A Refresher on Herpes Zoster, Current Status on Vaccination, and the Role of the Dermatologist

2011 ◽  
Vol 15 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Lyn C. Guenther ◽  
Charles W. Lynde
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Herpes Zoster ◽  
Preventive Medicine ◽  
Primary Care Physicians ◽  
Current Status ◽  
Age Group ◽  
Increased Risk

Background: Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a significant impact on quality of life. PHN is often chronic and difficult to treat. Dermatologists have always been involved in making the diagnosis of these conditions and, most recently, teaching the need for early antiviral therapy. Objective: With the introduction of a new vaccine, HZ and its difficult-to-treat complication PHN can be prevented or minimized. Preventive medicine is important and has been supported by dermatologists with sun safety programs. Patients receiving biologics are at increased risk of developing zoster. Conclusion: Dermatologists should embrace zoster vaccination and recommend routine vaccination of immunocompetent individuals > age 60 years, as well as patients of any age who are starting immunosuppressants, including biologics. Given that individuals over age 50 years are at risk for PHN and studies have shown that the vaccine's immunogenicity and safety are maintained in individuals age 50 to 59 years, vaccination in this age group may be considered. Some dermatologists may consider vaccinating their own patients, but most will likely recommend that vaccination be performed by their patients' primary care physicians.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals The role of Clinical-Functional Vulnerability Index-20 to detect quality of life in older adults assisted in primary care

2021 ◽  
Vol 67 (1) ◽  
pp. 83-87
Author(s):  
Levi Bezerra Sena ◽  
Larissa Paixão Batista ◽  
Flávia Fonseca Fernandes ◽  
Alfredo Nicodemos Cruz Santana
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Primary Care ◽  
Vulnerability Index

Differences between primary care physicians and specialised neurotologists in the diagnosis of dizziness and vertigo in Japan

2020 ◽  
Vol 134 (9) ◽  
pp. 764-768
Author(s):  
T Ito ◽  
S Matsuyama ◽  
T Shiozaki ◽  
D Nishikawa ◽  
H Akioka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Patient Satisfaction ◽  
Diagnostic Accuracy ◽  
Medical Records ◽  
Primary Care Physicians ◽  
Symptom Relief ◽  
Accurate Diagnosis ◽  
High Quality

AbstractObjectiveVertigo and dizziness are frequent symptoms in patients at out-patient services. An accurate diagnosis for vertigo or dizziness is essential for symptom relief; however, it is often challenging. This study aimed to identify differences in diagnoses between primary-care physicians and specialised neurotologists.MethodIn total, 217 patients were enrolled. To compare diagnoses, data was collected from the reference letters of primary-care physicians, medical questionnaires completed by patients and medical records.ResultsIn total, 62.2 per cent and 29.5 per cent of the patients were referred by otorhinolaryngologists and internists, respectively. The cause of vertigo or dizziness and diagnosis was missing in 47.0 per cent of the reference letters. In addition, 67.3 per cent of the diagnoses by previous physicians differed from those reported by specialised neurotologists.ConclusionTo ensure patient satisfaction and high quality of life, an accurate diagnosis for vertigo or dizziness is required; therefore, methods or materials to improve the diagnostic accuracy are needed.

scholarly journals Mixed anxiety and depressive disorder outcomes: prospective cohort study in primary care

2011 ◽  
Vol 198 (6) ◽  
pp. 472-478 ◽  
Author(s):  
Kate Walters ◽  
Marta Buszewicz ◽  
Scott Weich ◽  
Michael King
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Depressive Disorder ◽  
Psychiatric Diagnosis ◽  
Short Form ◽  
General Health Questionnaire ◽  
Consultation Rate ◽  
Increased Risk ◽  
Significant Difference

