Australian Family Physician August 2005 - Headache
Vol 34,(8):610 - 704
The theme for the August issue of
AFP is Headache. Articles for this month include diagnosing headache,
neck related causes of headache, atypical facial pain and migraine and
tension headache.
If pain persists...
Steve Trumble
There are few more infectious diseases in general practice than the headache; vivid descriptions of 'bands of steel wrapped around the temples' or 'stabbing pains through the left eye and into the brain' are virtually guaranteed to induce similar symptomatology in the clinician.
Presentations of headache in Australian general practice
Janice Charles, Anthea Ng, Helena Britt
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 'headache'. Patient reasons for encounter specified as migraine, cluster, vascular or tension headaches were not included in the analysis.
Diagnosing headache
Jacques Joubert
A systematic approach to the diagnosis of primary and secondary headache disorders requires the measurement of the frequency and the duration of headache.
Migraine - Diagnosis and treatment
Jacques Joubert
Migraine is a genetically determined recurrent pain syndrome accompanied by neurological and gastrointestinal features, involving interaction of external triggers and internal pathophysiology and the cause of considerable disability to sufferers.
Neck related causes of headache
Steve Jensen
Headaches emanating from sources in the cervical spine, so-called cervicogenic headache (CGH), are much more common than is usually thought by practitioners not trained in musculoskeletal medicine.
Atypical facial pain - A diagnostic challenge
Geoffrey Quail
Facial pain is a relatively frequent cause of presentation to both general medical and dental practitioners. Although in the vast majority of cases the cause is dental disease or tempero-mandibular joint dysfunction, the remaining patients are often difficult to diagnose and treat.
Migraine and tension headache - A complementary and alternative medicine approach
Michelle Woolhouse
Migraine and tension headache are common - affecting up to 10% and 40% of the Australian population respectively - and result in significant reduction in social activities and work capacity for sufferers.
Giant cell arteritis - Presenting as stroke, transient ischaemic attack and dementia
Olivia C Morris and Patrick Lockie
Stroke and multi-infarct dementia are most commonly caused by atherosclerotic disease and are irreversible. Stroke and dementia associated with giant cell arteritis are rare but important to recognise as they may be reversible if diagnosed and treated promptly.
Breast cancer - New and emerging technologies for diagnosis and management
Nehmat Houssami, James French, Meagan Brennan and Verity Ahern
Part six of this series discusses established and emerging technologies in breast cancer care, with an emphasis on technologies in diagnosis and treatment supported by evidence. These include percutaneous core biopsy techniques and breast imaging in diagnosis.
A1C - frequently asked questions
Patrick J Phillips
This article attempts to answer frequently asked questions concerning A1C, and provide guidance on how to make best use of A1C measurements in clinical practice.
Managing skin cancer - 23 golden rules
Anthony J Dixon and Richard Scott Hall
From their collective experience in Australia and the USA, dermasurgeons Anthony Dixon and Scott Hall have compiled a list of 'golden rules' for general practitioners to help reduce errors and problems with skin cancer management.
Hip fracture - Challenges in prevention and management
Christopher Beer and Emma Giles
Hip fracture is a common 'geriatric syndrome', presenting general practitioners with complex challenges in prevention and management. Hip fracture entails a high cost to both the individual and the community.
Failure to diagnose: subarachnoid haemorrhage
Sara Bird
Case histories are based on actual medical negligence claims, however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved.
At the stroke of midnight...
Stewart Jackel
In order to help us better understand our patients' experiences, Australian Family Physician is pleased to introduce the fourth in a series of articles written by people who are willing to share their stories.
Computerisation of records - Using nonmedical staff for past history summarisation
Adrian Elliot-Smith
An important component of a good medical record is a succinct history of key medical events for the patient.
Complementary and alternative medicine
Vicki Kotsirilos
This second article in a 2 part series exploring the issues around the use of complementary and alternative medicine (CAM) in the Australian general practice context gives an overview of the available evidence for the benefits and risks of CAM, and how to access that evidence.
Pain and numbness in the hands
Jerzy K Pawlak and TJ Kroczak
Case History
A woman, 76 years of age, presented with a long history of intermittent pain and numbness of both hands occurring most frequently during the night, and often relieved by rubbing and hanging the arms out of bed.
Clinical Challenge
Jenni Parsons
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.
Australian women's experience with Implanon
Edith Weisberg and Ian Fraser
Six hundred and fifty-one women were recruited at the time of implant insertion and asked to complete a self administered questionnaire immediately after insertion and at 3, 6 and 12 months after insertion.
Changes in HT prescriptions in Australia since 1992
Nathan J Coombs and John Boyages
Hormone therapy (HT) use in Australia and America increased from 1992. However, recent studies have highlighted its risks for breast and endometrial cancer, thromboembolic disorders and cardiovascular disease.3-6 One of these studies (the Women's Health Initiative [WHI] trial) was terminated prematurely because of excess adverse cardiovascular events and invasive breast cancer with oestrogen and progestogen.
Recognition of physical and psychological symptoms - No influence of GP demographic factors
The MaGPIe Research Group
Aim: To describe the relationship between general practitioner demographic factors and the recognition of psychological and physical symptoms in consultation.
Making use of waiting time - An organisational tool for encouraging health promotion in rural general practice
Catherine Harding, Tony Hobbs and Michelle Pendrick
General practitioners are in an ideal position to encourage health promotion activities: the community sees GPs as a credible source of health information; they see a high percentage of the population; and can alter patients' lifestyle behaviour. However they are often criticised for not providing this advice.