Aust Fam Physician
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It can be said that chronic pain patients comprise a large part of general practice. It would be accepted that general practitioners treat pain to the best of their abilities and, where indicated, use opioids for this purpose. After all, opioids have been used for the treatment of cancer and acute pain for many years. While a growing body of literature documents the trend of acceptance to prescribe opioids for the treatment of chronic noncancer pain, recent evidence suggests opioids may not achieve key outcomes of chronic pain management.
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Many newly arrived refugees come from countries with fragile primary health infrastructure. As a result they may have had patchy primary immunisation against vaccine preventable diseases. ⋯ The potential challenges include knowing which vaccines to give to provide catch up vaccination, access to appropriate vaccines through public health units, and adequate follow up to support completion of immunisation courses. The most useful immunisations for adolescent and adult refugees are adult diphtheria/tetanus, measles/mumps/rubella, inactivated polio, and hepatitis B vaccines. Immunisation programs for refugees require cooperation between primary health care practitioners and health policy makers to ensure that good primary health care is available to the most vulnerable groups arriving in Australia.
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Review Meta Analysis
Traveller's 'funny tummy' - reviewing the evidence for complementary medicine.
The gastrointestinal system is sensitive to both the place and means of travel and traveller's diarrhoea and motion sickness are among the most prevalent travel related conditions. There is now evidence to suggest that both of these ailments may be treated with safe and inexpensive complementary medicines.
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Age related macular degeneration (AMD) is a common condition seen in general practice. Over the past few years, new understanding of the condition has seen the rapid development of increasingly effective treatments. ⋯ Increasingly, AMD sufferers independently source information about the latest treatments. Consequently GPs are likely to hear more questions from their patients regarding treatment options. Antivascular endothelial growth factor drugs show exciting potential for an often debilitating condition. However, early referral and treatment is vital to successful outcomes and GPs can play an essential role in this process. As well, they can serve to provide ongoing information and counselling to their patients with AMD.
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Fever is among the most frequently reported problems in returning travellers. ⋯ The returned traveller may present with fever and it is important to exclude life threatening conditions such as malaria that may be related to the travel. A complete risk assessment should be undertaken, including a complete travel history, examination and further investigations, to help to narrow the differential diagnosis. Common tropical diseases found include malaria, dengue, enteric fever, rickettsial infections and respiratory infections. General practitioners should be alert to the public health implications of travel related diseases.