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Clinical presentation, diagnosis, and management

Section edited by Attila Altiner and Norbert Donner-Banzhoff

This section covers all aspects of patient diagnosis and treatment for acute and chronic conditions within the context of primary care.

Page 1 of 4

  1. Content type: Research article

    Responding to and caring for women who experience mental health problems during the perinatal period, from pregnancy up to one year after birth, is complex and requires a multidisciplinary response. Family phy...

    Authors: Maria Noonan, Owen Doody, Julie Jomeen, Andrew O’Regan and Rose Galvin

    Citation: BMC Family Practice 2018 19:154

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  2. Content type: Research article

    Colorectal cancer (CRC) develops from colorectal adenomatous polyps. This study is to determine if diabetes mellitus (DM), its treatment, and hemoglobin A1c (HbA1c) level are associated with increased risk of ...

    Authors: Katarzyna Budzynska, Daniel Passerman, Denise White-Perkins, Della A. Rees, Jinping Xu, Lois Lamerato and Susan Schooley

    Citation: BMC Family Practice 2018 19:145

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  3. Content type: Research article

    One million women per year seek medical advice for abnormal uterine bleeding (AUB) in the United Kingdom. Many low-risk patients who could be managed exclusively in primary care are referred to hospital based ...

    Authors: Brenda F. Narice, Brigitte Delaney and Jon M. Dickson

    Citation: BMC Family Practice 2018 19:135

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  4. Content type: Research article

    Entitlement to sickness benefits is a legal process requiring health-related reduced work capacity confirmed by a physician via a sickness certificate. However, there is a knowledge gap concerning physicians’ ...

    Authors: Monica Bertilsson, Silje Maeland, Jesper Löve, Gunnar Ahlborg Jr, Erik L. Werner and Gunnel Hensing

    Citation: BMC Family Practice 2018 19:133

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  5. Content type: Research article

    Medically unexplained symptoms (MUS) and somatoform disorders are common in general practices, but there is evidence that general practitioners (GPs) rarely use these codes. Assuming that correct classificatio...

    Authors: N. J. Pohontsch, T. Zimmermann, C. Jonas, M. Lehmann, B. Löwe and M. Scherer

    Citation: BMC Family Practice 2018 19:129

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  6. Content type: Study protocol

    Obesity is one of the most prevalent health problems in western societies. However, it seems not effectively managed in the healthcare system at present. Originating from smoking cessation a tool called the 5A...

    Authors: Franziska D. Welzel, Janine Stein, Alexander Pabst, Melanie Luppa, Anette Kersting, Matthias Blüher, Claudia Luck-Sikorski, Hans-Helmut König and Steffi G. Riedel-Heller

    Citation: BMC Family Practice 2018 19:97

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  7. Content type: Research article

    Adequate recognition of anxiety and depression by general practitioners (GPs) can be improved. Research on factors that are associated with recognition is limited and shows mixed results. The aim of this study...

    Authors: Henny Sinnema, Berend Terluin, Daniëlle Volker, Michel Wensing and Anton van Balkom

    Citation: BMC Family Practice 2018 19:99

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  8. Content type: Research article

    Efforts to improve treatment of pain using opioids have to adequately take into account their therapeutic shortcomings which involve addictiveness. While there are no signs of an “opioid epidemic” in Germany s...

    Authors: Johannes Maximilian Just, Linda Bingener, Markus Bleckwenn, Rieke Schnakenberg and Klaus Weckbecker

    Citation: BMC Family Practice 2018 19:92

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  9. Content type: Research article

    In 2013 the Dutch guideline for management of medically unexplained symptoms (MUS) was published. The aim of this study is to assess medical care for patients with persistent MUS as recorded in their electroni...

    Authors: Kate Sitnikova, Rinske Pret-Oskam, Sandra M. A. Dijkstra-Kersten, Stephanie S. Leone, Harm W. J. van Marwijk, Henriëtte E. van der Horst and Johannes C. van der Wouden

    Citation: BMC Family Practice 2018 19:88

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  10. Content type: Research article

    The prevalence of pain is very common in the oldest age group. Managing pain successfully is a key topic in primary care, especially within the ageing population. Different care settings might have an impact o...

