RESUMO
The general physician as well as the medical specialist may be confronted with a patient with one or two red eyes. To be adequately equipped we answer a series of questions on diagnosis, treatment and referral of patients with red eyes after trauma, or with conjunctivitis, keratitis, scleritis, uveïtis, endophthalmitis or acute glaucoma. Refer to an ophthalmologist or not?
Assuntos
Oftalmopatias , Humanos , Doença Aguda , Conjuntivite/diagnóstico , Conjuntivite/etiologia , Diagnóstico Diferencial , Endoftalmite/diagnóstico , Oftalmopatias/diagnóstico , Encaminhamento e Consulta , Esclerite/diagnóstico , Esclerite/tratamento farmacológicoRESUMO
The revised practice guideline 'Delirium' of the Dutch College of General Practitioners (NHG) provides recommendations about the prevention, early detection, diagnosis and treatment of delirium in elderly patients in general practice. The guideline now also offers tools for the treatment of delirium in terminally-ill patients. A patient with delirium can only be cared for at home if a safe environment and the continuous presence of carers can be guaranteed. This requires close cooperation between the care services and the home carers involved and good coordination with the general practice health centre. The discharge from hospital of patients with persistent symptoms of delirium to their homes requires optimal transfer from the specialist/nursing staff to the general practitioner and home carers involved. The NHG guideline therefore pays considerable attention to collaboration and transfer in the care of patients with delirium. The revised version of this guideline was developed in close collaboration with the revision of the multidisciplinary guideline on delirium produced by the Dutch Order of Medical Specialists.
Assuntos
Delírio/diagnóstico , Delírio/terapia , Medicina Geral/normas , Clínicos Gerais/normas , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Idoso , Delírio/prevenção & controle , Diagnóstico Diferencial , Geriatria , Serviços de Assistência Domiciliar , Humanos , Países Baixos , Sociedades MédicasRESUMO
The Dutch College of General Practitioners (NHG) guideline 'Abdominal pain in children' was published in September 2012. The guideline distinguishes between children with acute abdominal pain (≤ 1 week) and chronic abdominal pain (> 1 week). Abdominal pain can be caused by an underlying somatic condition or can have a functional nature. The chance of finding a somatic cause is far higher in children with acute abdominal pain than in children with chronic abdominal pain. In children with acute pain the emphasis is on diagnosis, whereas in children with chronic pain it is on treatment. Additional investigations in children without indications for a somatic cause can be limited to urinary investigation. Most children with functional abdominal pain can be treated by their GP. This treatment consists of explanation and advice to the patient and his or her parents, with the aim of providing reassurance. In children with continued severe functional abdominal pain, consultation with or possible referral to the paediatrician is advised.
Assuntos
Dor Abdominal/diagnóstico , Dor Abdominal/terapia , Medicina Geral/normas , Guias de Prática Clínica como Assunto , Criança , Feminino , Humanos , Masculino , Países Baixos , Padrões de Prática Médica , Sociedades MédicasRESUMO
Parkinson's disease is characterised by bradykinesia in combination with one or more of the following symptoms: rigidity, resting tremor and disorders of posture and balance. Refer a patient with suspected Parkinson's disease (or parkinsonism) for diagnosis and treatment preferably to a neurologist with expertise in movement disorders. The treatment of Parkinson's disease is symptomatic; to date, there is no treatment that slows disease progression. The treatment of patients with Parkinson's disease and its related disorders involves collaboration of the neurologist, Parkinson's disease nurse and general practitioner. In addition to recognizing the hypokinetic-rigid syndrome, the general practitioner has a role in diagnosing and treating associated symptoms and disorders, and in supporting and counseling the patient and their partner or caregiver.
Assuntos
Medicina Geral/normas , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Padrões de Prática Médica , Antiparkinsonianos/uso terapêutico , Humanos , Países Baixos , Modalidades de Fisioterapia , Sociedades MédicasRESUMO
The practice guideline for general practitioners (GPs) on polymyalgia rheumatica and temporal arteritis was published in February 2010 by the Dutch College of General Practitioners. This guideline provides GPs with recommendations for the diagnosis and treatment of polymyalgia rheumatica. After other disorders have been excluded, the diagnosis of 'polymyalgia rheumatica' is made in patients over the age of 50 who have bilateral pain in the neck and shoulder girdle and/or hip girdle that has lasted for longer than 4 weeks, morning stiffness that lasts longer than 60 minutes and an ESR > 40 mm in the first hour. After the diagnosis is made treatment with prednisone or prednisolone 15 mg per day is started. This dosage is diminished very gradually according to a uniform treatment schedule during a period of 3 months, thereafter depending on the clinical course. The practice guideline pays attention to the diagnosis and management of temporal arteritis only when it occurs concurrently with polymyalgia rheumatica.
Assuntos
Arterite , HumanosRESUMO
The practice guideline for general practitioners (GPs) on polymyalgia rheumatica and temporal arteritis was published in February 2010 by the Dutch College of General Practitioners. This guideline provides GPs with recommendations for the diagnosis and treatment of polymyalgia rheumatica. After other disorders have been excluded, the diagnosis of 'polymyalgia rheumatica' is made in patients over the age of 50 who have bilateral pain in the neck and shoulder girdle and/or hip girdle that has lasted for longer than 4 weeks, morning stiffness that lasts longer than 60 minutes and an ESR > 40 mm in the first hour. After the diagnosis is made treatment with prednisone or prednisolone 15 mg per day is started. This dosage is diminished very gradually according to a uniform treatment schedule during a period of 3 months, thereafter depending on the clinical course. The practice guideline pays attention to the diagnosis and management of temporal arteritis only when it occurs concurrently with polymyalgia rheumatica.