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Digestive Diseases (Basel, Switzerland) 2022Jaundice is a common clinical finding in clinical practice of hepatologists and general practitioners. It occurs when serum bilirubin levels exceed 3 mg/dL. (Review)
Review
BACKGROUND
Jaundice is a common clinical finding in clinical practice of hepatologists and general practitioners. It occurs when serum bilirubin levels exceed 3 mg/dL.
SUMMARY
In this review, we summarize the pathophysiological mechanism of jaundice, clinical approach to the patient with jaundice, and laboratory and imaging techniques. Clinical presentation of jaundice manifests through yellow skin and sclera coloration. Evaluation of every patient includes detailed medical history and examination. In the laboratory, evaluation of enzymes of hepatic inflammation as well as cholestatic enzymes with serum bilirubin must be included. Additional laboratory analysis and imaging modalities are needed in order to differentiate jaundice etiology. Moreover, imaging is available and needed in further evaluation, and treatment is dependent on the underlying cause.
KEY MESSAGES
In this review, we will outline the pathophysiological mechanism of jaundice, clinical approach to the patient with jaundice, and diagnostic and treatment approach to these patients.
Topics: Bilirubin; Cholestasis; General Practitioners; Humans; Jaundice; Liver Function Tests
PubMed: 34015787
DOI: 10.1159/000517301 -
Current Oncology (Toronto, Ont.) Jun 2019Hematopoietic stem-cell transplantation (hsct) is a medical procedure that consists of infusing stem cells after a short course of chemotherapy or radiotherapy, or both.... (Review)
Review
Hematopoietic stem-cell transplantation (hsct) is a medical procedure that consists of infusing stem cells after a short course of chemotherapy or radiotherapy, or both. It can be used in the treatment of various cancers, as well as some benign conditions. In the present review, we discuss the various types of hsct and their main indications. The principles of the transplant procedure itself and the basics of recipient selection are reviewed. Special attention is given to both the immediate and the long-term complications of hsct and their management strategies. Hematopoietic stem-cell transplantation is a potentially life-saving procedure and often the only curative option for a variety of diseases; however, it is not without significant toxicities.
Topics: General Practitioners; Hematopoietic Stem Cell Transplantation; Humans; Postoperative Complications
PubMed: 31285665
DOI: 10.3747/co.26.5033 -
Cureus Aug 2020The trauma and orthopaedic speciality continues to advance as surgery becomes more accessible and safe. However, the bygone days of treatment with traction still has its... (Review)
Review
The trauma and orthopaedic speciality continues to advance as surgery becomes more accessible and safe. However, the bygone days of treatment with traction still has its merits and should remain a part of practitioner's repertoire. This will allow the practitioners to be resourceful in times of unexpected scenarios. We aim to write this article to describe indications, applications of various forms of traction, and their relevant complications.
PubMed: 32983726
DOI: 10.7759/cureus.10034 -
Orthopaedics & Traumatology, Surgery &... Feb 2022Foot and hallux valgus surgery are amongst the most commonly performed surgeries, with a growing number of procedures leading to litigation. The aim of this conference... (Review)
Review
Foot and hallux valgus surgery are amongst the most commonly performed surgeries, with a growing number of procedures leading to litigation. The aim of this conference is to provide an update on the causes of malpractice claims and the associated risk factors. What are the causes of litigation? Acute or chronic residual pain, stiffness, metatarsalgia, consolidation delays, secondary displacements, suboptimal results are the most common causes found in litigious proceedings. What are the risk factors? Surgeon-related and patient-related risk factors exist. Percutaneous surgery or the development of outpatient hospitalization are not specific risk factors. From the point of view of practitioners, the application and traceability of recommendations for antibiotic prophylaxis, for thromboembolic disease, or for the checklist are essential, allowing causes of blame to be easily avoided. Information is fundamental. Since the Law of the 4th of March 2002, the surgeon-patient relationship has changed. Pre-operative information archived in the practitioner's file is essential. This includes written and oral information which is consented to and understood by the patient. Thus, the understanding and compliance with immediate post-operative instructions or adherence to the post-operative program are success factors regarding the surgical outcome. The patient must also be informed and aware of their own individual risk factors (e.g. smoking and immunosuppression, particularly) which require greater caution. What is the best way to reduce the risk of these claims being made? It is about traceability: traceability of clinical examination, procedures, information and exchanges with the patient. It is only under this principle that the surgeon-patient relationship can be clearer, respectful and consequently less conducive to litigation. LEVEL OF EVIDENCE: V; expert opinion.
Topics: Hallux Valgus; Humans; Malpractice; Risk Factors; Surgeons
PubMed: 34838752
DOI: 10.1016/j.otsr.2021.103152 -
Australian Family Physician Oct 2007Genetic screening programs in Australia are primarily carried out during pregnancy for maternal thalassaemia carrier status, chromosomal conditions and neural tube... (Review)
Review
BACKGROUND
Genetic screening programs in Australia are primarily carried out during pregnancy for maternal thalassaemia carrier status, chromosomal conditions and neural tube defects in the fetus, and for a number of conditions in the newborn.
OBJECTIVE
This article describes these programs and the general practitioner's role, particularly around offering prenatal screening that includes nongenetic aspects (eg. smoking, alcohol), to enable good practice.
DISCUSSION
General practitioners can be involved in offering prenatal screening and in giving increased risk results from prenatal and newborn screening, with due consideration of informed decision making and counselling about the meaning of the result. Increased risk results from these screening programs are followed up by further testing where required. As genetic contribution to diseases, especially complex common conditions, becomes better understood, more genetic tests will become available. This may impact on the role of the GP in population genetic screening programs.
