ABSTRACT
We present a case of a 52-year-old woman of Ghanaian origin who developed Plasmodium falciparum malaria 4âyears after leaving Africa. She had not returned to an endemic area since. We hypothesize several possible scenarios to explain this infection, of which we believe recrudescence of P. falciparum is the most plausible. This occurred most likely as a consequence of waning immunity several years after leaving a high-transmission area. She recovered after a 3-day treatment with atovaquone/proguanil.
Subject(s)
Antimalarials/therapeutic use , Atovaquone/therapeutic use , Endemic Diseases , Malaria, Falciparum , Proguanil/therapeutic use , Travel , Disease Transmission, Infectious , Drug Combinations , Female , Ghana/epidemiology , Humans , Malaria, Falciparum/diagnosis , Malaria, Falciparum/drug therapy , Malaria, Falciparum/epidemiology , Malaria, Falciparum/transmission , Middle Aged , Plasmodium falciparum/drug effects , RecurrenceABSTRACT
BACKGROUND: Communication between general practitioners (GPs) and specialists is an important aspect of qualitative care. Efficient communication exchange is essential and key in guaranteeing continuity of care. Inefficient communication is related to several negative outcomes, including patient harm. This study aimed to investigate the perception of GPs and hospital-based specialists in Belgium of the quality of their mutual communication. METHODS: A cross-sectional study was conducted among GPs and specialists. Participants were asked to complete a validated questionnaire on several aspects of their mutual communication. RESULTS: Response rates of 17.9% (343/1.912) for GPs and 17.3% (392/2.263) for specialists were obtained. Both specialists and GPs qualify their mutual telephone accessibility as suboptimal. Specialists think poorly of the GP referral letter, in contrast to GP perception. Eighty per cent of the GPs feel that specialists address their questions appropriately; specialists have a similar perception of their own performance. According to 16.7% of the specialists, GPs not always follow their recommendations. Contrarily, GPs rate their compliance much higher (90.7%). Less than half of the GPs feel that the specialists' letter arrives on time, whereas specialists have a different and a more positive perception. CONCLUSIONS: GPs and specialists disagree on several aspects of their mutual communication. These include the perception of accessibility, in both directions, and of the timeliness of written communication. Feedback is positively appreciated, again in both directions. Nevertheless, specialists feel that uptake of their recommendations is insufficient. Hence, there may remain significant room for improvement, which could contribute significantly to continuity of care and patient safety.
Subject(s)
Communication , General Practitioners , Hospitalists , Specialization , Adult , Belgium , Cross-Sectional Studies , Female , Humans , Interprofessional Relations , Male , Referral and Consultation , Surveys and QuestionnairesSubject(s)
Agricultural Workers' Diseases/microbiology , Disease Outbreaks , Mycobacterium bovis/isolation & purification , Tuberculosis, Bovine/transmission , Tuberculosis, Pulmonary/microbiology , Aged , Animals , Antitubercular Agents/therapeutic use , Belgium/epidemiology , Cattle , Dairying , Drug Resistance, Multiple, Bacterial , Fatal Outcome , Female , Genotype , Humans , Minisatellite Repeats , Mycobacterium bovis/drug effects , Radiography , Tuberculosis, Bovine/epidemiology , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Pulmonary/drug therapyABSTRACT
A 99mTc-MDP bone scan was performed on a 65-yr-old woman because of joint pain. The study showed bilateral lung uptake and no abnormalities of the affected joints. Wegener's vasculitis was diagnosed. Lung uptake on bone scans has been noted in various conditions but not Wegener's vasculitis. The differential diagnosis of lung uptake on bone scan should include Wegener's vasculitis.
