The European journal of general practice
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Zenker's diverticulum is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle. It occurs commonly in elderly patients (over 70 years) and the typical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss. ⋯ This case demonstrates once more the importance of history taking and follow-up in medical care. Attentive listening by a family physician could have probably prevented the delay of service in this case.
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The gap between the relatively high prevalence of provoked vulvodynia (PVD) in the general population and the low incidence in primary care can partly be explained by physicians' lack of knowledge about the assessment and management of PVD. ⋯ To improve the care for women with PVD, attitude and skills of GPs regarding taking a sexual history and performing a vulvovaginal examination should be addressed, as well as GPs' coping strategies regarding their professional uncertainty.
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Burnout is a growing problem among healthcare professionals and may be mitigated and even prevented by measures designed to promote empathy and resilience. ⋯ Although burnout was relatively uncommon in our sample, it was associated with low levels of empathy. This finding and our observation of lower empathy levels in rural settings require further investigation. [Box: see text].
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Randomized Controlled Trial Multicenter Study
Impact of practice, provider and patient characteristics on delivering screening and brief advice for heavy drinking in primary healthcare: Secondary analyses of data from the ODHIN five-country cluster randomized factorial trial.
The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training. ⋯ Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised. Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552.
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Individuals with atrial fibrillation (AF) face a fivefold increased risk of ischaemic stroke compared with those without the condition. Recent studies suggest that individuals with asymptomatic AF also face an increased risk of ischaemic stroke, but their condition is often not recognized and diagnosed until an ischaemic stroke event has occurred. Identification of individuals with undiagnosed AF at increased risk for stroke is critical in promoting optimal intervention with anticoagulants. ⋯ It was determined that improved detection and diagnosis of AF, combined with appropriate anticoagulation strategies, will be crucial for improving stroke prevention and reducing its associated social and economic costs.