BackgroundMixed anxiety and depressive disorder (MADD) is common yet ill-defined, with little known about outcomes.AimsTo determine MADD outcomes over 1 year.MethodWe recruited 250 adults attending seven London general practices with mild–moderate distress. Three groups were defined using a diagnostic interview: MADD, other ICD–10 psychiatric diagnosis, no psychiatric diagnosis. We assessed symptoms of distress (General Health Questionnaire–28), quality of life (12-item Short Form Health Survey), general practitioner (GP) diagnosis and consultation rate at baseline, 3 months and 1 year.ResultsTwo-thirds of participants with MADD had no significant psychological distress at 3 months (61%) or 1 year (69%). However, compared with those with no diagnosis, individuals had twice the risk of significant distress (incidence rate ratio 2.39, 95% CI 1.29–4.42) at 3 months but not 1 year, and persistently lower quality of life (mental health functioning). There was no significant difference in GP consultation rate/diagnosis.ConclusionsThe majority with MADD improved, but individuals had an increased risk of significant distress at 3 months and a lower quality of life. As we cannot currently predict those with a poorer prognosis these patients should be actively monitored in primary care.

scholarly journals Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with chronic kidney disease: a randomized controlled trial

2019 ◽  
Author(s):  
Patrick Saudan ◽  
Belen Ponte ◽  
Nicola Marangon ◽  
Chantal Martinez ◽  
Lena Berchtold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Clinical Care ◽  
Randomised Trial ◽  
Dialysis Initiation ◽  
The Impact

Abstract Background: Optimal clinical care of patients with chronic kidney disease (CKD) requires collaboration between primary care physicians (PCP) and nephrologists. We undertook a randomised trial to determine the impact of superimposed nephrologist care compared to guidelines-directed management by PCPs in CKD patients after hospital discharge. Methods: Stage 3b-4 CKD patients were enrolled during a hospitalization and randomised in two arms: Co-management by PCPs and nephrologists (interventional arm) versus management by PCPs with written instructions and consultations by nephrologists on demand (standard care). Our primary outcome was death or rehospitalisation within the 2 years post-randomisation. Secondary outcomes were: urgent renal replacement therapy (RRT), decline of renal function and decrease of quality of life at 2 years. Results: From November 2009 to the end of June 2013, we randomised 242 patients. Mean follow-up was 51 + 20 months. Survival without rehospitalisation, GFR decline and elective dialysis initiation did not differ between the two arms. Quality of life was also similar in both groups . Compared to randomised patients, those who either declined to participate in the study or were previously known by nephrologists had a worse survival. Conclusion: These results do not demonstrate a benefit of a regular renal care compared to guided PCPs care in terms of survival or dialysis initiation in CKD patients. Increased awareness of renal disease management among PCPs may be as effective as a co-management by PCPs and nephrologists in order to improve the prognosis of moderate-to-severe CKD.

scholarly journals ASSESSMENT OF AWARENESS OF FAMILY PHYSICIANSABOUT THE OSTEOPOROSIS AS A PROBLEM OF ELDERLY

2017 ◽  
Vol 9 (1) ◽  
pp. 79-82
Author(s):  
O Yu Kuznetsova ◽  
I E Moiseeva
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Care Physicians ◽  
Age Group ◽  
Treatment Of Osteoporosis ◽  
Family Doctors ◽  
Primary Health ◽  
Prevalence Of Osteoporosis

The prevalence of osteoporosis in Russia is about 10%, and in the age group over 50 years - up to 25-35%. The role of primary care physicians in the prevention, diagnosis and treatment of this disease is high, because 80% of patients seeking medical help in primary health care. The article presents the results of the assessment of the awareness of the general practitioners (family doctors) on the preven- tion, diagnostics and treatment of osteoporosis

scholarly journals Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with stable chronic kidney disease: a randomized controlled trial

2019 ◽  
Author(s):  
Patrick Saudan ◽  
Belen Ponte ◽  
Nicola Marangon ◽  
Chantal Martinez ◽  
Lena Berchtold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Clinical Care ◽  
Randomised Trial ◽  
Dialysis Initiation ◽  
The Impact

Abstract Background: Optimal clinical care of patients with chronic kidney disease (CKD) requires collaboration between primary care physicians (PCP) and nephrologists. We undertook a randomised trial to determine the impact of superimposed nephrologist care compared to guidelines-directed management by PCPs in CKD patients after hospital discharge. Methods: Stage 3b-4 CKD patients were enrolled during a hospitalization and randomised in two arms: Co-management by PCPs and nephrologists (interventional arm) versus management by PCPs with written instructions and consultations by nephrologists on demand (standard care). Our primary outcome was death or rehospitalisation within the 2 years post-randomisation. Secondary outcomes were: urgent renal replacement therapy (RRT), decline of renal function and decrease of quality of life at 2 years. Results: From November 2009 to the end of June 2013, we randomised 242 patients. Mean follow-up was 51 + 20 months. Survival without rehospitalisation, GFR decline and elective dialysis initiation did not differ between the two arms. Quality of life was also similar in both groups . Compared to randomised patients, those who either declined to participate in the study or were previously known by nephrologists had a worse survival. Conclusion: These results do not demonstrate a benefit of a regular renal care compared to guided PCPs care in terms of survival or dialysis initiation in CKD patients. Increased awareness of renal disease management among PCPs may be as effective as a co-management by PCPs and nephrologists in order to improve the prognosis of moderate-to-severe CKD.

