Australian Family Physician March - Chronic respiratory disease
Vol 39, (3) 81 - 176
The theme for the March issue of AFP is chronic respiratory
disease.
This month's articles include fitness to fly, chronic lung disease,
COPD, interstitial lung disease, poliomyelitis, coronary heart disease
and primary care nursing workforce.
COPD
Janice Charles, Helena Britt, Salma Fahridin
The BEACH data confirmed that patients managed for COPD were
significantly more likely than average to be male.
Investigation in chronic lung disease - Too much, too little, just right!
Graham Simpson
Lung problems are common in general practice. History
and examination are invaluable; however considered
selection of investigations can assist the clinician to reach
a diagnosis.
COPD - Diagnosis, management and the role of the GP
Julia Walters
Chronic obstructive pulmonary disease (COPD) is a
common condition characterised by breathlessness, cough
and sputum production.
Interstitial lung disease - An approach to diagnosis and management
James Ward, Christine McDonald
Interstitial lung disease (ILD) is a term that describes a
diverse range of lung conditions, which are an important
cause of morbidity and mortality in all age groups.
Patients with lung disease - Fit to fly?
Leigh M Seccombe, Matthew J Peters
Commercial air travel is cheap and accessible. Many
patients living ever better lives despite chronic lung
disease wish to, and do, fly. Statistics tell us that
misadventure is rare and that flight must be safe for the
majority of people.
Is it all in the act?
Carolyn O’Shea
Struggling to breathe is one of the most
distressing symptoms to have, or to
witness. Treating acute shortness of
breath is rewarding for both the patient
and the doctor.
Worth fighting for - Advocacy for general practice research
Tania Winzenberg
General practitioners are well aware
of the increasing burden being placed
on the health care system by the rising
prevalence of chronic diseases - they
see its effects every day.
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
Charcot osteoarthropathy of the foot
Byron M Perrin, Marcus J Gardner, Anwar Suhaimi, David Murphy
One of the most devastating complications of diabetes is Charcot osteoarthropathy.
It can lead to gross structural deformities of the foot and ankle, and subsequent skin
ulceration and lower limb amputation from soft tissue or bony infection.
Painful nail lesions
Sergio Vano-Galvan, Teresa Garate, Dong-Lai Ma, Pedro Jaén
A man, 58 years of age, presented with a 4 year history of painful lesions of his nails.
His previous history included hypertension, diabetes mellitus and hyperlipidaemia.
Poliomyelitis - Prevention in travellers
Cora A Mayer, Amy A Neilson
This article is the second in a series providing a summary of prevention strategies and
vaccination for infections that may be acquired by travellers.
Coronary heart disease – the benefits of exercise
Frances M Wise
Cardiovascular disease, coronary heart disease (CHD) and stroke kill more people than any other disease. In Australia, CHD accounts for 17% of all deaths.
Chronic urticaria – assessment and treatment
Suran Fernando, Andrew Broadfoot
Urticaria is characterised by the rapid appearance of transient, pruritic skin swellings (wheals) of variable size surrounded by reflex erythema lasting less than 24 hours and leaving no residual skin changes. Urticaria is a common condition, affecting up to 20% of the population.
Impact of structured education and self management on rural asthma outcomes
Ann Larson, Jacki Ward, Leanne Ross, David Whyatt,
Martin Weatherston, Louis Landau
Asthma is an important health priority
affecting around 11% of the population.
The majority of patients with asthma
seen in general practice are reported to
have uncontrolled symptoms and poor
knowledge and skills in their asthma
management, medication use and device
technique.
Children in the ACT with asthma – are they taking preventer medication according to guidelines?
Maree Brown, Christine Phillips, Karen Ciszek, Debbie Burton, Robyn Attewell, Tim McDonald, Kathryn Dwan
In Australia, over 3.9 million people have
been diagnosed with asthma and over 2
million have current symptoms. Parent
reported asthma prevalence in children
ranges from 14–16%.
Slipped upper femoral epiphysis in children – delays to diagnosis
Prue Weigall, Sharon Vladusic, Ian Torode
Slipped upper femoral epiphysis (SUFE) is a disorder of the paediatric and adolescent hip. It is characterised by displacement of the upper femoral epiphysis from the metaphysis through the physis (Figure 1, Table 1). Internationally, reports of the incidence of this condition vary between 0.2 per 100 000 and 10 per 100 000.1,3 Prompt diagnosis and management is important as delayed diagnosis is known to be associated with poorer long term outcomes.
Optimising the medical care of doctors – Part 2 – before the consultation
Hilton Koppe
In this article, and those that follow, helpful strategies to overcome some
of these barriers will be outlined, with the goal of optimising the medical
care of doctors. This article will consider strategies that can be used
before the consultation begins.
Primary care nursing workforce in Australia – a vision for the future
Rhian Parker, Lynne Walker, Kelsey Hegarty
The National Health and Hospital Reform Commission Report (NHHRC) and the Draft National Primary Health Care Strategy offer a vision for a better coordinated, multidisciplinary
primary health care system in Australia.
Equitable access, improved care and care
coordination in primary health care are
core components of this vision. Integral
to this is a workforce that can work in an interprofessional way to provide quality and timely care to patients. There is good evidence supporting nurses undertaking an expanded role in the primary health care team.
Pharmacists in general practice – a proposed role in the multidisciplinary team
Evan Ackermann, Ian Douglas Williams, Christopher Freeman
Australia continues to explore methods to restructure primary health care services to meet stressors within the
health system. The primary health care
strategy and its support for larger general practices and multidisciplinary team contributions, raise opportunities for re-engineering general practice services.
Health care services for adults with cerebral palsy
Barbara Field, Adam Scheinberg, Adam Cruickshank
Cerebral palsy (CP) is the most common physical disability in childhood. Over 33 000 Australians are estimated to have CP. Many adults with CP have ongoing complex medical and therapy needs and
continue to benefit from coordinated,
multidisciplinary health care services.
Increasing numbers of young adults with
CP are transitioning to adult services from coordinated multidisciplinary paediatric hospital services.
Tips from the toolkit: 2 – assessing organisational strengths
Neville Steer
‘SWOT’ is a familiar term used in the development of business strategy. It is based on the identification of strengths, weaknesses, opportunities and threats as part of a strategic analysis approach. While there are a range of more sophisticated models for analysing and developing business strategy, it is a useful model for general practice as it is less time consuming than other approaches.
Book reviews
Books reviewed this month are Pitfalls in Prescribing and How to Avoid Them by Hugh McGavock and The Art of General Practice by John Murtagh.
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.
Clinical challenge
Rachel Lee
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.