Aust Fam Physician
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Pituitary disease is relatively uncommon, but because failure to recognise and manage it correctly has such severe repercussions, it has an importance out of proportion to its prevalence. ⋯ The clinical presentation of pituitary disease varies from asymptomatic to severe features of endocrine disturbance. Establishing the diagnosis is not easy and requires a strong clinical suspicion supported by radiology and specific biochemical tests. Treatment is directed toward both the underlying pathology and the endocrine disturbances present.
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To develop and explore the use of a patient satisfaction questionnaire based on patient perceptions of items which influence satisfaction and to explore patient and practitioner characteristics which influence the results. ⋯ This project found the items patients identified were similar to those identified by practitioners, and reiterated previous findings that there is substantial variability in the levels of satisfaction reported by patients of Australian general practices.
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Primary nocturnal enuresis is common, and if left untreated has considerable psychological ramifications on children as they get older. ⋯ By far the most successful treatment is the bed wetting alarm. In recent years desmopressin nasal spray has also found a clinical niche as a short term solution for children attending school camps or sleeping over at friends' houses. It may also be used as an adjunct to the use of the alarm. Treatment with imipramine is increasingly in disfavour because the relapse rate is unacceptably high and fatal overdose is a possibility.
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Paediatric lacerations and burns are common problems. ⋯ A significant number of lacerations are minor and can be managed without hospitalisation, provided due care is paid to adequate assessment and pain relief. Minor burns can also be managed without hospitalisation. Frequent change of dressings should be avoided but any burn that is not healed within 7-10 days should be considered for possible skin grafting.