Australian Family Physician November 2005 - Renal Disease
Vol 34, (11): 898 - 992.
The theme for the November issue of AFP is Renal
Disease. Articles include glomerulonephritis, chronic kidney disease,
automated reporting of GFR, diabetic nephropathy and childhood urinary
conditions.
Understanding...
Steve Trumble
It's rare to hear a professional educator using the words: 'My grandfather planted the mango tree that I was born under'. That is the image, however, with which delegates at this year's RACGP Annual Scientific Convention were presented.
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
Management of renal problems in Australian general practice
Janice Charles, Graeme Miller, Anthea Ng
The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of consultations involving the management of renal problems.
Glomerulonephritis - Management in general practice
Nicole M Isbel
Glomerulonephritis (GN) is an important cause of both acute and chronic kidney disease, however the diagnosis can be difficult due to the variability of presenting features.
Chronic kidney disease - Management
David W Johnson, Tim Usherwood
Chronic kidney disease (CKD), defined as a glomerular filtration rate less than 60 mL/min/1.73 m2 and/or evidence of kidney damage for a period of at least 3 months, is an increasingly common, serious and under-recognised condition. A recent population study demonstrated that one in every 6 Australian adults has CKD (of which the vast majority are unaware).
Automated reporting of GFR - Coming soon to a laboratory near you!
David W Johnson, Tim Usherwood
Serum creatinine concentration is an unreliable and insensitive marker of chronic kidney disease (CKD). To improve CKD detection, Australasian guidelines have recently recommended that laboratories calculate and report an estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula with every request for serum creatinine concentration
Diabetic nephropathy - How might we prevent, retard, or cope with it?
Kathy Nicholls
Working life for most Australian doctors in adult practice is heavily involved with diabetes and its complications. The development of nephropathy is strongly intertwined with that of retinopathy, neuropathy and vasculopathy, and with reduced life duration and quality.
Childhood urinary conditions
Steven J McTaggart
Urinary abnormalities are commonly detected in children and can be due to a wide range of conditions. This article provides an overview of common urinary abnormalities presenting in childhood to assist general practitioners in planning further investigation and management.
Proteinuria
CARI guidelines
The CARI guidelines initiative is an Australian evidence based project that aims to provide high quality, evidence based clinical practice guidelines for the management of all stages of kidney disease.
Cardiovascular issues of COX-2 inhibitors and NSAIDs
Melinda Wong, Phil Chowienczyk, Bruce Kirkham
Rofecoxib (Vioxx) was withdrawn from the market because of increased death from cardiovascular (CV) events. Other selective cyclooxygenase-2 (COX-2) inhibitors and traditional nonsteroidal anti-inflammatory drugs (NSAIDs) may share this risk, but to what extent is unclear.
Ductal carcinoma in situ - Management
Kirsty Stuart, John Boyages, Meagan Brennan, Owen Ung
This ninth article in our series on breast disease will focus on ductal carcinoma in situ of the breast - a proliferation of potentially malignant cells within the lumen of the ductal system.
Patient Education: Ductal carcinoma in situ
The NSW Breast Cancer Institute
Ductal carcinoma in situ (DCIS) is a change in the cells that line the milk ducts of the breast. When DCIS develops, the cells that line the ducts grow in a manner that is not controlled; they heap up but do not move outside the duct.
The ESSENCE of health care
Craig Hassed
As community attitudes develop, health care costs spiral, and evidence accumulates, the health care system is steadily recognising the importance of moving toward more holistic and wellness based models. Such models have been shown to reduce costs and lead to better therapeutic outcomes.
Diabetes and the skin - Part 2
Pat Phillips,Warren Weightman
Case history - Susan. Susan aged 22 years, has had type 1 diabetes since the age of 9. She and her parents had some difficult times during Susan's adolescence with multiple hospital admissions for diabetic ketoacidosis and hypoglycaemia.
Brain Teaser: Groin rash
Jerzy K Pawlak, TJ Kroczak
Case history
A man, 42 years of age, presented with a rash in his groin area. Examination revealed plaques with scaling sharp margins with occasional pustules and central clearing.
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.
The RACGP Examination - Changes from 1999-2004
Amy Jasper, John Hinchy, Kaye Atkinson, Morton Rawlin
Promoting and maintaining the quality and standards of Australian general practice on behalf of the profession and the Australian community is The Royal Australian College of General Practitioners' central activity.
Failure to diagnose: renal disease
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. This article discusses a claim arising out of the failure to diagnose glomerulonephritis and examines the legal concepts of causation and loss of chance.
The skill of the consultation - Some observations on how not to do it
Max Kamien
Some observations on how not to do it
I have recently been an 'expert witness' in the district court, an examiner for the RACGP, and an observer of medical practice in San Francisco. In the first situation I was being grilled; in the second I was doing the grilling. The last situation is more gentle than the first, but both are artificial situations with potential for error.
Research - getting started
Daisy Tan, Shalini Saxena
For most of us, research is a word remote from our everyday lives. Our first introduction to research in general practice kicked off rather remotely at the Registrar Research Workshop held in Broken Hill, New South Wales.
My novice research experience
Jan Gartlan In medical school I was not interested in research, and just concentrated on passing exams. 'Evidence based medicine' (EBM) was the new buzz phrase, but was not a big part of the curriculum.
Book Reviews
Book Reviews of 'Clinical Cases for General Practice Exams' and 'Coming To Life'
As a general practice registrar, I jumped at the opportunity to review a book that aims to assist doctors in their preparation for the clinical component of the RACGP Examination.
Screening for social anxiety - A pilot study
Ian Wilson
Social anxiety disorder (SAD) is characterised by fear of negative evaluation.1 Sufferers become anxious when they perceive themselves as the centre of attention, finding it difficult to speak in public, attend social events and deal with authority figures.
Depression after cardiac hospitalisation - The Identifying Depression as a Comorbid Condition (IDACC) study
Victoria Wade, Frida Cheok, Geoff Schrader, Ann-Louise Hordacre, Julie Marker
The Identifying Depression as a Comorbid Condition (IDACC) study aimed to identify depressive symptoms in hospitalised cardiac patients and support management of depression in general practice.
Depression associated with combined oral contraceptives - A pilot study
Jayashri Kulkarni, Jacynth Liew, Kathryn A Garland
Over one-quarter (27%) of Australian women aged 18-49 years use oral contraception (47% in women aged 20-24 years).1 They are the primary method of choice for 40% of women (71% aged 20-24 years).1
Patient recruitment for a practice nurse study
Diann Eley, Desley Hegney, Elizabeth Patterson
General practice nurses (PNs) can support better management of chronic diseases. Internationally, nurse managed clinics are used in coordinating and managing chronic illness and are more effective then traditional care.1-4 They have also been used in Australia in heart failure5 and diabetes6 management.