Australian Family Physician December 2004 - Abdominal Pain
Vol 33(12):961-1056
In December 2004 we look at the issue of abdominal pain.
The issue includes articles on assessment and management of chronic
pelvic pain in women, biliary pain, colonic diverticular disease and
current concepts in management gastro-oesophageal reflux disease. Also
included are articles on prescription of SSRIs to adolescents, a
medicolegal case study on failure to diagnose appendicitis and
recruitment in primary care research.
Lessons on prescribing and drug safety from the withdrawal of rofecoxib
Mark Nelson, Flavia Cicuttini
Merck Sharp and Dohme (Australia)'s recent recall of rofecoxib not only shook the company's financial foundations, but also the faith that doctors and patients had in the safety of modern pharmaceutical medicines.
Presentations of abdominal pain in Australian general practice
AIHW General Practice Statistics and Classification Unit
The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of the consultations in general practice involving a patient presentation of abdominal pain.
Chronic pelvic pain in women - assessment and management
Marie-Louise Dick
Chronic pelvic pain (CPP) is a common condition that poses diagnostic and management challenges for doctors and their patients.
Biliary pain
Sean Mackay, Peter Dillane
Gallstones are a common cause of abdominal pain. Gallstones are present in 20% of women and 8% of men, but might not cause symptoms.
Colonic diverticular disease
Malcolm Steel
Diverticular disease of the colon is common and the spectrum is broad, ranging from asymptomatic diverticulosis to perforation and massive haemorrhage requiring emergency colectomy.
Gastro-oesophageal reflux disease - current concepts in management
Leon Piterman, Mark Nelson, John Dent
Gastro-oesophageal reflux disease (GORD) is defined as recurring symptoms or mucosal damage resulting from exposure of the distal oesophagus to reflux of gastric contents. In the past, GORD has been managed with a 'step up' approach beginning with antacids and progressing to H2 antagonists or proton pump inhibitors (PPI) as required.
Referring to a child psychiatrist
Richard England
Child psychiatry is a highly specialised practice and many general practitioners are uncertain how to manage a child who might require such intervention.
Common psychological disorders in childhood
Lisa Ciechomski, Grant Blashki, Bruce Tonge
Children with anxiety, attention deficit hyperactivity, and disruptive behaviour disorders are frequently seen in general practice and often present with somatic complaints, comorbidity and complex family relationships.
When should GPs prescribe SSRIs for adolescent depression?
Leanne Rowe, Bruce Tonge, Glenn Melvin
Depression is a common disorder, increasing in prevalence in all ages. Research on the effective treatment of adolescent depression is lacking. Concern is growing about the recent increase in general practitioner prescribing of antidepressants and reports that selective serotonin reuptake inhibitors (SSRIs) may precipitate suicidal behaviour in adolescents.
Acute pain and opioid seeking behaviour
Moira G Sim, Gary K Hulse, Eric Khong
This is the ninth and final article in a series of case files from general practice that explore treatment issues around substance use and commonly encountered general practice presentations.
Rehabilitation in Guillian Barre syndrome
Fary Khan
Guillian Barre syndrome (GBS) is the most common form of neuromuscular paralysis. It mostly affects young people and can cause long term residual disability.
Brain teaser: Choroidal melanoma
Jerzy K Pawlak
A 51 year old woman with a known choroidal melanoma (diagnosed 5 years earlier) presented with marked visual loss to her right eye due to a massive retinal haemorrhage.
Clinical challenge
Jenni Parsons
Questions for this month's clinical challenge are based on theme articles in this issue.
Pregnancy and ocular complications
Chris Hodge, Timothy Roberts
Sarah, aged 32 years, attends for a pre-pregnancy health check. She is generally healthy but has a strong family history of diabetes.
Failure to diagnose: appendicitis
Sara Bird
While appendicitis is a relatively infrequent reason for presentation in the general practice setting, claims against general practitioners alleging a failure to diagnose appendicitis are not uncommon. This article examines some of the factors involved in the delay in diagnosis of appendicitis and outlines some risk management strategies for GPs.
Educating the good GP - the 33rd William Arnold Conolly Oration
Max Kamien
This is an edited version of the oration delivered at the Annual Scientific Convention in Melbourne, 30 September 2004
The National Rural Faculty Bursary Essay - To promote remote: a positive approach to rural general practice
Ken Liu
Australian Family Physician is proud to publish the winning essay in the inaugural National Rural Faculty Bursary.
Approaching the future of general practice - how systems thinking might help
Joachim Sturmberg
General practice in Australia is facing an uncertain future leaving many general practitioners to wonder if it is still worthwhile to stay in practice. At the 2003 Royal Australian College of General Practitioners (RACGP) Convention Forum, GPs identified retention of the workforce to be of primary importance to their profession.
Recruitment in primary care research
Mark Nelson
Once you have the tools to conduct research, three major impediments stand between you and answering your research question: funding, ethics and recruitment.
Haemochromatosis - a future focus for continuing education in general practice
Megan Young, Marie-Louise Dick, Peter O'Rourke
This study aimed to assess the educational needs of general practitioners with regards to the diagnosis and management of hereditary haemochromatosis.
Reactions to adverse events among Australian and Norwegian doctors
Ivar J Aaraas, Barbara Jones, Tarun Sen Gupta
Honest disclosure is emerging as the ideal approach toward adverse events, in contrast to the previous approach of concealing them.
