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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 5

  1. Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management.

    Authors: Diana Fernández, Carlos Brotons, Irene Moral, Mateja Bulc, Mélanie Afonso, Hülya Akan, Susana Pinto, Jasna Vucak and Carlos Manuel da Silva Martins

    Citation: BMC Family Practice 2019 20:162

    Content type: Research article

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  2. Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Little is known on how posterior canal BPPV affects health-related quality of life in patients diagnosed and treated at primary ...

    Authors: Ricard Carrillo Muñoz, José Luis Ballve Moreno, Iván Villar Balboa, Yolanda Rando Matos, Oriol Cunillera Puertolas, Jesús Almeda Ortega, Estrella Rodero Perez, Xavier Monteverde Curto, Carles Rubio Ripollès, Noemí Moreno Farres, Austria Matos Mendez, Jean Carlos Gomez Nova, Marta Bardina Santos, Johan Josué Villarreal Miñano, Diana Lizzeth Pacheco Erazo and Anabella María Hernández Sánchez

    Citation: BMC Family Practice 2019 20:156

    Content type: Research article

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  3. The changes in the models of care for mental disorders towards a community focus and deinstitutionalisation might have risen General practitioners’ (GPs) workload, increasing their mental health concerns and t...

    Authors: C. Barcons, B. García, C. Sarri, E. Rodríguez, O. Cunillera, N. Parellada, B. Fernández, C. E. Alvarado, C. Barrio, J. C. Fleta, D. Ruiz and R. Torrubia

    Citation: BMC Family Practice 2019 20:155

    Content type: Research article

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  4. Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The...

    Authors: Cesar I. Fernandez-Lazaro, Juan M. García-González, David P. Adams, Diego Fernandez-Lazaro, Juan Mielgo-Ayuso, Alberto Caballero-Garcia, Francisca Moreno Racionero, Alfredo Córdova and Jose A. Miron-Canelo

    Citation: BMC Family Practice 2019 20:132

    Content type: Research article

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  5. Otoscopy alone has low sensitivity and specificity for acute otitis media (AOM). Otomicroscopy and pneumatic methods are superior to otoscopy. However, these methods require clinical skills. The use of differe...

    Authors: Pär-Daniel Sundvall, Chrysoula E. Papachristodoulou and Lena Nordeman

    Citation: BMC Family Practice 2019 20:127

    Content type: Research article

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  6. Brain tumour patients see their primary care doctor on average three or more times before diagnosis, so there may be an opportunity to identify ‘at risk’ patients earlier. Suspecting a brain tumour diagnosis i...

    Authors: K. Zienius, Ip Chak-Lam, J. Park, M. Ozawa, W. Hamilton, D. Weller, D. Summers, L. Porteous, S. Mohiuddin, E. Keeney, W. Hollingworth, Y. Ben-Shlomo, R. Grant and P. M. Brennan

    Citation: BMC Family Practice 2019 20:118

    Content type: Research article

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  7. Few studies in Portugal have attempted to assess the impact of psychological interventions in primary health care regarding the problems shared by clients, and which variables predicted the success of this int...

    Authors: Miguel Ricou, Sílvia Marina, Paula Marinho Vieira, Ivone Duarte, Inês Sampaio, Joana Regalado and Catarina Canário

    Citation: BMC Family Practice 2019 20:116

    Content type: Research article

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  8. Harmful alcohol consumption in Germany is a serious public health problem: About 7.7 million adults in Germany can be classified as risky alcohol consumers, about 74,000 deaths per year are related to alcohol ...

    Authors: T. Hoffmann, K. Voigt, J. Kugler, L. Peschel, A. Bergmann and H. Riemenschneider

    Citation: BMC Family Practice 2019 20:115

    Content type: Research article

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  9. The German clinical guideline on tobacco addiction recommends that general practitioners (GPs) provide brief stop-smoking advice to their patients according to the “5A” or the much briefer “ABC” method, but it...

    Authors: Sabrina Kastaun, Verena Leve, Jaqueline Hildebrandt, Christian Funke, Stephanie Becker, Diana Lubisch, Wolfgang Viechtbauer, Olaf Reddemann, Linn Hempel, Hayden McRobbie, Tobias Raupach, Robert West and Daniel Kotz

    Citation: BMC Family Practice 2019 20:107

    Content type: Study protocol

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  10. Anxiety is under-recorded and under-treated in the UK and is under-represented in research compared with depression. Detecting anxiety can be difficult because of co-existing conditions. GPs can be reluctant t...

    Authors: M. C. Barnes, D. Kessler, C. Archer and N. Wiles

    Citation: BMC Family Practice 2019 20:106

    Content type: Research article

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  11. Antidepressant use continues to rise, mainly explained by an increase in the proportion of patients receiving long term treatment. Although treatment guidelines recommend discontinuation after sustained remiss...

