A case of finding of asymptomatic 3rd stage myxomatous degeneration of the mitral valve in general practice

2020 ◽  
Vol 24 (3) ◽  
pp. 33-38
Author(s):  
Irina V. Yubrina ◽  
Svetlana O. Filippova ◽  
Igor A. Bozhkov ◽  
Diana A. Vrabiy
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Mitral Valve ◽  
Male Patient ◽  
Pathological Findings ◽  
Diagnostic Algorithms ◽  
Myxomatous Degeneration

The case of asymptomatic 3rd stage myxomatous degeneration of the mitral valve in a 42-year old male patient is presented. The patient was referred to Tuberculosis dispensary No. 5 for investigation of pathological findings revealed by fluorography during the coronavirus pandemic period. The patient was examined by TB specialists and the general practitioner in accordance with new interdisciplinary diagnostic algorithms primary involving the GP. As а result of the detailed investigation the patient was found to have previously undiagnosed consequences of pneumonia caused by COVID-19 and 3rd stage myxomatous degeneration of the mitral valve.

scholarly journals Standing order use in general practice: the views of medicine, nursing and pharmacy stakeholder organisations

2017 ◽  
Vol 9 (1) ◽  
pp. 47 ◽  
Author(s):  
Robyn Taylor ◽  
Eileen McKinlay ◽  
Caroline Morris
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Access To Health Care ◽  
Timely Manner ◽  
Face To Face ◽  
Standing Order ◽  
Access To Health ◽  
General Practices ◽  
Pharmacy Data ◽  
The Impact

ABSTRACT INTRODUCTION Standing orders are used by many general practices in New Zealand. They allow a practice nurse to assess patients and administer and/or supply medicines without needing intervention from a general practitioner. AIM To explore organisational strategic stakeholders’ views of standing order use in general practice nationally. METHODS Eight semi-structured, qualitative, face-to-face interviews were conducted with participants representing key primary care stakeholder organisations from nursing, medicine and pharmacy. Data were analysed using a qualitative inductive thematic approach. RESULTS Three key themes emerged: a lack of understanding around standing order use in general practice, legal and professional concerns, and the impact on workforce and clinical practice. Standing orders were perceived to extend nursing practice and seen as a useful tool in enabling patients to access medicines in a safe and timely manner. DISCUSSION The variability in understanding of the definition and use of standing orders appears to relate to a lack of leadership in this area. Leadership should facilitate the required development of standardised resources and quality assurance measures to aid implementation. If these aspects are addressed, then standing orders will continue to be a useful tool in general practice and enable patients to have access to health care and, if necessary, to medicines without seeing a general practitioner.

Myxomatous degeneration of the mitral valve

1970 ◽  
Vol 25 (1) ◽  
pp. 127 ◽  
Author(s):  
Benjamin Schuster ◽  
Robert H. Davis ◽  
John H. Kohler ◽  
Suzanne B. Knoebel
Keyword(s):  
Mitral Valve ◽  
Myxomatous Degeneration

An acute eye condition masquerading as a flu-like syndrome: A potential pitfall in general practice

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Evita Evangelia Christou ◽  
◽  
Xenophon Bazoukis ◽  
Alexandra Papoudou-Bai ◽  
Maria Stefaniotou ◽  
...  
Keyword(s):  
General Practice ◽  
Differential Diagnosis ◽  
General Practitioner ◽  
Gastrointestinal Symptoms ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Potential Pitfall ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Systemic Condition

Acute primary angle closure glaucoma may masquerade a systemic condition. Proper differential diagnosis is requisite. A 52-year-old female visited the general practitioner due to her progressively worsening headache accompanied by gastrointestinal symptoms. This condition presented acutely while reading a book at semiprone position in a not well illuminated room.

Psychiatric disorders in adolescents in primary care

1998 ◽  
Vol 173 (6) ◽  
pp. 508-513 ◽  
Author(s):  
Tami Kramer ◽  
M. Elena Garralda
Keyword(s):  
Primary Care ◽  
General Practice ◽  
General Practitioner ◽  
Psychiatric Disorders ◽  
Health Risks ◽  
Physical Symptoms ◽  
Global Assessment Scale ◽  
Scale Scores ◽  
Research Interviews ◽  
Internalising Disorders

