AFP - Australian Family Physician

Australian Family Physician September - Hands and feet

Vol 38, (9) 657 - 752

Australian Family
Physician September - Hands and feet

The theme for the September issue of AFP is Hands and feet. This month's articles include Carpal tunnel syndrome, Sweaty, smelly hands and feet, Persistent foot pain, My hands shake – classification and treatment of tremor & Carpal tunnel syndrome – can it be a work related condition?

From the mind to the hands

Carolyn O’Shea
There are times when the unseen becomes seen. Two recent events highlighted this for me. The first was an evening telephone call about a 10 month old with a rash, asking: ’Could be measles?’ The second was a patient asking if I was worried about her blood sugar levels (BSL), which had become elevated in the past month.

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.

Carpal tunnel syndrome

Janice Charles, Salma Fahridin, Helena Britt
Between April 2000 and March 2009, carpal tunnel syndrome was managed 1700 times among 885 400 encounters in the BEACH program (Bettering the Evaluation and Care of Health) at a rate of two contacts per 1000 encounters. This extrapolates to about 195 000 contacts annually across Australia.

Sweaty, smelly hands and feet

Catherine E Scarff
Palmoplantar hyperhidrosis, with or without offensive odour (bromhidrosis), can have a devastating effect on a patient’s life. The condition usually begins in childhood or adolescence and can impact greatly on education, career choices and social development.

Persistent foot pain

Peter Baquie
Persistent foot pain can present difficulties in both diagnosis and management.

My hands shake - Classification and treatment of tremor

Dharshana Sirisena, David R Williams
Tremor is the most common movement disorder in the community and is defined as a rhythmic oscillatory movement of a body part. Classification of tremors is helpful for accurate diagnosis, prognosis and treatment. Most tremors can be separated according to the state in which they occur, that is, during rest or action. Other clinical features, including frequency, amplitude and associated neurological signs, further define tremor.

Carpal tunnel syndrome - Can it be a work related condition?

W Bruce Conolly AM, John H McKessar
Carpal tunnel syndrome is one of the most common hand conditions seen in clinical practice. Many in the workforce, both male and female, will develop carpal tunnel syndrome and many will claim that their workplace has caused their condition.

Motherhood and mental illness - Part 2 – management and medications

Jacqueline Frayne, Thinh Nguyen, Suzanna Allen, Jonathan Rampono
General practitioners see many women who may be on medication for the management of their mental illness before, during, or after a pregnancy.

Type 1 diabetes - Still the commonest form of diabetes in children

Matthew A Sabin, Fergus J Cameron, George A Werther
Obesity is rife within the community, and associated conditions such as type 2 diabetes and cardiovascular disease threaten the future health of our children. While type 2 diabetes has been the focus of much media attention, type 1 diabetes mellitus remains the commonest form of newly diagnosed diabetes in childhood.

Children get type 2 diabetes too

Jessica Phillips, Patrick J Phillips
In recent years there has been a worldwide increase in the number of diagnoses of type 2 diabetes mellitus (T2DM) in children and adolescents. This has become a major focus for the work of the International Diabetes Federation. In Australia, most children and adolescents with diabetes have type 1 diabetes. However, more young Australians are developing T2DM.

Food allergy and intolerance

Linda Hodge, Anne Swain, Kim Faulkner-Hogg
This article forms part of a series looking at the relationship between diet and good health, and the role of the dietitian in the primary health care team. This article discusses adverse reactions to food including IgE mediated food allergy and nonimmunological food reactions. Coeliac disease, a T-cell mediated reaction to gluten, will be discussed in the next article in this series.

Lessons from the past - Historical trends in the RACGP examination

Russell Jones, Morton Rawlin, Kaye Atkinson, Jan Radford, Leon Au, Dene Egglestone
The Royal Australian College of General Practitioners (RACGP) examination has been the major route to Fellowship of the RACGP for 50 years.

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.

AFP in Practice

AFP in Practice questions are designed to get you started in a small group learning (SGL) activity in your practice or with colleagues. Requirements to earn 40 Category 1 CPD points for a SGL activity are: minimum of four and a maximum of 10 people, minimum of 8 hours of discussion in a year, and at least two GPs.

Failure to diagnose: tendon injuries

Sara Bird
The patient, 18 years of age, injured her right middle finger while playing netball on 1 June 2007. She presented to her general practitioner the following day.

Bushfires and human health in a changing environment

Fay H Johnston
Bushfires are an integral part of the Australian environment. While the immediate health impacts of these fires can be devastatingly obvious, there are many other serious aspects of bushfires that remain less well understood.

Preparing Australian medical students for climate change

Evelyn I Hamel Green, Grant Blashki, Helen L Berry, David Harley, Graeme Horton, Gillian Hall
Climate change is now recognised as a global public health problem and the future medical workforce will be working during a period when the health impacts of climate change are likely to be significant.

The Royal Australian College of General Practitioners