    Authors: Carolien Wentink, Marloes J. Huijbers, Peter Lucassen, Cornelis Kramers, Reinier Akkermans, Eddy Adang, Jan Spijker and Anne E. M. Speckens

    Citation: BMC Family Practice 2019 20:105

    Content type: Study protocol

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  12. Malnutrition (specifically undernutrition) in older, community-dwelling adults reduces well-being and predisposes to disease. Implementation of screen-and-treat policies could help to systematically detect and...

    Authors: Philine S. Harris, Liz Payne, Leanne Morrison, Sue M. Green, Daniela Ghio, Claire Hallett, Emma L. Parsons, Paul Aveyard, Helen C. Roberts, Michelle Sutcliffe, Siân Robinson, Joanna Slodkowska-Barabasz, Paul S. Little, Michael A. Stroud and Lucy Yardley

    Citation: BMC Family Practice 2019 20:100

    Content type: Research article

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  13. General practitioners increasingly use point-of-care ultrasonography despite a lack of evidence-based guidelines for their appropriate use in primary care. Little is known about the integration of ultrasonogra...

    Authors: Camilla Aakjær Andersen, Annette Sofie Davidsen, John Brodersen, Ole Graumann and Martin Bach Jensen

    Citation: BMC Family Practice 2019 20:89

    Content type: Research article

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  14. Patients with anemia are frequently encountered in primary care. Once anemia is detected, it is essential to define the type and identify the underlying cause prior to initiation of treatment. In most cases, t...

    Authors: Anders Larsson, Lena Carlsson, Bo Karlsson and Miklos Lipcsey

    Citation: BMC Family Practice 2019 20:77

    Content type: Research article

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  15. The national guideline for sore throat, endorsed by the Danish Society of General Medicine, recommends the use of the modified Centor score and streptococcal rapid antigen detection test to guide diagnosis and...

    Authors: Kasper Basse Reinholdt, Maria Rusan, Pernille Rosbjerg Hansen and Tejs Ehlers Klug

    Citation: BMC Family Practice 2019 20:75

    Content type: Research article

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  16. Patients with medically unexplained physical symptoms (MUPS) are common in primary care, with a spectrum from mild to moderate and chronic MUPS. The burden of chronic MUPS is high, and early identification of ...

    Authors: Paula Elisabeth van Westrienen, Martijn Frits Pisters, Cindy Veenhof and Nicolaas Johannes de Wit

    Citation: BMC Family Practice 2019 20:66

    Content type: Research article

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  17. Right bundle branch block is one of the most common electrocardiographic abnormalities. Most cases of right bundle branch block are detected in asymptomatic patients in primary care, so a correct interpretatio...

    Authors: M. Alventosa-Zaidin, G. Pera, C. Roca Saumell, N. Mengual Miralles, M. V. Zamora Sanchez, T. Gros Garcia, L. Guix Font, M. Benitez Camps, J. Francisco-Pascual and J. Brugada Terradellas

    Citation: BMC Family Practice 2019 20:58

    Content type: Research article

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  18. Serious infections in older people are associated with unplanned hospital admissions and high mortality. Recognising the presence of a serious infection and making an accurate diagnosis are important challenge...

    Authors: Sara McKelvie, Abigail Moore, Caroline Croxson, Daniel S. Lasserson and Gail N. Hayward

    Citation: BMC Family Practice 2019 20:56

    Content type: Research article

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  19. The demand for out-of-hours (OOH) primary care has increased during the last decades, with a considerable amount of contacts for young children. This study aims to describe the reasons for encounter (RFE), the...

    Authors: Jørgen Lous, Grete Moth, Linda Huibers, Peter Vedsted and Morten Bondo Christensen

    Citation: BMC Family Practice 2019 20:36

    Content type: Research article

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  20. Previous studies in general practice and hospital settings have identified that prescribing of non-insulin diabetes medications may be sub-optimal in people with type 2 diabetes (T2D) and renal impairment. Sin...

    Authors: Jo-Anne Manski-Nankervis, Sharmala Thuraisingam, Janet K. Sluggett, Gary Kilov, John Furler, David O’Neal and Alicia Jenkins

    Citation: BMC Family Practice 2019 20:29

    Content type: Research article

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  21. Stress urinary incontinence (SUI) is the most prevalent subtype of urinary incontinence and is a bothering condition in women. Only a minority of those with SUI consult a general practitioner (GP). EHealth wit...

    Authors: Lotte Firet, Chrissy de Bree, Carmen M. Verhoeks, Doreth A. M. Teunissen and Antoine L. M. Lagro-Janssen

    Citation: BMC Family Practice 2019 20:21

    Content type: Research article

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  22. Uncontrolled blood pressure remains an urgent issue in clinical practice worldwide. This study aimed to compare the characteristics and effectiveness of hypertension control in family medicine pratice in the f...

