Aust Fam Physician
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Facial pain is a relatively frequent cause of presentation to both general medical and dental practitioners. Although in the vast majority of cases the cause is dental disease or tempero-mandibular joint dysfunction, the remaining patients are often difficult to diagnose and treat. ⋯ A detailed history, clinical examination, imaging and laboratory investigations may be required to establish the cause of atypical facial pain. An assessment of the patient's mental state is mandatory, as depression or psychological overlay is common. In a small number of cases, the diagnosis remains unclear despite detailed investigation. These patients may have their symptoms ameliorated by empirical pharmacological therapy.
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Routine clinical measurements of glycated haemoglobin first became available during the early 1970s and are now accepted as the standard for estimated overall glycaemic exposure and risk of microvascular complications in diabetes. ⋯ Blood glucose gives immediate day-to-day information and A1C usually gives a reliable estimate of the average glycaemic exposure over the past 6-8 weeks. Both are important components of glycaemic monitoring. Discrepancies between these two estimates of glycaemia can usually be resolved by checking blood glucose and A1C techniques. Target A1C is less than 7%, but encouraging patients to aim slightly lower (eg. by 0.5%) on A1C can result in significant reduction in complication risk. There is a clear relationship between glycaemic control reflected by A1C and the progression of microvascular complications in both type 1 and type 2 diabetes.
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Hip fracture is a common "geriatric syndrome", presenting general practitioners with complex challenges in prevention and management. Hip fracture entails a high cost to both the individual and the community. ⋯ General practitioners have a key role in preventing hip fracture and optimising the ongoing care of patients who have suffered a fracture.