Aust Fam Physician
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The World Health Organisation estimates that 2 billion people have been infected with hepatitis B and about 180 million people infected with hepatitis C worldwide. More than 350 million have chronic hepatitis B and 130 million have chronic hepatitis C infection. Most infections of hepatitis B and C are from unsafe injection practices, both medical and nonmedical; from household contacts; or, in the case of hepatitis B, from 'vertical' transmission from mother to child. ⋯ Most people carrying hepatitis will be asymptomatic with infection detected by screening. Refugees need counselling, education and support to come to terms with the implications of hepatitis B and C for both themselves and their families. In Australia both viruses can be treated in those with active infection and general practitioners can be involved in diagnosis, follow up and shared care management.
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This article examines a medical negligence claim involving an allegation of failure to perform an electrocardiogram, leading to a delay in diagnosis of long QT syndrome.
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We describe reported immunisation status and primary health care utilisation in refugee and migrant young people in western Sydney, New South Wales. ⋯ Refugee and migrant young people are likely to have a poor utilisation of primary health care relative to their needs. Most who had seen a GP in Australia required catch up immunisation. Stronger links and increased GP education about the requirements of these young people are needed to improve immunisation status and GP utilisation in this high risk group.
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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.