    Authors: Diana Jurić, Ivančica Pavličević, Ana Marušić, Mario Malički, Ivan Buljan, Velen Šarotić, Nataša Mrduljaš-Đujić, Ante Komparak, Miona Vujević, Danijela De Micheli-Vitturi, Pjera Šušnjar, Tina Puljiz, Minka Jerčić, Dario Leskur and Matko Marušić

    Citation: BMC Family Practice 2019 20:10

    Content type: Research article

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  23. Comorbid depression is common in patients with type 2 diabetes (DM2) and/or coronary heart disease (CHD) and is associated with poor quality of life and adverse health outcomes. However, little is known about ...

    Authors: Alide D. Pols, Karen Schipper, Debbie Overkamp, Harm W. J. van Marwijk, Maurits W. van Tulder and Marcel C. Adriaanse

    Citation: BMC Family Practice 2018 19:202

    Content type: Research article

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  24. Depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease. The number of prescriptions for antidepressants has risen dramatically in recent yea...

    Authors: Carolyn A. Chew-Graham, Thomas Shepherd, Heather Burroughs, Katie Dixon and David Kessler

    Citation: BMC Family Practice 2018 19:197

    Content type: Research article

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  25. Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, he...

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

    Citation: BMC Family Practice 2018 19:196

    Content type: Research article

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  26. Anxiety and depression are common in older adults, but often under-recognised by GPs. Rather than perceiving themselves as suffering from anxiety or depression, older adults are more likely to self-identify as...

    Authors: Alice Moult, Heather Burroughs, Tom Kingstone and Carolyn A. Chew-Graham

    Citation: BMC Family Practice 2018 19:185

    Content type: Research article

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  27. Mental health (MH) problems have considerable personal and societal implications. Systematic MH screening may raise general practitioners’ (GP) awareness of the current need of treatment in their listed patien...

    Authors: Christine Geyti, Else-Marie Dalsgaard, Annelli Sandbæk, Helle Terkildsen Maindal and Kaj Sparle Christensen

    Citation: BMC Family Practice 2018 19:176

    Content type: Research article

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  28. Mental illness, and particularly stress-related disorders such as exhaustion disorder, is continuously increasing in today’s society. It is important to identify patients who consult for potentially stress-rel...

    Authors: Annika Adamsson and Susanne Bernhardsson

    Citation: BMC Family Practice 2018 19:172

    Content type: Research article

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  29. Many oldest-old (> 80-years) with multimorbidity and polypharmacy are at high risk of inappropriate use of medication, but we know little about whether and how GPs would deprescribe, especially in the frail ol...

    Authors: Sophie Mantelli, Katharina Tabea Jungo, Zsofia Rozsnyai, Emily Reeve, Clare H. Luymes, Rosalinde K. E. Poortvliet, Arnaud Chiolero, Nicolas Rodondi, Jacobijn Gussekloo and Sven Streit

    Citation: BMC Family Practice 2018 19:169

    Content type: Research article

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  30. Patients with chronic conditions must mobilize capacity to access and use healthcare and enact self-care. In order for clinicians to create feasible treatment plans with patients, they must appreciate the limi...

    Authors: Kasey R Boehmer, Maria Kyriacou, Emma Behnken, Megan Branda and Victor M Montori

    Citation: BMC Family Practice 2018 19:164

    Content type: Research article

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  31. Lack of control of hypertension is one of the most prevalent problems encountered by general practitioners (GPs). Self-measured blood pressure monitoring at home (SMBP) and self-titration of medication could b...

    Authors: José Sanfélix-Genovés, Clara L. Rodríguez-Bernal, Irene Marco-Moreno, Patricia Martinez-Ibañez, Lucía Martinez-Ibañez, María Bóveda-García, Ignacio Barreira-Franch, Mercedes Calleja-Del Ser, Greta Borrás-Moreno, Eugenia Avelino-Hidalgo, Marina Escrig-Veses, Margherita Lauriano, Margarita Giménez-Loreiro, Laura Bellot-Pujalte, Aníbal García-Sempere, Salvador Peiró…

    Citation: BMC Family Practice 2018 19:160

    Content type: Study protocol

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  32. 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

    Content type: Research article

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  33. 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

    Content type: Research article

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  34. 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

    Content type: Research article

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  35. 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

    Content type: Research article

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  36. 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

    Content type: Research article

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  37. 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

    Content type: Research article

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  38. 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

    Content type: Study protocol

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  39. 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

    Content type: Research article

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  40. 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

    Content type: Research article

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  41. 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

    Content type: Research article

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  42. 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

    Content type: Research article

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  43. 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

    Content type: Research article

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  44. 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

    Content type: Research article

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  45. 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

    Content type: Research article

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  46. 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

    Content type: Research article

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  47. 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

    Content type: Research article

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  48. 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

    Content type: Research article

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