Topics: Australia; Decision Making; Female; Genetic Predisposition to Disease; Genetic Testing; Humans; Physician's Role; Physicians, Family; Pregnancy; Prenatal Care
PubMed: 17925898
DOI: No ID Found -
Indian Dermatology Online Journal 2024
PubMed: 38550847
DOI: 10.4103/idoj.idoj_91_24 -
Australasian Psychiatry : Bulletin of... Jun 2023Terminating a therapeutic relationship can be particularly challenging and onerous for the treating medical practitioner. There are multiple reasons why a practitioner...
OBJECTIVE
Terminating a therapeutic relationship can be particularly challenging and onerous for the treating medical practitioner. There are multiple reasons why a practitioner may desire to terminate the relationship, ranging from inappropriate behaviour and assault through to threatened or actual litigation. This paper provides psychiatrists as well as all doctors and support staff who work alongside them with a simple, step-by-step visual guide to terminating a therapeutic relationship, giving due consideration to their professional and legal obligations in line with common recommendations by medical indemnity organisations.
CONCLUSIONS
If a practitioner's ability to manage the patient is inadequate or compromised due to an emotional, financial, or legal circumstance, it is reasonable to consider termination of the relationship. Practical steps such as taking contemporaneous notes, writing to the patient and their primary care doctor, ensuring continuity of healthcare, and communicating with authorities where appropriate have been identified as components commonly recommended by medical indemnity insurance organisations.
Topics: Humans; Physician-Patient Relations; Emotions
PubMed: 36866774
DOI: 10.1177/10398562231159544 -
Cureus Mar 2023People travel all around the world to explore, trade, sojourn, etc. Millions of individuals cross national and international borders. Travel medicine services are... (Review)
Review
People travel all around the world to explore, trade, sojourn, etc. Millions of individuals cross national and international borders. Travel medicine services are offered by general practitioners, specialized travel clinics, or immunization centers. Epidemiology, illness prevention, and travel-related self-treatment are all included in the interdisciplinary field of travel medicine. The main objective is to keep travelers alive and in good health, by reducing the effects of illness and accidents through preventative measures and self-care. The danger to a traveler's health and well-being must be understood, and the travel medicine practitioner's job is to help their patient or client recognize and manage those risks. The absence of any disease or symptom does not always indicate good health. Chronic illness sufferers, including those with cancer, diabetes, and hypertension, can maintain a reasonable level of health and mobility. Travel medicine is a rapidly developing, extremely dynamic, multidisciplinary field that calls for knowledge of a range of travel-related illnesses as well as current information on the global epidemiology of infectious and non-infectious health risks, immunization laws and requirements around the world, and the shifting trends in drug-resistant infections. Pre-travel consultation aims to reduce the traveler's risk of disease and harm while on the road through preventive counseling, education, recommended drugs, and essential vaccines. Specialized medical guidance can help reduce the potential health risks of travel. Emporiatrics is not only used for traveling advice or things to be done during the period of the journey but it also creates room in implementing the interdisciplinary subject with new methods or development of new policies, technologies, and various programs to reduce unnecessary problems of the travelers, which will boost tourism.
PubMed: 37082503
DOI: 10.7759/cureus.36343 -
Sensors (Basel, Switzerland) Feb 2022Processes for evaluating software architecture (SA) help to investigate problems and potential risks in SA. It is derived from many studies that proposed a plethora of... (Review)
Review
Processes for evaluating software architecture (SA) help to investigate problems and potential risks in SA. It is derived from many studies that proposed a plethora of systematic SA evaluation methods, while industrial practitioners currently refrain from applying them since they are heavyweight. Nowadays, heterogeneous software architectures are organized based on the new infrastructure. Hardware and associated software allow different systems, such as embedded, sensor-based, modern AI, and cloud-based systems, to cooperate efficiently. It brings more complexities to SA evaluation. Alternatively, lightweight architectural evaluation methods have been proposed to satisfy the practitioner's concerns, but practitioners still do not adopt these methods. This study employs a systematic literature review with a text analysis of SA's definitions to propose a comparison framework for SA. It identifies lightweight features and factors to improve the architectural evaluation methods among industrial practitioners. The features are determined based on the practitioner's concerns by analyzing the architecture's definitions from stakeholders and reviewing architectural evaluation methods. The lightweight factors are acquired by studying the five most commonly used lightweight methods and the Architecture-based Tradeoff Analysis Method (ATAM), the most well-known heavyweight method. Subsequently, the research addresses these features and factors.
Topics: Hernia, Inguinal; Herniorrhaphy; Humans; Industry; Software; Surgical Mesh
PubMed: 35161996
DOI: 10.3390/s22031252 -
Forensic Science International. Synergy 2022This article discusses the gap between the Inquest Legislation of Tanzania and the medical practitioner's teaching curriculum which also covers the medico-legal field....
This article discusses the gap between the Inquest Legislation of Tanzania and the medical practitioner's teaching curriculum which also covers the medico-legal field. The Tanzanian law clearly states that 'any Government medical practitioner' may be given the responsibility of exhumation, provision of post mortem order and then examination of the corpse where there are ample circumstances requiring an inquest to assist police investigation and the Judiciary in determining whether the cause of death was natural. However, the medical training curriculum in Tanzania for many years did not offer any courses of forensic exhumation and identification of human skeletal remains. Therefore, there has been a gap between the legal entities and the curriculum organization of medical practitioner: a condition that leads to medical practitioners failing to fully support the criminal investigation departments and the judicial system. The article highlights the existing gap and its challenges, shortage of experts in the field of forensic science services and provides some suggestions on how to address these challenges where the proposed methods can be applied to both short- and long-term plans.
PubMed: 35958940
DOI: 10.1016/j.fsisyn.2022.100276