Australian journal of general practice
-
Data are sparse on how well the absolute risk approach is implemented in primary healthcare. The aim of this study was to quantify absolute cardiovascular disease (CVD) risk, appropriate use of blood pressure (BP)-lowering and lipid-lowering therapy, and clinical target responses in the Busselton baby boomer population. ⋯ These data confirm substantial under treatment of Australian adults who are at high CVD risk. Enhanced implementation of absolute CVD risk assessment and evidence-based treatment in high-risk adults has potential for substantial health gains.
-
Radial-sided wrist pain is a common patient complaint that can have a dramatic effect on the patient's productivity at work, sporting or artistic pursuits and activities of daily living. ⋯ The correct diagnosis of this debilitating tendon condition and the seeking of early treatment yields excellent outcomes for patients. While there are numerous possible aetiologies, the pathophysiology is defined as a stenosing condition of the first dorsal compartment. Assessment elicits pain over the radial styloid that is caused by the restricted glide of the tendons. Ultrasonography has been shown to be useful in diagnosis and treatment planning, especially if an intercompartmental septum is present. Treatment involves corticosteroid injections and orthoses prescriptions. These should not be used in isolation; many other therapy techniques have been shown to be effective in the management of De Quervain's tenosynovitis.
-
The incidence of skin cancers in Australia continues to rise. Early detection and timely management are required. ⋯ Skin cancer awareness campaigns encourage patients to see their general practitioners (GPs) for complete skin examination. GPs are expected to correctly identify benign and malignant skin lesions and understand their high risk patients. A systematic approach to the skin examination combined with knowledge and awareness of diagnostic tools can aid in the early detection of skin malignancies, and prompt escalation as necessary.
-
Palpitations are one of the most common presentations to general practice. While they are usually benign, they may be associated with an adverse prognosis. ⋯ Not all palpitations are due to arrhythmia, and because of the transitory nature of palpitations, the work-up will usually be performed between episodes. Direction from history, examination and 12-lead electrocardiography will guide further investigations and will often include an echocardiogram and ambulatory electrocardiographic monitoring. The intensity of ambulatory electrocardiographic monitoring and diagnostic work-up will be dictated by the frequency, nature and severity of symptoms, and will sometimes require incorporation of new technologies and electrophysiology referral. Ultimately, management must be tailored on a case-by-case basis depending on the cause of palpitations and symptom severity.
-
In a medical negligence claim, courts must consider whether a doctor acted in accordance with the required standard of care. Experts may disagree on what should have been done, particularly in light of knowledge that a patient has been harmed. In Australia, the law gives further guidance on the standard of care, providing that doctors will not have breached their duty if they acted in a manner that, at the time the service was provided, was widely accepted by peer professional opinion as competent professional practice. ⋯ In two recent cases, courts in different states have considered the role of professional guidelines in establishing what was widely accepted as competent professional practice.