General Practice Physician Research Articles

Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial

Objective To assess the effectiveness of supervised exercise therapy compared with usual care with respect to recovery, pain, and function in patients with patellofemoral pain syndrome.Design Open label randomised controlled...

Características clínico bioquímicas de pacientes con patología hipofisaria

Descriptive studies in our country of hypophysis diseases are uncommon. Pituitary adenoma are unfrequent, however this pathology represent 10-12% of brain tumors. Pituitary adenomas are derived of adenohypophysis cells, depending of cellular line, clinical and biochemical characteristics are different. The aim of our study was to describe these characteristics in our patients. We study 58 patients with diagnosis of pituitary tumor, with regular follow-up in our Hospital, between 1999-2001. The next data were recorded: epidemiological, clinical and biochemical data. Average age at diagnosis was 36.4 years (DS 16.34 years), with a 70.61% of females. The most frequent tumor was prolactinoma and non-functioning adenomas, amenorrhea was the most frequent symptom with the specialist physician (15%) and the general practice physician was the first step in diagnosis protocol. Cerebral image technique was realized in 54 patients, with a 15.5% of normal exploration and 78.6% with lesions, with 24.14% of microadenoma and macroadenoma. Invasive lesions (craniopharyngiomas, germinomas and invasive adenomas) representing a 6.9%. Depression, hypertension and diabetes mellitus were the most frequent diseases in these patients. Prolactinoma is the most frequent hypophysis pathology. Amenorrhea and/or galactorrhea are the most common symptom. Response to medical and surgical treatment was excellent in prolactinomas.

Women in general practice: Responding to the sexual division of labour?

This paper provides an exploration of the gendered nature of the working experience of women within a high status and predominantly male dominated medical specialty, that of general practice or primary care physician. Women currently represent just over a third of all general practitioners in the U.K. and their numbers have been increasing. Women now account for 60% of new recruits into general practice. Despite this increase, consideration of the experience and role of women within medicine has largely focused on hospital medicine. The findings presented are derived from a three year project, that aimed to develop an understanding of the role women health workers play in the U.K. in the construction and provision of primary health care services for women. The methods employed consisted of a series of postal surveys and qualitative interviews conducted with GPs, female nurses and women service users. The first section of the discussion provides an exploration of the nature and impact of the sexual division of labour within general practice and the resulting occupational marginalisation of women GPs. Attention is given to identifying the key processes whereby the sexual division of labour is maintained and reproduced, particularly through the normative expectations of colleagues, patients and women GPs themselves. The final section presents a typology of the differing strategies the sampled women GPs adopted for managing their working roles in response to the existence of a sexual division of labour. The conclusion highlights the possible impact of the differing strategies upon the functioning of women within general practice and their relationship with women users of the service.

Sex Reassignment at Birth-Reply

In our article, 1 we limited our recommendation for treatment to those cases similar in nature, ie, individuals whose only medical situation was that of having a traumatic loss of the penis postnatally. Dr Benjamin asks for advice on management for a much broader spectrum of conditions. He asks for (1) advice for those cases most likely to confront the general practice physician, (2) how this case differs from those in which individuals who are born with normal genitalia request a change of sex, and (3) if the case originally reported is only of statistical interest. We respond to these questions in reverse order. Cases of a neonate losing his penis due to trauma are exceedingly rare. The particular case reported is notable as it was initially taken as proof for a model of treatment by which cases of ambiguous genitalia came to be managed. From the original reports of

The Role of Physicians in Reporting and Evaluating Child Sexual Abuse Cases

Physicians become involved in child sexual abuse when they must report suspected abuse or when they are asked to medically evaluate a child who is an alleged victim of abuse. This article reviews recent progress in the medical profession's attention to child sexual abuse and discusses current issues surrounding reporting and medical evaluation. The reporting requirement raises several concerns for pediatricians. Their legal responsibilities as reporters may conflict with their traditional relationship with the family as a unit and with the confidentiality of the doctor-patient relationship. Knowledge about pediatric anogential anatomy is in a relatively early stage of development, and few pediatricians receive training adequate to enable them to determine whether medical observations are consistent with sexual abuse. Even fewer pediatricians receive training in the unique considerations and needs present when taking the medical history of a possible abuse victim or when preserving evidence for possible later use in court. The medical evidentiary evaluation of suspected sexual abuse also raises a number of concerns. There is great variability in referral patterns, which determine whether a medical examination will be requested and whether a general practice physician or a specialist will be asked to conduct the exam. Although professional medical associations have laid out broad outlines of recommended procedures for medical exams when sexual abuse is suspected, more detailed protocols are needed for addressing the many cases where findings are ambiguous or subtle. Often physicians need training in forensics and assistance in coordinating services with multiple agencies and professions. Finally, attention must be given to ensuring adequate cost reimbursement for medical evaluations.

The Home Care Practice and Attitudes of Minnesota Family Physicians

Assess home care practice and attitudes of Minnesota family physicians (FPs). Mailed survey. State of Minnesota. Members of the Minnesota Academy of Family Physicians, 80% of the FPs practicing in the state. A 55-item mailed, self-complete questionnaire regarding general practice and personal physician characteristics (18 questions), specific questions regarding geriatric and home care practice and related attitudes (37 questions); up to four reminder or follow-up surveys were sent. Descriptive summary of FP home care practice and attitudes. Eighty percent of surveys were completed, 76% of responding physicians made at least one home visit in the previous year, and 92% of home visits were to geriatric patients. Discriminant function analysis identified six significant (P less than 0.001) variables that explained 52% of the variance (r2 = 0.52, Wilks Lambda = 0.48) in home visiting behavior between frequent home visiting FPs (greater than 24 visits/year) and non-visiting FPs. FPs most likely to do home visiting were older and tended to have small group or solo practices in rural settings. The survey documented continued decline (from previously published surveys) of physician home visiting behavior and widespread dissatisfaction with reimbursement. However, attitudes regarding home care provided by other professionals were highly positive.

Personality profiles of physician extenders.

Objective psychological measurements and personal historical data were taken on 67 physician extenders in 5 consecutive classes at a southeastern university over 18 mo., October 1972 to April 1974. The findings describe certain psychological characteristics associated with physician-extender students and compare these profiles with various similar groups. The physician extender's general personality type resembles that of the general practice physician. Comparisons with medical students show them to be more concerned with pragmatic matters and implies preferences which most likely favor a technological occupation. All of these measurements are not, however, necessarily associated with academic or occupational success. Future studies should concern relationships between these measurements and criteria of academic and occupational success.

A Counselor Education Program for Intern Physicians

In recent years it has been estimated that from 30 percent to 50 percent of the medical complaints brought to the family or general practice physician are functional in nature and may be psychosocial in origin (Harmon, Masuda & Holmes 1970). While chemotherapy may be appropriate for the patient with acute situational anxiety and psychiatric consultation may be appropriate for the severely neurotic or psychotic patient, the family practice physician has few remedies for the patient with chronic aches and pains, housewife syndrome, middle‐age depression, businessman's fatigue, and a host of other quasimedical complaints.