    Authors: Tina Mallon, Annette Ernst, Christian Brettschneider, Hans-Helmut König, Tobias Luck, Susanne Röhr, Siegfried Weyerer, Jochen Werle, Edelgard Mösch, Dagmar Weeg, Angela Fuchs, Michael Pentzek, Luca Kleineidam, Kathrin Heser, Steffi Riedel-Heller, Wolfgang Maier…

    Citation: BMC Family Practice 2018 19:85

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  11. Content type: Research article

    Assessment of chest pain in general practice is challenging. General practitioners (GPs) often feel uncertainty when dealing with chest pain. The role of new diagnostic tools is yet unclear.

    Authors: Leen Biesemans, Lotte E. Cleef, Robert T. A. Willemsen, Beatrijs B. N. Hoorweg, Walter S. Renier, Frank Buntinx, Jan F. C. Glatz and Geert-Jan Dinant

    Citation: BMC Family Practice 2018 19:80

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  12. Content type: Research article

    Prostate cancer is the most common cancer in men in the UK. NICE guidelines on recognition and referral of suspected cancer, recommend performing digital rectal examination (DRE) on patients with urinary sympt...

    Authors: Daniel Jones, Charlotte Friend, Andreas Dreher, Victoria Allgar and Una Macleod

    Citation: BMC Family Practice 2018 19:79

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  13. Content type: Research article

    Inappropriate prescription of antibiotics is the leading driver of antimicrobial resistance (AMR). The majority of antibiotics are prescribed in primary care.

    Authors: Gloria Córdoba, Anne Holm, Tina Møller Sørensen, Volkert Siersma, Håkon Sandholdt, Marjukka Makela, Niels Frimodt-Møller and Lars Bjerrum

    Citation: BMC Family Practice 2018 19:65

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  14. Content type: Research article

    Many tools exist to guide family physicians’ impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians’ subjective ...

    Authors: Clara Korenvain, Ida-Maisie Famiyeh, Sheila Dunn, Cynthia R. Whitehead, Paula A. Rochon and Lisa M. McCarthy

    Citation: BMC Family Practice 2018 19:61

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  15. Content type: Research article

    Gout is an increasingly prevalent form of inflammatory arthritis. Although effective treatments for gout exist, current management is suboptimal due to low medication adherence rates and treatments that are no...

    Authors: Allyce B. Counsell, Amy D. Nguyen, Melissa T. Baysari, Diluk R. W. Kannangara, Andrew J. McLachlan and Richard O. Day

    Citation: BMC Family Practice 2018 19:54

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  16. Content type: Research article

    Due to the raised public awareness of Lyme Borreliosis (LB), its increased incidence and the increased availability of serological tests, the demand for diagnostic testing on LB has increased. This may affect ...

    Authors: Esmée Botman, C. Wim Ang, Johanna H. K. Joosten, Pauline Slottje, Johannes C. van der Wouden and Otto R. Maarsingh

    Citation: BMC Family Practice 2018 19:43

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  17. Content type: Research article

    Dizziness is a common reason for consulting a general practitioner and there is a broad range of possible underlying aetiologies. There are few evidence-based data about prevalence, aetiology and prognosis in ...

    Authors: Stefan Bösner, Sonja Schwarm, Paula Grevenrath, Laura Schmidt, Kaja Hörner, Dominik Beidatsch, Milena Bergmann, Annika Viniol, Annette Becker and Jörg Haasenritter

    Citation: BMC Family Practice 2018 19:33

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  18. Content type: Research article

    The pattern of alcohol consumption in Ireland has serious societal and health consequences. General practice is well placed to screen for problem alcohol use and to carry out brief interventions. The aims of t...