scholarly journals Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with stable chronic kidney disease: a randomized controlled trial

2020 ◽  
Author(s):  
Patrick Saudan ◽  
Belen Ponte ◽  
Nicola Marangon ◽  
Chantal Martinez ◽  
Lena Berchtold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Clinical Care ◽  
Randomised Trial ◽  
Dialysis Initiation ◽  
The Impact

Abstract Background: Optimal clinical care of patients with chronic kidney disease (CKD) requires collaboration between primary care physicians (PCP) and nephrologists. We undertook a randomised trial to determine the impact of superimposed nephrologist care compared to guidelines-directed management by PCPs in CKD patients after hospital discharge. Methods: Stage 3b-4 CKD patients were enrolled during a hospitalization and randomised in two arms: Co-management by PCPs and nephrologists (interventional arm) versus management by PCPs with written instructions and consultations by nephrologists on demand (standard care). Our primary outcome was death or rehospitalisation within the 2 years post-randomisation. Secondary outcomes were: urgent renal replacement therapy (RRT), decline of renal function and decrease of quality of life at 2 years. Results: From November 2009 to the end of June 2013, we randomised 242 patients. Mean follow-up was 51 + 20 months. Survival without rehospitalisation, GFR decline and elective dialysis initiation did not differ between the two arms. Quality of life was also similar in both groups . Compared to randomised patients, those who either declined to participate in the study or were previously known by nephrologists had a worse survival. Conclusion: These results do not demonstrate a benefit of a regular renal care compared to guided PCPs care in terms of survival or dialysis initiation in CKD patients. Increased awareness of renal disease management among PCPs may be as effective as a co-management by PCPs and nephrologists in order to improve the prognosis of moderate-to-severe CKD.

scholarly journals Food Implications in Central Sensitization Syndromes

2020 ◽  
Vol 9 (12) ◽  
pp. 4106
Author(s):  
Elena Aguilar-Aguilar ◽  
Helena Marcos-Pasero ◽  
Maria P. Ikonomopoulou ◽  
Viviana Loria-Kohen
Keyword(s):  
Quality Of Life ◽  
Central Sensitization ◽  
Multiple Chemical Sensitivity ◽  
Dietary Guidelines ◽  
Current Status ◽  
Micronutrient Deficiencies ◽  
Dietary Recommendations ◽  
Dietary Interventions

Fibromyalgia (FM), chronic fatigue syndrome (CFS) and multiple chemical sensitivity (MCS) are some of the central sensitization syndromes (CSSs). The complexity of their diagnosis, the high interindividual heterogeneity and the existence of multi-syndromic patients requires a multifaceted treatment. The scientific literature is contradictory regarding the role of food in CSS, and evidence on the role of nutrition in MCS is particularly scarce. This review consists in gathering information about the current status of dietary recommendations (i.e., special dietary interventions, the role of additives, presence of micronutrient deficiencies, nutritional supplements and elimination of other nutrients and substances) and discussing the scientific evidence in depth to shed light on appropriate nutritional treatment managements for CSS patients. Current indications show that dietary modifications may vastly improve the patients’ quality of life at a low cost. We suggest personalized treatment, taking into consideration the severity of the disease symptoms, quality of life, coexistence with other diseases, pharmacological treatment, changing clinical characteristics, nutritional status, energy requirements and food tolerances, among others, as the best ways to tailor specific dietary interventions. These approaches will partially overcome the lack of scientific and clinical research on MSC. Patients should also be advised on the serious consequences of following dietary guidelines without a dietitian’s and clinician’s supervision.

Sign in / Sign up

Export Citation Format

Share Document