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General Physical Examination (general + physical_examination)
Selected AbstractsSmallpox vaccination site complicationsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006Kirk H. Waibel MD The typical resolution of the smallpox vaccination site is a smooth scar, a sequela that is discussed during prevaccination counseling. In addition, other types of lesion may develop at the scar site, including short- or long-term benign and malignant changes, as reviewed below. Although current recommendations do not discuss potential scar complications or scar surveillance, healthcare providers would benefit from an awareness of these potential complications, and should consider periodic scar surveillance as part of a general physical examination. [source] Population-based study of the relationship between mutations in the hemochromatosis (HFE) gene and arthritisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2006Colin A Sherrington Abstract Background and Aim:, Mutations in the hemochromatosis (HFE) gene are carried by one in three individuals of British Isles descent and may result in increased iron stores. These increased iron stores could potentially induce or exacerbate diseases, such as arthritis, in which iron has a role in pathogenesis. Although arthritis is a well-known association of clinically overt hereditary hemochromatosis, controversy surrounds the role of mutations in the HFE gene as risk factors for arthritis. The aim of the present study was to determine whether mutations in the HFE gene are associated with an increased prevalence of arthritis. Methods:, A population-based study was conducted in Busselton, Western Australia, of the prevalence of arthritis in 1372 individuals of British Isles descent. Participants completed a questionnaire and general physical examination. Analysis for C282Y and H63D HFE mutations was undertaken. Unadjusted and adjusted odds ratios (OR) were calculated for the relationship between HFE mutations and the prevalence of self-reported, doctor-diagnosed arthritis. Results:, There was no association between the presence of HFE mutations and the prevalence of self-reported, doctor-diagnosed arthritis (C282Y/wild type (WT) adjusted OR = 1.041 (95% confidence interval (CI) 0.68,1.61), H63D/WT OR = 0.76 (95% CI 0.53,1.08), C282Y/C282Y OR = 0.39 (95% CI 0.04,3.63), C282Y/H 63D OR = 0.808 (95% CI 0.27,2.42), H63D/H63D OR = 0.419 (95% CI 0.13,1.36)). Overall adjusted OR for arthritis in participants with one or more HFE mutations was 0.81 (95% CI 0.61,1.09). Conclusions:, Mutations of the HFE gene are not risk factors for arthritis in populations of British Isles descent. [source] Skin Cancer Prevention in the Primary Care Setting: Assessment Using a Standardized PatientPEDIATRIC DERMATOLOGY, Issue 2 2007M.P.H., Robin L. Hornung M.D. A secondary goal was to test the feasibility of this technique as a measure of actual physician behaviors in the outpatient setting. We used a convenience sample of 15 primary care physicians. The standardized patient was an 18-year-old woman with skin phototype I. She presented to physicians as needing a general physical examination for a summer lifeguard job at a beach. She stated a family history of skin cancer. Physician performances were rated using a standard checklist completed by the standardized patient following each visit. We found that none of the physicians asked questions specifically related to skin phototype or sun exposure habits such as childhood sunburns. Only 13% asked about mole changes. For counseling, 67% of physicians recommended sunscreen use; only 7% discussed sunscreen types or procedures for effective use. Only 13% counseled other skin protective behaviors. No significant differences by physician gender were found in these areas; however, female physicians counseled more global health behaviors than male physicians (p , 0.01). Our pilot data suggest that little skin cancer primary prevention counseling is performed for high-risk patients. The standardized patient technique worked well in obtaining outcome data for physicians' preventive practices. [source] The prevalence of diabetic retinopathy in patients with screen-detected type 2 diabetes in Denmark: the ADDITION studyACTA OPHTHALMOLOGICA, Issue 3 2009Toke Bek Abstract. Background:, The prevalence of type 2 diabetes is increasing, but the exact prevalence of the disease and its accompanying late complications are unknown. In the Anglo-Danish-Dutch study of Intensive Treatment in People with Screen-detected Diabetes in Primary Care (ADDITION study), patients with hitherto undiagnosed type 2 diabetes are identified using a stepwise screening strategy in selected general practices. This article reports the occurrence of diabetic retinopathy in this population. Methods:, In Århus and Copenhagen counties, a total of 12 708 of the persons invited by mail were screened for diabetes mellitus. Consequently, 763 persons with type 2 diabetes were identified; 670 of these (335 from each of the two centres) underwent a general physical examination (including measurement of blood pressure and HbA1c) and an ophthalmological examination (including measurement of visual acuity and fundus photography). Retinopathy was graded from the photographs by counting all retinopathy lesions. Results:, Forty-five (6.8%) of the examined patients had any retinopathy, of which the majority was minimal. No patients had severe non-proliferative or proliferative diabetic retinopathy. There was no significant difference between age, sex and visual acuity among patients with and without retinopathy. However, the patients with retinopathy had significantly higher HbA1c and systolic and diastolic blood pressure than the patients without retinopathy. Conclusion:, Patients with screen-detected diabetes have a low prevalence of diabetic retinopathy and no vision-threatening lesions. Screening for diabetic retinopathy should be focused on those patients who have already been diagnosed with type 2 diabetes during routine clinical practice. [source] | ||||||||||