    Authors: Andrew O’Regan, Walter Cullen, Louise Hickey, David Meagher and Ailish Hannigan

    Citation: BMC Family Practice 2018 19:30

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  19. Content type: Research article

    The objectives were to identify 1) the clinician and child characteristics associated with; 2) clinical management decisions following from, and; 3) the prognostic value of; a clinician’s ‘gut feeling somethin...

    Authors: Sophie Turnbull, Patricia J. Lucas, Niamh M. Redmond, Hannah Christensen, Hannah Thornton, Christie Cabral, Peter S. Blair, Brendan C. Delaney, Matthew Thompson, Paul Little, Tim J. Peters and Alastair D. Hay

    Citation: BMC Family Practice 2018 19:25

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  20. Content type: Research article

    Suggested strategies in reducing the impact of non-communicable diseases (NCD) are early diagnosing and screening. We have limited proof of benefit of population screening for NCD. Increased mortality in perso...

    Authors: Pål Jørgensen, Arnulf Langhammer, Steinar Krokstad and Siri Forsmo

    Citation: BMC Family Practice 2017 18:98

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  21. Content type: Research article

    Empirical prescribing of antibiotics to women with symptoms of acute cystitis prior to culture results is common, but subsequent culture results are often negative. A clinical decision aid for prescribing deci...

    Authors: Warren J. McIsaac, Rahim Moineddin, Ildikó Gágyor and Tony Mazzulli

    Citation: BMC Family Practice 2017 18:89

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  22. Content type: Research article

    Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively eng...

    Authors: Ladson Hinton, Andrés F. Sciolla, Jürgen Unützer, Edward Elizarraras, Richard L. Kravitz and Ester Carolina Apesoa-Varano

    Citation: BMC Family Practice 2017 18:88

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  23. Content type: Research article

    The primary care out-of-hours (OOH) services in Norway are characterized by high contact rates by telephone. The telephone contacts are handled by local emergency medical communication centres (LEMCs), mainly ...

    Authors: Vivian Midtbø, Guttorm Raknes and Steinar Hunskaar

    Citation: BMC Family Practice 2017 18:84

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  24. Content type: Research article

    Anal disorders are largely underestimated in general practice. Studies have shown patients conceal anal symptoms leading to late diagnosis and treatment. Management by general practitioners is poorly described...

    Authors: Géraldine Tournu, Laurent Abramowitz, Camille Couffignal, Frédéric Juguet, Agnès Sénéjoux, Stéphane Berger, Anne-Laure Wiart, Marc Bernard, Françoise Provost, Hélène Pillant-Le Moult, Dominique Bouchard and Jean-Pierre Aubert

    Citation: BMC Family Practice 2017 18:78

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  25. Content type: Research article

    Antidepressant prescribing continues to increase, with 5-16% of adults receiving antidepressants annually. Total prescribing growth is due in part to increased long-term use, greater selective serotonin re-upt...

    Authors: Chris F. Johnson, Brian Williams, Stephen A. MacGillivray, Nadine J. Dougall and Margaret Maxwell

    Citation: BMC Family Practice 2017 18:72

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  26. Content type: Research article

    Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the populat...

    Authors: Salima Gasmi, Nicholas H. Ogden, Patrick A. Leighton, Ariane Adam-Poupart, François Milord, L. Robbin Lindsay, Sapha Barkati and Karine Thivierge

    Citation: BMC Family Practice 2017 18:65

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  27. Content type: Research article

    Depression is a common health condition affecting up to a third of patients attending primary care, where most of the care for people with depression is provided. Adequate recognition of depression is the crit...

    Authors: Abebaw Fekadu, Girmay Medhin, Medhin Selamu, Tedla W. Giorgis, Crick Lund, Atalay Alem, Martin Prince and Charlotte Hanlon

    Citation: BMC Family Practice 2017 18:56

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  28. Content type: Research article

    Municipal drinking water contaminated with the parasite Giardia lamblia in Bergen, Norway, in 2004 caused an outbreak of gastrointestinal infection in 2500 people, according to the Norwegian Prescription Database...

