Australian Family Physician July 2007 - Arrhythmias
Vol 36, (7) 491–576
The theme for the July issue of AFP
is arrhythmias. This month's articles include emergency management of
acute cardiac arrhythmias, pacemaker therapies, catheter ablation
techniques, management of atrial fibrillation, pharmacologic management
of tachycardia and thyroid lumps and bumps.
Web of Knowledge
Kath O'Connor
The Australian Family Physician editorial office is abuzz with excitement. Thomson Scientific has selected AFP for coverage in their Science Citation Index Expanded
(SCIE).
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
Atrial fibrillation in Australian general practice
Salma Fahridin, Janice Charles, Graeme Miller
The BEACH program is a continuous national study of general practice activity in Australia. This article provides an analysis of the encounters where atrial fibrillation was managed from April 2004 to March 2006. This synopsis provides a backdrop against which articles in this issue of Australian Family Physician can be further considered.
Emergency management of acute cardiac arrhythmias
Hugh JM Grantham
Anything other than normal sinus rhythm can be classified as an arrhythmia. However not all arrhythmias need
acute intervention.
Pharmacologic management of tachycardia
Peter M Kistler, Manoj N Obeyesekere
Cardiac arrhythmias may present with palpitations, chest pain, shortness of breath, dizziness and syncope. Diagnosis may be complicated by an inability to document the arrhythmia particularly when symptoms are infrequent and short lived.
Management of atrial fibrillation
Peter M Kistler, Jonathon Habersberger
Atrial fibrillation affects a significant proportion of the Australian population, affecting approximately 5% of people over
65 years of age.
Catheter ablation techniques in managing arrhythmias
Peter M Kistler
Pharmacological management of arrythmias is not curative, is sometimes difficult, and may be associated with significant morbidity.
Pacemaker therapies in cardiology
Geoffrey Toogood
Since the first cardiac pacemaker was inserted in 1958 vast changes have occurred in both the technology of the devices and their indications.
Integrative medicine and arrhythmias
Avni Sali, Luis Vitetta
Abnormalities of cardiac arrhythmias and conduction can be lethal (sudden cardiac death and stroke) or symptomatic (dizziness or palpitations). This article reviews the role of nutrients in the treatment of arrhythmias.
Colchicine - What is its place in the management of acute gout?
Tania Winzenberg, Jane Zochling
This series of articles facilitated by the Cochrane Musculoskeletal Group (CMSG) aims to place the findings of recent Cochrane musculoskeletal reviews in a context immediately relevant to general practitioners. This article considers the place of colchicine in the management of acute gout.
Thyroid lumps and bumps
Meagan Brennan, James French
Thyroid nodules are extremely common, with 7% of adults having palpable nodules and up to 50% having nodules visible on ultrasound. About 5% of thyroid nodules are malignant. Thyroid nodules may occur as isolated, often incidental findings, or may be associated with systemic features of thyrotoxicosis or hypothyroidism. They may be solitary or may present as a dominant nodule in a multinodular goitre.
How I use the internet
Farooq Qureshi
Ms MC, aged 22 years, has come to ask my advice regarding the discontinuation of warfarin after an episode of deep vein thrombosis (DVT) 3 months ago. She is a hockey player and keen to cease her anticoagulant medication, but is concerned about the recurrence of DVT.
Actinic keratoses
Alvin Chia, Gilberto Moreno, Adrian Lim, Stephen Shumack
Actinic keratoses (AK) commonly occur in the caucasian population living in environments of high levels of sun exposure, and are considered to be a marker for chronic sun damage. This article reviews the epidemiology, pathogenesis, and current debate on AK as precancerous lesions. The various treatment options for AK, including combination therapy, are also discussed.
Skin and Cushing syndrome
Patrick J Phillips, Warren Weightman
'I feel like a traffic light stuck on red. My friends ask me if I'm having hot flushes but this isn't flushes, it's permanent and I'm still having periods.' Carol is describing her facial appearance. She is 42 years of age, has had trouble controlling her weight all her life and has gained 10 kg over the past 2-3 years.
Type 2 diabetes mellitus - Guidelines for initiating insulin therapy
Bu Beng Yeap
Insulin is often indicated for patients with suboptimally controlled type 2 diabetes mellitus, despite lifestyle modification
and oral antidiabetic agents.
Painful nodules on the fingers and toes
Keng Yin Loh
Case study: A 25 year old college student with a past history of congenital heart disease presented with high grade fever and palpitations. He complained of painful red nodules on his finger pulp and his toes.
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. Answers to this clinical challenge will be published next month, and are available immediately following successful completion online. Check clinical challenge online for this month's completion date.
Just one opioid prescription?
Colin Malcolm Brown, Geoff Anderson
It can be said that chronic pain patients comprise a large part of general practice. It would be accepted that general practitioners treat pain to the best of their abilities and, where indicated, use opioids for this purpose.
Publishing in peer review journals - Criteria for success
Ellen McIntyre, Sarah Louise Eckermann, Miriam Keane, Anne Magarey, Leigh Roeger
Peer review papers contribute to the body of knowledge that forms the evidence on which best practice is based. Publishing facilitates knowledge sharing, thereby enabling individuals and organisations to contribute to the body of evidence on best practice.
Failure to diagnose: long QT syndrome
Sara Bird
This article examines a medical negligence claim involving an allegation of failure to perform an electrocardiogram,
leading to a delay in diagnosis of long QT syndrome.
Refugee youth - Immunisation status and GP attendance
Paul Thomas, Bronwyn Milne, Shanti Raman, Smita Shah
We describe reported immunisation status and primary health care utilisation in refugee and migrant young people in
western Sydney, New South Wales.
Macrocytosis - An Australian general practice perspective
Stella Elisabeth Rumsey, Bevan Hokin, Parker John Magin, Dimity Pond
Clinicians' approaches to identifying and investigating red blood cell macrocytosis are variable. There is little literature on the Australian primary care approach.
Clinical usefulness of 'vocal fremitus' and 'vocal resonance' - GP perceptions and practice
Kyaw San Hla
Assessment of vocal fremitus (VF) and vocal resonance (VR) (whereby vocal vibrations are felt or heard during a clinical examination) is an established art of physical examination of the respiratory system. Textbooks on clinical examination include these procedures as part of the standard method.
Skin cancer in general practice - Impact of an early detection campaign
Barbara Reen, Kay Coppa, David P Smith
In the summer of 2004-2005, The Cancer Council NSW conducted a skin cancer early detection campaign encouraging people aged over 50 years to check their own skin and see a doctor as soon as possible if they noticed any suspicious or changing spots.
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