Australian Family Physician August 2008 - Upper abdominal pain
Vol 37, (8) 593-688
The theme for the August issue of AFP
is Upper abdominal pain. This month's articles include upper abdominal
pain, rational investigation of upper abdominal pain, surgical causes of
upper abdominal pain, lessons
from the TAPS study and nonabdominal causes of abdominal pain.
That 'gut feeling'
Carolyn O'Shea
Upper abdominal pain can be a dilemma in general
practice. Sometimes the likely diagnosis is clear in your mind
after the first sentence of the patient’s history is revealed –
and only gets confirmed the further you delve into the history
and examination.
Letters to the editor
The opinions expressed by correspondents in this column are in no way endorsed by either the Editors or The Royal Australian College of General Practitioners.
Upper abdominal pain
Janice Charles, Salma Fahridin, Graeme Miller
Female patients were significantly more likely to present
(8 per 1000 encounters) at upper abdominal encounters than
were males (6 per 1000).
Rational investigation of upper abdominal pain
Florian Grimpen, Paul Pavli
Upper abdominal pain is a common problem with an
extraordinary diversity of possible causes. Many patients have
no structural disease, and making the correct diagnosis can be
a challenge.
Helicobacter pylori - The latest in diagnosis and treatment
Björn Stenström, Aruni Mendis, Barry Marshall
European and North American guidelines on the management
of Helicobacter pylori infection were updated in 2007.
Surgical causes of upper abdominal pain
Natalie Zantuck, May-Ling Wong, Sean Mackay
In Australia, abdominal pain is a common presenting complaint
in the general practice setting. Identifying a surgical cause is
important and warrants prompt specialist referral.
Nonabdominal causes of abdominal pain - Finding your heart in your stomach!
Spiro Tsipouras
The diagnosis of abdominal pain is difficult and often
inaccurate. Nonabdominal disease, in particular cardiac and
pulmonary disease, may present with abdominal symptoms.
Lessons from the TAPS study - Managing investigation results – is your practice system safe?
Meredith A B Makeham, Charles Bridges-Webb AO, Michael R Kidd
The Threats to Australian Patient Safety (TAPS) study collected
648 anonymous reports about threats to patient safety from a
representative random sample of Australian general practitione
Iatrogenic neuropsychiatric syndromes
Keat Choong, Razvan A Ghiculescu
Although tramadol induced neuropsychiatric toxicity, dependence
and withdrawal have been extensively reported in chronic pain
sufferers, such cases continue to surface in clinical practice.
Cholesteatoma – diagnosing the unsafe ear
Phillip Chang, Samuel Kim
Cholesteatoma represents the most common destructive disease of
the ear, affecting the adult and paediatric population alike.
Androgen deprivation therapy - Managing side effects
Shahrir Kabir, Pascal Mancuso, Prem Rashid
Prostate cancer is the most common nondermatologic cancer in
Australian men. Androgen deprivation therapy (ADT) as a modality
of treatment is being increasingly used much earlier and for a longer
period of time.
'Great tan but I feel awful'
Patrick J Phillips, Warren Weightman
'Everyone says I look great but I feel awful. I’ve lost
weight, I feel sick all the time, I don't have any energy and
I struggle just to get through the day'.
Reasoning for registrars - An overview for supervisors and medical educators
Louise Stone
As supervisors and medical educators, one of the most
difficult tasks we face is helping a general practice
registrar who is struggling to adapt to the primary care
environment.
AFP in Practice
AFP in Practice questions are designed to get you started in a small group learning (SGL) activity in your practice or with colleagues. Requirements to earn 40 Category 1 CPD points for a SGL activity are: minimum of four and a maximum of 10 people, minimum of 8 hours of discussion in a year, and at least two GPs.
Clinical Challenge
Questions for this month's clinical challenge are based on articles in this issue. The style and scope of questions is in keeping with the MCQ of the College Fellowship exam. The quiz is endorsed by the RACGP Quality Assurance and Continuing Professional Development Program and has been allocated 4 CPD points per issue.
Assessing general practice knowledge base - The applied knowledge test
Joachim P Sturmberg, Elizabeth A Farmer
A multiple choice based knowledge test has been part of the
examination for Fellowship of The Royal Australian College of General
Practitioners (RACGP) since its inception.
Reminder or recall?
Sara Bird
The terms 'reminder' and 'recall' are often used together and,
sometimes, interchangeably. This article outlines the differences
between these two terms and discusses the duty of general
practitioners to implement reminder and recall systems in their
practices.
Generation Z - Striking the balance: healthy doctors for a healthy community
David A Mitchell
We have a multigenerational workforce. Popular social
science has loosely divided the five living generations into the
'builders' (or matures/veterans), 'baby boomers' and the
respective generations 'X', 'Y' and 'Z'.
Doctors, disease and James Joyce
Robert M Kaplan
The Irish author James Joyce is regarded as the greatest
modernist writer of his time. His works, notably The Dead, A
Portrait of the Artist as a Young Man, Ulysses and Finnegans
Wake - are intensely autobiographic including meticulous
descriptions of illness and states of health
Assessing hypogonadism in men - How helpful are current testosterone assays?
Julie D Newman, James C G Doery
In recent years, hormone therapy (HT) with testosterone has
gained increasing prominence and popularity in aging men. It
has a demonstrated ability to decrease fat mass and increase
lean body mass in men with initial 'low' testosterone levels.
Prevalence of psychological distress in university students - Implications for service delivery
Helen M Stallman
Mental health problems are one of the leading causes of disability in
Australia. General practitioners are often the first and only point of
service for people suffering mental health problems, while many do
not access services at all.
GPs understanding of how depression affects gay and HIV positive men
Christy Newman, Susan Kippax, Limin Mao, Deborah Saltman AM, Michael Kidd
This article explores qualitative descriptions of how a group of
Australian general practitioners understand the relationship between
depression, gender, and sexuality in their gay male patients, including
gay men who are HIV negative and those who are HIV positive.
The GreenClinic pilot - Educational intervention for environmentally sustainable general practice
Alison Fogarty, Grant Blashki, Elle Morrell, Graeme Horton
GreenClinic was a pilot educational program developed by the
Australian Conservation Foundation and Doctors for the Environment
Australia. The program ran between October 2006 and March 2007
with the aim of informing and encouraging general practitioners to
employ more environmentally sustainable practices in their clinics.
GPs as medical educators - An Australian train-the-trainer program
Sanjiva S Wijesinha, Catherine N Kirby, Caroline Tasker, Leon Piterman
General practitioners undertake ongoing education in many areas. A
train-the-trainer (TTT) approach may be an option for facilitation of
continuing professional development (CPD) activities.
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