    Authors: Eva Stormorken, Leonard A. Jason and Marit Kirkevold

    Citation: BMC Family Practice 2017 18:49

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  29. Content type: Research article

    Up to 33% of the general population over 50 years of age are affected by nocturnal leg cramps. Currently there are no generally accepted clinical characteristics, which identify nocturnal leg cramps. This stud...

    Authors: Joannes Hallegraeff, Mathieu de Greef, Wim Krijnen and Cees van der Schans

    Citation: BMC Family Practice 2017 18:29

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  30. Content type: Debate

    Many patients consult their GP because they experience bodily symptoms. In a substantial proportion of cases, the clinical picture does not meet the existing diagnostic criteria for diseases or disorders. This...

    Authors: Marianne Rosendal, Tim C Olde Hartman, Aase Aamland, Henriette van der Horst, Peter Lucassen, Anna Budtz-Lilly and Christopher Burton

    Citation: BMC Family Practice 2017 18:18

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  31. Content type: Research article

    Point-of-care testing (POCT) in primary care may improve rational antibiotic prescribing. We examined use of POCT in Denmark, including patient- and general practitioner (GP)-related predictors.

    Authors: Steffen Haldrup, Reimar W. Thomsen, Flemming Bro, Robert Skov, Lars Bjerrum and Mette Søgaard

    Citation: BMC Family Practice 2017 18:9

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  32. Content type: Research article

    Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However...

    Authors: Victor Johan Bernard Huiskes, David Marinus Burger, Cornelia Helena Maria van den Ende and Bartholomeus Johannes Fredericus van den Bemt

    Citation: BMC Family Practice 2017 18:5

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  33. Content type: Research article

    European guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to H...

    Authors: Ivo K. Joore, Denise E. Twisk, Ann M. Vanrolleghem, Maria de Ridder, Suzanne E. Geerlings, Jan E. A. M. van Bergen and Ingrid V. van den Broek

    Citation: BMC Family Practice 2016 17:161

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  34. Content type: Research article

    Chest pain assumed to be of non-coronary origin (NCCP) may be linked to enhanced mortality due to coronary heart disease (CHD). The aim of this study was to follow NCCP patients, as defined in primary care, wi...

    Authors: Staffan Nilsson and Petter Järemo

    Citation: BMC Family Practice 2016 17:159

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  35. Content type: Research article

    Severe illness among parents may interfere with their parenting. Children having ill or substance-abusing parents are at risk of own health problems and psychosocial difficulties. The health care system should...

    Authors: Frøydis Gullbrå, Tone Smith-Sivertsen, Guri Rortveit, Norman Anderssen and Marit Hafting

    Citation: BMC Family Practice 2016 17:154

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  36. Content type: Research article

    Scottish Intercollegiate Guidelines Network and National Institute of Health and Care Excellence guidelines stress the importance of assessing patients with psoriasis for psoriatic arthritis, comorbidities ass...

    Authors: Alan G. Wade, Gordon M. Crawford, David Young, Joyce Leman and Neil Pumford

    Citation: BMC Family Practice 2016 17:145

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  37. Content type: Research article

    Even though addressing lifestyle problems is a major recommendation in most guidelines for the treatment of hypertension (HTN), alcohol problems are not routinely addressed in the management of hypertension in...

    Authors: Jürgen Rehm, Jose Angel Arbesu Prieto, Markus Beier, Didier Duhot, Alessandro Rossi, Bernd Schulte, José Zarco, Henri-Jean Aubin, Michael Bachmann, Carsten Grimm, Ludwig Kraus, Jakob Manthey, Emanuele Scafato and Antoni Gual

    Citation: BMC Family Practice 2016 17:130

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  38. Content type: Research article

    Cholesterol-lowering therapy with statins is recommended in established cardiovascular disease (CVD) and should be considered for patients at high cardiovascular risk. We surveyed statin treatment before first...

    Authors: Gunnar Nilsson, Eva Samuelsson, Lars Söderström and Thomas Mooe

    Citation: BMC Family Practice 2016 17:110

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  39. Content type: Research article

    Personality disorder (PD) is associated with elevated suicide risk, but the level of risk in primary care settings is unknown. We assessed whether PD among primary care patients is linked with a greater elevat...