BackgroundLittle is known about psychiatric disorders in adolescents who attend primary care.MethodProspective study of 13- to 16-year-olds consecutively attending general practice. Information was obtained from adolescents, parents and general practitioners, using questionnaires and research interviews.Results136/200 (68%) of adolescent attenders took part. Two per cent presented with psychiatric complaints. From research interviews with adolescents, psychiatric disorder in the previous year was found in 38%, with moderate impairment of functioning in over half (according to Children's Global Assessment Scale scores). Most disorders (42/50, 84%) were emotional (‘internalising’) disorders. Psychiatric disorders were significantly associated with high levels and intensity of physical symptoms and with increased health risks. General practitioner assessment of psychiatric disorders was low on sensitivity (20.8%) but high on specificity (90.7%). Doctors identified most severely affected adolescents.ConclusionsDepressive and anxiety disorders are common among adolescent general practice attenders and linked to increased physical symptoms; general practitioner recognition is limited.

scholarly journals Comparison of Outcomes of Mitral Valve Repair for Leaflet Prolapse with Advanced versus Mild/Moderate Myxomatous Degeneration

2018 ◽  
Vol 59 (6) ◽  
pp. 1288-1295
Author(s):  
Ying Guo ◽  
Changpeng Song ◽  
Xi Wu ◽  
Xinxin Zheng ◽  
Jie Lu ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Myxomatous Degeneration ◽  
Leaflet Prolapse

scholarly journals Drivers of ‘clinically unnecessary’ use of emergency and urgent care: the DEUCE mixed-methods study

2020 ◽  
Vol 8 (15) ◽  
pp. 1-256
Author(s):  
Alicia O’Cathain ◽  
Emma Knowles ◽  
Jaqui Long ◽  
Janice Connell ◽  
Lindsey Bishop-Edwards ◽  
...  
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
General Practitioner ◽  
Health Service ◽  
Health Services ◽  
Focus Groups ◽  
Emergency Departments ◽  
Help Seeking ◽  
Mixed Methods Study ◽  
Coping Capacity

Background There is widespread concern about the pressure on emergency and urgent services in the UK, particularly emergency ambulances, emergency departments and same-day general practitioner appointments. A mismatch between supply and demand has led to interest in what can be termed ‘clinically unnecessary’ use of services. This is defined by the research team in this study as ‘patients attending services with problems that are classified as suitable for treatment by a lower urgency service or self-care’. This is a challenging issue to consider because patients may face difficulties when deciding the best action to take, and different staff may make different judgements about what constitutes a legitimate reason for service use. Objectives To identify the drivers of ‘clinically unnecessary’ use of emergency ambulances, emergency departments and same-day general practitioner appointments from patient and population perspectives. Design This was a sequential mixed-methods study with three components: a realist review; qualitative interviews (n = 48) and focus groups (n = 3) with patients considered ‘clinically unnecessary’ users of these services, focusing on parents of young children, young adults and people in areas of social deprivation; and a population survey (n = 2906) to explore attitudes towards seeking care for unexpected, non-life-threatening health problems and to identify the characteristics of someone with a tendency for ‘clinically unnecessary’ help-seeking. Results From the results of the three study components, we found that multiple, interacting drivers influenced individuals’ decision-making. Drivers could be grouped into symptom related, patient related and health service related. Symptom-related drivers were anxiety or need for reassurance, which were caused by uncertainty about the meaning or seriousness of symptoms; concern about the impact of symptoms on daily activities/functioning; and a need for immediate relief of intolerable symptoms, particularly pain. Patient-related drivers were reduced coping capacity as a result of illness, stress or limited resources; fear of consequences when responsible for another person’s health, particularly a child; and the influence of social networks. Health service-related drivers were perceptions or previous experiences of services, particularly the attractions of emergency departments; a lack of timely access to an appropriate general practitioner appointment; and compliance with health service staff’s advice. Limitations Difficulty recruiting patients who had used the ambulance service to the interviews and focus groups meant that we were not able to add as much as we had anticipated to the limited evidence base regarding this service. Conclusions Patients use emergency ambulances, emergency departments and same-day general practitioner appointments when they may not need the level of clinical care provided by these services for a multitude of inter-related reasons that sometimes differ by population subgroup. Some of these reasons relate to health services, in terms of difficulty accessing general practice leading to use of emergency departments, and to population-learnt behaviour concerning the positive attributes of emergency departments, rather than to patient characteristics. Social circumstances, such as complex and stressful lives, influence help-seeking for all three services. Demand may be ‘clinically unnecessary’ but completely understandable when service accessibility and patients’ social circumstances are considered. Future work There is a need to evaluate interventions, including changing service configuration, strengthening general practice and addressing the stressors that have an impact on people’s coping capacity. Different subgroups may require different interventions. Study registration This study is registered as PROSPERO CRD42017056273. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 15. See the NIHR Journals Library website for further project information.

scholarly journals Myxomatous degeneration of the mitral valve

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Felippe Lazar ◽  
Laís Costa Marques ◽  
Vera Demarchi Aiello
Keyword(s):  
Mitral Valve ◽  
Myxomatous Degeneration
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