scholarly journals Epidemiology and Toxicology of Ciguatera Poisoning in the Colombian Caribbean

Marine Drugs ◽  
2020 ◽  
Vol 18 (10) ◽  
pp. 504
Author(s):  
Roberto Navarro Quiroz ◽  
Juan Carlos Herrera-Usuga ◽  
Laura Maria Osorio-Ospina ◽  
Katia Margarita Garcia-Pertuz ◽  
Elkin Navarro Quiroz
Keyword(s):  
Primary Care ◽  
Low Frequency ◽  
Primary Care Practitioner ◽  
Viral Etiology ◽  
Adequate Treatment ◽  
Multiple Factors ◽  
Large Numbers ◽  
Coral Fish ◽  
Cardinal Symptoms ◽  
Epidemiological Link

Ciguatera is a food intoxication caused by the consumption of primarily coral fish; these species exist in large numbers in the seas that surround the Colombian territory. The underreported diagnosis of this clinical entity has been widely highlighted due to multiple factors, such as, among others, ignorance by the primary care practitioner consulted for this condition as well as clinical similarity to secondary gastroenteric symptoms and common food poisonings of bacterial, parasitic or viral etiology. Eventually, it was found that people affected by ciguatoxins had trips to coastal areas hours before the onset of symptoms. Thanks to multiple studies over the years, it has been possible to identify the relation between toxigenic dinoflagellates and seagrasses, as well as its incorporation into the food chain, starting by fish primarily inhabiting reef ecosystems and culminating in the intake of these by humans. Identifying the epidemiological link, its cardinal symptoms and affected systems, such as gastrointestinal, the peripheral nervous system and, fortunately with a low frequency, the cardiovascular system, leads to a purely clinical diagnostic impression without necessitating further complementary studies; in addition, what would also help fight ciguatera poisoning is performing an adequate treatment of the symptoms right from the start, without underestimating or overlooking any associated complications.

scholarly journals Epidemiology and Toxicology of Ciguatera Poisoning in the Colombian Caribbean

2020 ◽  
Author(s):  
Roberto Navarro Quiroz ◽  
Juan Carlos Herrera-Usuga ◽  
Laura Maria Osorio-Ospina ◽  
Katia Margarita Garcia-Pertuz ◽  
Elkin Navarro Quiroz
Keyword(s):  
Food Poisoning ◽  
Low Frequency ◽  
Primary Care Practitioner ◽  
Viral Etiology ◽  
Adequate Treatment ◽  
Multiple Factors ◽  
Large Numbers ◽  
Coral Fish ◽  
Cardinal Symptoms ◽  
Epidemiological Link

The ciguatera is a food poisoning caused by the consumption of primarily coral fish; these species exist in large numbers in the seas that bathe the Colombian territory. The underreported diagnosis of this clinical entity has been widely highlighted due to multiple factors, as are among others, ignorance by the primary care practitioner consulted for this condition, clinical similarity with secondary gastroenteric symptoms, to common food poisonings of bacterial, parasitic or viral etiology. Eventually people affected by ciguatotoxin are related to trips to coastal areas hours before the onset of symptoms. Thanks to multiple studies over the years it has been possible to identify the relation of the dinoflagellates in the assembly of said toxin and its introduction into the food chain, starting by fish primarily inhabiting reef ecosystems and culminating in the intake of these by humans. Identifying the epidemiological link, its cardinal symptoms and affected systems such as gastrointestinal, peripheral nervous system and fortunately with a low frequency, the cardiovascular system, leads to a purely clinical diagnostic impression without further complementary studies, performing an adequate treatment primarily symptomatic without underestimating or overlooking any associated complications.

669-P: Serial Online Education Helps Break Down Primary Care Practitioner Barriers to Insulin Therapy for T2DM Management

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 669-P
Author(s):  
WENDY TURELL ◽  
CAROLE DREXEL ◽  
RICHARD S. BEASER
Keyword(s):  
Primary Care ◽  
Online Education ◽  
Insulin Therapy ◽  
Primary Care Practitioner

scholarly journals Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044372
Author(s):  
Mat Nawi Zanaridah ◽  
Mohd Noor Norhayati ◽  
Zakaria Rosnani
Keyword(s):  
Primary Care ◽  
Evidence Based Medicine ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Sectional Study ◽  
Primary Care Practitioner ◽  
Cross Sectional ◽  
Primary Care Practitioners ◽  
Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

scholarly journals Diagnostic and treatment barriers to persistent somatic symptoms in primary care – representative survey with physicians

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marco Lehmann ◽  
Nadine Janis Pohontsch ◽  
Thomas Zimmermann ◽  
Martin Scherer ◽  
Bernd Löwe
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Rating Scales ◽  
Treatment Guidelines ◽  
Somatic Symptoms ◽  
Diagnosis And Treatment ◽  
Treatment Barriers ◽  
Adequate Treatment ◽  
Physical Disease ◽  
Federal States

