Aust Prescr
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Accurate diagnostic tests that provide results in a timely manner are essential for the clinical and public health management of COVID-19 disease The choice as to which test to use will depend on the clinical presentation and the stage of the illness Nucleic acid tests, using real-time reverse transcriptase-polymerase chain reaction, are the most appropriate for diagnosing acute infection. Combined deep nasal (or nasopharyngeal) and throat swabs are the preferred sample Serology can be used to diagnose previous infection, more than 14 days after the onset of symptoms Antigen tests are in development and their role is not yet defined Interpretation of results must take into account the pre-test probability of the patient having the disease. This is based on their clinical presentation and epidemiological risk
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Co-formulated tenofovir disoproxil plus emtricitabine is highly effective as pre-exposure prophylaxis for HIV It is suitable for men who have sex with men, for heterosexual sex and for people who use intravenous drugs when there is a risk of HIV infection Pre-exposure prophylaxis is one pill per day and can be prescribed by all medical practitioners and nurse practitioners via the Pharmaceutical Benefits Scheme. It is best prescribed in a three-monthly program with regular monitoring for patient adherence, safety, HIV and other sexually transmitted infections Prophylaxis is well tolerated but requires monitoring for kidney toxicity and low bone density
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The Australian asthma guidelines have recently been updated and include additional treatment options for adults and adolescents with mild asthma Mild asthma is not necessarily a benign condition and patients are still at risk of severe flare-ups, particularly if they overuse short-acting beta2 agonists such as a salbutamol inhaler For adults and adolescents with mild asthma, the updated guidelines include as-needed inhaled low-dose budesonide–formoterol as an alternative to daily low-dose inhaled corticosteroid plus as-needed short-acting beta2 agonist The budesonide–formoterol combination should be taken as needed to provide symptom relief and reduce the risk of severe exacerbations
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The prevalence of autism spectrum disorder is increasing. It usually presents in childhood with abnormal behaviour and development The diagnosis can be difficult. There are often comorbidities which can cause confusion Non-drug treatments are first line. ⋯ Cognitive behaviour therapy can be effective, but in some cases selective serotonin reuptake inhibitors may have a role Most patients have problems sleeping, but drugs are not usually used to treat sleep disorders in children Antipsychotics, such as risperidone, may be considered for irritability and aggression. Clonidine is first line for children with Tourette syndrome. Patients need regular monitoring because of the adverse effects of these drugs
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Vulvovaginitis is a commonly encountered problem in general practice. It usually presents with irritation and vaginal discharge A thorough examination is essential in order not to miss the less common causes. ⋯ Antifungals and antibiotics are therefore used in management Not all causes are infective. Several skin disorders can affect the vulva Ongoing or recurrent symptoms require careful evaluation and further investigation