"Journal of family medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139369410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-14DOI: 10.26420/jfammed.2023.1332
Fix Am, Happel R, Peterson B
Spinal cord pathology is a diverse topic with a broad range of causes. Etiologies include trauma, inflammatory processes, infections, vascular disease, neoplasm, degenerative conditions and toxin exposure. Regardless of etiology, spinal pathology often presents as rapidly progressive paraparesis. Transverse Myelitis (TM) is a rare, acute segmental inflammatory spinal cord disorder characterized with motor, sensory, and/or autonomic dysfunction. This process usually occurs post-infection, but may also be related to acute neuro-inflammatory disorders. This paper will present a case of TM refractory to medication and describe the diagnosis of Spinal Dural Arteriovenous Fistula (SDAVF). SDAVF is a rare condition in which there is an arteriovenous fistula formed on the dural surface of the spinal cord which typically drains via retrograde flow through the medullary vein, thereby causing enlargement of coronal venous plexus.
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