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Point-of-Care Ultrasound is a method of performing a rapid clinical ultrasound, with the aim of responding to a clinical question immediately. This is not an ultrasound performed systematically as the radiologists do, nor does it pretend to replace it. It is useful in some kind of screening (abdominal aortic aneurysm) and is of special interest in ultrasound-guided procedures (joint infiltration by injection).It allows to adapt the derivations, minimising the uncertainty, ruling out certain pathologies due to its high diagnostic precision. It can also lead to overdiagnosis, if the examinations carried out are not limited to the organs on which our clinical suspicion is based.Ultrasound is one tool more in the diagnostic process, but its use must be limited to certain clinical situations. Its use in early detection of prevalent diseases in Primary Care should be properly evaluated. On the other hand with more evidence of a high diagnostic accuracy in a large list of pathological conditions.  相似文献   
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There is an increasing request by patients or their representatives not to have some data registered in their clinical history or if such data exists to be deleted. Without doubt, this is so because such clinical data is accessed by various professionals who in most cases are not directly involved in caring for such patients. On the other hand, such data is copied and iteratively and unnecessary reproduced in various discharge reports and others forms. The problem arises when such controversial data refer to particularly sensitive clinical aspects such as assisted reproduction techniques, which invades personal and family privacy. Therefore, the question is who determines what data should be recorded in the medical records and according to what criteria should be taken that decision?  相似文献   
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Objective

To assess the incidence of pertussis (whooping cough) in subjects aged 50 years and older in France.

Methods

Participating family physicians (FPs) using the patient record management software AxiSanté® included patients aged 50 years and older, who had signed an informed consent form, presenting with persistent cough for 7 to 21 days. Bordetella genetic material was detected by polymerase chain reaction (PCR) on nasopharyngeal samples collected at the FP's discretion.

Results

A total of 42 FPs included 129 patients from June 2013 to August 2014 (large cities: 38; medium-sized cities: 57; rural areas: 34); 106 samples were analyzed. Overall, 30 pertussis cases were diagnosed: 10 cases confirmed by PCR, 18 purely clinical cases, and two direct epidemiological cases. The crude incidence rate per 100,000 patients aged  50 years was 103.6 (95% CI: 69.9–47.9): 77.1 in large cities, 103.1 in medium-sized cities, and 143.9 in rural areas. The extrapolated incidence rate per 100,000 persons aged  50 years was 187.1 (95% CI: 126.2–67.1): 131.1 in large cities, 256.1 in medium-sized cities, and 242.2 in rural areas.

Conclusion

The population aged 50 years and older can serve as a reservoir. Its role in Bordetella pertussis circulation should be taken into account for pertussis booster vaccination programs.  相似文献   
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