Aust Fam Physician
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Although tramadol induced neuropsychiatric toxicity, dependence and withdrawal have been extensively reported in chronic pain sufferers, such cases continue to surface in clinical practice. ⋯ Patients and prescribers are reminded of the risk of severe morbidity including seizures associated with tramadol withdrawal. Serotonin syndrome can be precipitated with tramadol use especially in combination with other serotonergic drugs.
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Most Australian and all New Zealand residents now have 24 hour access to free telephone advice and symptom triage. Australasia is following an international trend triggered by a perceived need for standardised advice, demand management (primary care and emergency department), and equity of access. A growing literature describes the impact of this new service on existing primary health services. ⋯ Australian and New Zealand services are similar with respect to the demographics of callers, when they call, and the issues on which they seek advice. Further study is needed in order to understand how telenursing can best be integrated with general practice and other primary care services.
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The medical humanities is a broad area of study and practice encompassing all nontechnical or 'human' aspects of medicine. ⋯ The medical humanities serve three main goals: the study of the human aspects of medicine from within traditional arts disciplines of history, philosophy, sociology and literature; the intersection of medicine and the creative arts; and the training of more insightful and compassionate doctors. This article briefly explores these three goals and discusses their value for the medical community.