Malcom Randall Department of Veterans Affairs Medical Center

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primary care :: Article Creator Primary Care In Crisis: A Physician's Take On Reform Source: Imtmphoto/Shutterstock This blog reviews how the role of primary care practice has diminished greatly over the past 40 years. When I became a physician in the 1980's primary care medicine entailed a physician specializing in pediatrics, family medicine, or internal medicine who served as the main point of contact for a panel of patients. The primary care physician evaluated patients for their annual check-ups, monitored patients with chronic conditions, and was also available for same-day or same-week visits when someone was sick. The primary care physician was able to address more than 90% of the care of sick patients in their clinic, and occasionally would refer patients for evaluation by a specialist. In rare cases, when the required level of care could not be handled in the clinic, such as when a patient required intravenous...
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Impact of the mandatory Hepatitis A immunization program: before and after the vaccine in Ankara, Central of Turkey. - Physician's Weekly

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Kanık Yüksek S, Tezer H, Özkaya Parlakay A, Gülhan B, Kara A, Çiftçi E, Tapısız A, Çelik M, Özdemir H, Aykaç K, Demirdağ TB, Tural Kara T, Hayran G, İnce E. Impact of the mandatory Hepatitis A immunization program: before and after the vaccine in Ankara, Central of Turkey. Turk J Pediatr 2019; 61: 677-685. In Turkey Hepatitis A virus (HAV) infection is considered to be moderateendemic. Hepatitis A vaccine was included in the mandatory vaccination schedule of Turkey on November 2012. We aimed to evaluate the cases of HAV infection followed in Ankara, which is located in the center of Central Anatolia, retrospectively according to the date of the administration of the mandatory hepatitis A vaccine. A total of 272 children followed-up between January 2008 and December 2015 for HAV infection in five separate hospitals were enrolled to the study. There were 200 (68.2%) cases in the pre-vaccination group, 72 (31.74%) cases in the post-vaccination group, and 55.1% were male in total. The immunization status were as follow; 89.7% (n = 244) unvaccinated, 0.4% (n = 1) vaccinated and 9.9% (n = 27) with unknown immune status. There was a statistically significant difference between the groups in hospitalization rates, but no statistically significant differences in hospitalization indications, length of hospital stay, complication types and proportions, and normalization period of transaminases. The national hepatitis A immunization program in Turkey has had a significant impact when the targeted population is considered, with suggestive herd protection effects.



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