The European journal of general practice
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In Romania data on cardiovascular risk factors are sparse. ⋯ There were relevant gender differences in modifiable cardiovascular risk factors. Many patients failed to meet treatment targets.
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In the Irish Midland Health Service Executive (HSE) Diabetes Structured Care Project, additional resources were targeted at general practice in the absence of a local hospital-based specialized diabetes unit. ⋯ Primary-care-led structured care, with relatively limited but well-focused investment, can achieve quality of care for patients with diabetes, comparable to international best practice.
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To determine the prevalence of multimorbidity in primary care, by age, sex, and socio-economic class, and to analyse the trend in multimorbidity over the last 20 years. ⋯ The increasing amount of multimorbidity in primary care as well as the increasing number of chronic diseases per patient leads to more complex medical care. The general practitioner needs guidelines focusing on multimorbidity to support this care. The registration of chronic diseases by the general practitioner will become more complex and time-consuming.
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Randomized Controlled Trial
Early intervention with inhaled corticosteroids in subjects with rapid decline in lung function and signs of bronchial hyperresponsiveness: results from the DIMCA programme.
Asthma is generally accepted as an inflammatory disease that needs steroid treatment. However, when to start with inhaled steroids remains unclear. A study was undertaken to determine when inhaled corticosteroids should be introduced as the first treatment step. ⋯ In this study, the early introduction of inhaled corticosteroids in newly diagnosed asthmatic subjects with rapid decline in lung function did not prove to be either clinically relevant or statistically significant in reversing the decline in FEV(1). For PC(20), no significant changes were detected.
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To evaluate the ability of elbow extension, with the patient in a supine position, as a diagnostic test of an insignificant injury, with the purpose of avoiding unnecessary radiographs. ⋯ Elbow extension as a diagnostic test in a primary care setting can predict severe elbow injuries and can be safely used in practices with no radiology facilities.