Abstract Background Many patients consult their primary care physician with persistent somatic symptoms such as pain or sickness. Quite often these consultations and further diagnostic measures yield no medical explanation for the symptoms – patients and physicians are left in uncertainty. In fact, diagnostic and treatment barriers in primary care hinder timely health-care provision for patients suffering from persistent somatic symptoms (PSS). The significance of individual barriers is still unknown. We compare and quantify these barriers from the perspective of primary care physicians and identify subpopulations of primary care physicians who experience particular barriers as most severe. Methods We mailed a questionnaire to primary care physicians (PCP) in Germany and asked them which barriers they consider most important. We invited a random sample of 12,004 primary care physicians in eight federal states in Germany. Physicians provided anonymous mailed or online responses. We also mailed a postcard to announce the survey and a mail reminder. Main measures were Likert rating scales of items relating to barriers in the diagnosis and treatment of PSS in primary care. Information on demography and medical practice were also collected. Results We analyzed 1719 data sets from 1829 respondents. PCPs showed strongest agreement with statements regarding (1.) their lack of knowledge about treatment guidelines, (2.) their perceptions that patients with PSS would expect symptom relief, (3.) their concern to overlook physical disease in these patients, and (4.) their usage of psychotropic drugs with these patients. More experienced PCPs were better able to cope with the possibility of overlooking physical disease than those less experienced. Conclusions The PCPs in our survey answered that the obligation to rule out severe physical disease and the demand to relieve patients from symptoms belong to the most severe barriers for adequate treatment and diagnosis. Moreover, many physicians admitted to not knowing the appropriate treatment guidelines for these patients. Based on our results, raising awareness of guidelines and improving knowledge about the management of persistent somatic symptoms appear to be promising approaches for overcoming the barriers to diagnosis and treatment of persistent somatic symptoms in primary care. Trial registration German Clinical Trials Register (Deutschen Register Klinischer Studien, DRKS) https://www.drks.de/drks_web/setLocale_EN.do The date the study was registered: October 2nd 2017 The date the first participant was enrolled: February 9th 2018 DRKS-ID: DRKS00012942

scholarly journals Clinical case of hemolytic disease of the newborn with incompatibility of the blood of the mother and fetus in the “minor” erythrocyte antigen

2019 ◽  
Vol 6 (3) ◽  
pp. 77-82
Author(s):  
E. L. Krivosheina ◽  
T. S. Mikhailova
Keyword(s):  
Blood Cells ◽  
Clinical Observation ◽  
Clinical Signs ◽  
Low Frequency ◽  
Early Diagnostics ◽  
Hemolytic Disease ◽  
Adequate Treatment ◽  
Special Aspect ◽  
Nucleated Red Blood Cells ◽  
Erythrocyte Antigen

Presented a clinical observation of hemolytic disease of the newborn as a result of fetus immunization with low-frequency erythrocyte antigen (Lutheran). The special aspect of the case is the presence of hyperleukocytosis with evident regenerative shift of neutrophils to the left to singular blastic variants, thrombocytopenia, high reticulocytosis (more than 1000 ‰) and a great number of nucleated red blood cells (normoblasts) in the newborn’s hemogram. In myelogram a sharp expansion of erythroid sprout (90 %) and signs of dizerythropoiesis were determinded. Typical clinical signs and isoserological incompatibility of mother and fetus in erythrocyte antigen provided basis for early diagnostics and adequate treatment of hemolytic disease of the newborn.

scholarly journals A TEST FOR RARE MALE MATING ADVANTAGE WITH DROSOPHILA PSEUDOOBSCURA KARYOTYPES

Genetics ◽  
1984 ◽  
Vol 107 (4) ◽  
pp. 577-589
Author(s):  
Wyatt W Anderson ◽  
Celeste J Brown
Keyword(s):  
Mating Success ◽  
Low Frequency ◽  
Behavioral Observation ◽  
Drosophila Pseudoobscura ◽  
Male Mating ◽  
Frequency Dependent ◽  
Mating Advantage ◽  
Large Numbers ◽  
Laboratory Populations ◽  
Statistical Artifact

ABSTRACT Recent work has called into question the reality of the rare male mating advantage, pointing out that it could be a statistical artifact of marking flies for behavioral observation or of experimental bias in collecting males. We designed an experiment to test for rare male mating advantage that avoids these sources of bias. Large numbers of males of three Drosophila pseudoobscura karyotypes were allowed to mate with females of one karyotype in population cages. The females were then isolated before multiple mating occurred and their progeny used to diagnose the males that mated them. Populations were studied at five sets of male karyotypic frequencies. The mating success of the male homokaryotypes ST/ST and CH/CH, relative to that of the heterokaryotype ST/CH, was frequency dependent. Both ST/ST and CH/CH males displayed a statistically significant mating advantage at low frequency by comparision with their mating success in the midrange of karyotypic frequencies. Both male homokaryotypes also showed a significantly greater mating success at high homokaryotypic frequency than at intermediate frequencies, which is the same as saying that the heterokaryotype not only failed to show a rare male advantage but actually suffered a mating disadvantage at low frequency. We conclude that rare male mating advantage is not always an experimental or methodological artifact but does occur in laboratory populations of D. pseudoobscura. It may occur for some genotypes and not for others, however, and it may be only one of several forms of frequency-dependent mating behavior operating in a population.

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