    Authors: Michael Doyle, David While, Pearl L. H. Mok, Kirsten Windfuhr, Darren M. Ashcroft, Evangelos Kontopantelis, Carolyn A. Chew-Graham, Louis Appleby, Jenny Shaw and Roger T. Webb

    Citation: BMC Family Practice 2016 17:106

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  40. Content type: Research article

    Adolescence and young adulthood are important developmental periods. Screening for health compromising behaviours and mental health disorders during routine primary care visits has the potential to assist clin...

    Authors: Marianne J. Webb, Sylvia D. Kauer, Elizabeth M. Ozer, Dagmar M. Haller and Lena A. Sanci

    Citation: BMC Family Practice 2016 17:104

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  41. Content type: Research article

    Consultations involving patients with multiple somatic symptoms may be considered as challenging and time-consuming by general practitioners (GPs). Yet, little is known about the possible links between consult...

    Authors: Mette T. Rask, Anders H. Carlsen, Anna Budtz-Lilly and Marianne Rosendal

    Citation: BMC Family Practice 2016 17:100

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  42. Content type: Research article

    An increase in a patient’s visits to doctors usually raises concerns and may be a ‘red flag’ for a patient’s deterioration of health. The aim of this study was to analyze whether an increase of patient-physici...

    Authors: Johannes Hauswaldt, Eva Hummers-Pradier and Wolfgang Himmel

    Citation: BMC Family Practice 2016 17:94

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  43. Content type: Research article

    Clinical guidelines for single diseases often pose problems in general practice work with multimorbid patients. However, little research focuses on how general practice is affected by the demand to follow multipl...

    Authors: Bjarne Austad, Irene Hetlevik, Bente Prytz Mjølstad and Anne-Sofie Helvik

    Citation: BMC Family Practice 2016 17:92

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  44. Content type: Research article

    Multiple diagnostic algorithms for heart failure exist. However, it is unclear whether these algorithms are incorporated in the ‘scripts’ clinicians use in every day practice. Scripts are networks of organised...

    Authors: Klaartje Decaluwe, Jan Degryse and Bert Vaes

    Citation: BMC Family Practice 2016 17:86

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  45. Content type: Research article

    The Education Thérapeutique des patients Insuffisants Cardiaques (ETIC; Therapeutic Education for Patients with Cardiac Failure) trial aimed to determine whether a pragmatic education intervention in general prac...

    Authors: Hélène Vaillant-Roussel, Catherine Laporte, Bruno Pereira, Marion De Rosa, Bénédicte Eschalier, Charles Vorilhon, Romain Eschalier, Gilles Clément, Denis Pouchain, Jean-François Chenot, Claude Dubray and Philippe Vorilhon

    Citation: BMC Family Practice 2016 17:80

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  46. Content type: Study protocol

    People with cognitive problems, and their families, report distress and uncertainty whilst undergoing evaluation for dementia and perceive that traditional diagnostic evaluation in secondary care is insufficie...

    Authors: Sam T. Creavin, Sarah J. Cullum, Judy Haworth, Lesley Wye, Antony Bayer, Mark Fish, Sarah Purdy and Yoav Ben-Shlomo

    Citation: BMC Family Practice 2016 17:79

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    The Erratum to this article has been published in BMC Family Practice 2016 17:119

  47. Content type: Research article

    Data is lacking on comorbid personality disorders (PD) and fibromyalgia syndrome (FMS) in terms of prevalence, and associated healthcare and societal costs. The main aim of this study was to assess the prevale...

    Authors: Laura Gumà-Uriel, M. Teresa Peñarrubia-María, Marta Cerdà-Lafont, Oriol Cunillera-Puertolas, Jesús Almeda-Ortega, Rita Fernández-Vergel, Javier García-Campayo and Juan V. Luciano

    Citation: BMC Family Practice 2016 17:61

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