Abstract Aims Dysfunctional vascular access in haemodialysis has varied clinical presentations, including prolonged bleeding, pain, loss of thrill, difficulties needling and ineffective dialysis. We aimed to establish whether specific presentations correlate with a higher frequency adverse imaging findings intervention. Methods Duplex ultrasound scans (DUS) surgical AV fistulae grafts performed...

BACKGROUND In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Though guidelines have supported the use of Spinal Manipulative Therapy (SMT) for low back pain (LBP), General Practitioners (GP) referral patterns to the 3 registered professions that perform SMT are generally unknown. METHOD A short questionnaire was designed and piloted. Demographic inf...

BACKGROUND Joint pain, specifically chronic knee pain (CKP), is a frequent cause of chronic pain and limitation of function and mobility among older adults. Multiple evidence-based guidelines recommend exercise as a first-line treatment for all patients with CKP or knee osteoarthritis (KOA), yet healthcare practitioners' attitudes and beliefs may limit their implementation. This systematic revi...

Living with any chronic pain carries a heavy economic and social price.Aiming for accurate diagnosis and effective management from the first presentation may help to reduce the disruption of the woman’s life and may avoid an endless succession of referrals, investigations and operations.This guideline aims to provide an evidence-based framework for the initial assessment of women with chronic p...

An earlier diagnosis of ankylosing spondylitis (AS) is required because there is still a 5-7 year delay between first symptoms and diagnosis, and new effective treatments are available for active disease. Primary care physicians need easy to apply parameters to help them identify patients with suspected AS for onward referral. The best measures found were inflammatory back pain and HLA-B27 posi...

Patients presenting with sharp pain in their throat after eating fish were studied to determine the site and frequency of impacted fish bones. In 79% no fish bone was demonstrated despite careful follow up. In those proven to have a fish bone 93% were in the oropharynx. The role of X-rays and the indications for referral for endoscopy are discussed.

Introduction Shoulder pain is common and the prognosis often unfavourable. Dutch guidelines on treatment of shoulder in primary care recommend a corticosteroid injection or referral to exercise therapy, if initial management fails persists. However, evidence effectiveness compared with especially long term, limited. This trial will assess clinical cost physiotherapist-led therapy over 12 months...

introduction: the family physician program is one of the most important plans for increasing the equitable access and affordable health services. this study aimed to examine the performance of urban family physicians and associated factors in the third year of its implementation. method: a cross-sectional study was conducted on all family physicians (31 persons) working in the private and publi...

AIM To report details concerning symptoms (especially pain) preceding the development of malignant cord compression (MCC); delays between onset/reporting of symptoms and confirmed diagnosis of MCC; accuracy of investigations carried out. METHODS A prospective observational study examined the diagnosis, management and outcome of 319 patients diagnosed with MCC at three Scottish cancer centres ...