Australian Family Physician June 2003 - Men's Health
Vol 32 (6):386-481
Our June 2003 issue addresses many issues related to Men's
Health including the PSA debate, health promotion, male reproductive
health, erectile dysfunction and andrology.
Editorial: Men's health
Jenni Parsons
Concerns about men's health and wellbeing have come to the fore in many areas over recent years. In addition to the well documented lower life expectancy and increased cardiovascular mortality, concerns have arisen about the educational achievements of boys, high youth male suicide rates and high rates of health risk behaviour in men.
The PSA debate
Mark Harris, Mark Frydenberg, Anthony J Costello, Max Gardner, Paul Nisselle
Five prominent Australian's discuss the debate around prostate specific antigen.
Promoting men's health
Robert H Hall
In the past men have declined to follow health authority recommendations to go to their general practitioner for preventive health checks.
Male reproductive health - what is the GP's role?
Sanjiva Wijesinha
Male reproductive health issues cause considerable morbidity, as well as mortality, in our community. Although 'women's health' has been a separate and important subject of medical interest for many years, it is only recently that the study of male health, andrology, has gained impetus as an area of research and clinical importance.
Erectile dysfunction - a guide to diagnosis and management
Paul Arduca
Erectile dysfunction (ED) is a common age related problem best managed in general practice. The incidence of ED will thus increase as men live longer. It is only in the past decade that the pathophysiology of ED has been well understood.
Testosterone defiency in men
Carolyn A Allan, Robert I McLachlan
Testosterone deficiency (hypoandrogenism) is the commonest hormonal deficiency in men but its clinical presentation may be subtle and its diagnosis overlooked unless actively considered.
Patient Education: Prostate cancer
Mark Frydenberg
Prostate cancer, which occurs mainly in men over the age of 50 years, is a condition where cells within the prostate grow and divide abnormally and a tumour grows in the prostate. Unlike most other cancers in the body, small areas of cancer cells in the prostate are common in many men.
Patient Education: PSA - Pros and cons
Melina Gattellari, Jeanette E Ward
Some doctors advise men to have regular PSA tests from about 50 years of age until they are 70, even if they have no symptoms of prostate cancer.
The type 2 tablet
Patrick Phillips, Jody Braddon
Diabesity - the association of type 2 diabetes and obesity - is a major public health problem worldwide and is increasing dramatically in Australia. The abnormalities associated with diabetes, the 'type 2 diabetes syndrome' are cardiovascular risk factors and increased cardiovascular events.
Choosing a drug from within a class
Sepehr Shakib, Alison George
In the last issue of Australian Family Physician, we discussed how considerations of efficacy, safety, suitability and cost help us choose between different drug classes for a particular indication. Not surprisingly similar considerations are involved when choosing between different drugs within the same class.
'For men only' - A mental health prompt list in primary care
Suzanne Brownhill, Kay Wilhelm, Gregory Eliovson, Merilyn Waterhouse
Barriers to detecting symptoms of depression in male patients in primary care include patients' reticence to self disclose and doctors' failing to ask questions that tap into their patient's emotional distress.
Nicorandil induced oral ulceration
C S Farah, L M Carey, N W Savage
Many drugs cause oral ulcerative lesions, including antihypertensive drugs such as angiotensin converting enzyme inhibitors and angiotensin 2 receptor antagonists, antimetabolites, and cytotoxic drugs. So too does nicorandil, a new class of potassium channel activator used for angina pectoris.
Brain teaser: Ear discomfort
Steve Trumble, Craig Blandy
This 48 year old Vietnamese man presented to his GP complaining of discomfort and decreased acuity in his right ear. The symptoms had come suddenly, two days after he returned to Australia from a visit to his parents in a remote part of rural Vietnam. While there, he sought traditional therapies for his osteoarthritis. The appearance of the pinna is a shown. The external auditory meatus was completely obstructed by cerumen.
Eye series: Increasing visual disturbances
Chris Hodge, David McKay
During her consultation a 78 year old patient describes an increasing problem with her reading. She requires more light to read properly and has noticed, with great frustration, that she often seems to skip letters or entire words. She also complains of difficulty adjusting to dimly lit rooms when coming in from outside.
Clinical challenge
Now gain 4 CPD points per issue
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.
GP attitudes to male reproductive and sexual health education and promotion
Carolyn Poljski, Caroline Tasker, Catherine Andrews, Sanjiva Wijesinha, Leon Piterman, David de Kretser
Despite evidence that men believe the general practitioner is an appropriate person to assist with sexual health issues, few men actually access medical practitioners for such assistance.
Andrology Australia
Carol A Holden, David de Kretser
In recent years, the state of men's health in Australia has received greater attention. This is primarily as a result of statistical comparisons between the health of men compared to that of women with reports of comparatively lower life expectancy and higher risk of more serious health problems such as coronary heart disease and cancer.
Research: Asthma Action Plan
H John Fardy
The article by Kable et al (page 470 this issue) demonstrates that general practitioners are not totally comfortable with writing Asthma Action Plans (AAPs) for patient's with asthma. The evidence from a Cochrane review has demonstrated that written AAPs, regular medical review and self management education improves the outcome for adults with asthma.
Research: Are the components of the Asthma Action Plan important in managing childhood asthma?
Sheree Kable, Richard Henry, Malcolm Ireland, Jill Cockburn
To gauge the importance and relevance placed by general practitioners on components of the National Asthma Campaign's 'Six step' Asthma Management Plan for childhood asthma.
Research: Stress, personal and educational problems in vocational training
Sarah L Larkins, Margaret Spillman, John W Vanlint, Richard B Hays
Australian general practitioners suffer from high levels of stress, but the incidence among GP registrars during vocational training is less well described.
Research: Apart from Medicare what other work do GPs do?
Deborah Field, Alison M Ward, Derrick G Lopez
Although Australian general practitioners are increasingly being encouraged to perform more non-Medicare funded work, little is known about the its extent or nature.