The European journal of general practice
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Chronic diseases in most cases belong to the category of non-communicable diseases (NCDs), which are the main cause of mortality globally. Cardiovascular diseases, diabetes, chronic obstructive pulmonary disease and cancer are the four NCDs responsible for 82% of NCD deaths. Prevention of NCDs implies health promotion activities that encourage healthy lifestyle and limit the initial onset of chronic diseases. ⋯ We still lack clear standards for patients with multiple chronic diseases. The applicability of a single evidence-based guideline to multimorbid patients is limited and can be problematic. Well-designed PHC studies focusing on the impact of medical interventions on morbidity, mortality and quality of life in the fields of early diagnosis, early treatment and multimorbidity are still needed.
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The new guideline on cardiovascular disease (CVD) prevention, issued by the European Society of Cardiology was endorsed by 10 other societies, including Wonca Europe. It advices on how to reduce the cardiovascular (CV) risk in the population and attributes an important role to the general practitioner (GP). ⋯ The new guideline gives room for a personalized approach and emphasizes that CV risk estimation and counselling need regular follow-up. We highlight the recommendations that most caught our eye and comment on the challenges for general practice.
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Multicenter Study
Previous antibiotic exposure and antibiotic resistance of commensal Staphylococcus aureus in Spanish primary care.
Commensal flora of healthy people is becoming an important reservoir of resistant bacteria. ⋯ Although no causal inference is possible, an association was observed between previous antibiotic dispensation and isolation of resistant organisms in community-dwelling individuals, mainly between packages of penicillin and penicillin-resistant staphylococci.
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In 2016, a new version of the European Guidelines on Cardiovascular Prevention was released, representing a partnership between the European Association for Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology (ESC) and nine European societies, including Wonca-Europe. The ESC guidelines underscore the importance of a lifetime approach to cardiovascular (CV) risk since both CV risk and prevention are dynamic and continuous as patients' age and/or accumulate co-morbidities. ⋯ The ESC guidelines are based on 'to do' and 'not to do' messages. Of note, what remains uncertain is stated at the end of each dedicated chapter, confirming that guidelines are not absolute rules, and should be interpreted in the light of the healthcare worker's knowledge and experience, patient preferences and the local social, cultural and economic situation.