Pub Date : 2024-08-01DOI: 10.31128/AJGP-04-23-6819
Fang Joe Chen, Jae Hong Park
Background: Globus pharyngeus, or globus, is characterised by the sensation of a lump or tightness in the throat. Symptoms can be persistent, difficult to treat and often reoccur. Globus is a common issue in the community, with lifetime prevalence occurring in up to 45% of the population.
Objective: This article aims to provide a narrative review of potential causes of globus, as well as a suggested guideline for work-up and management in the primary care setting.
Discussion: Causes for globus remain uncertain; however, current opinion focuses on a mixture of muscle tension and mucosal irritation. It is estimated that globus makes up 4% of all primary care referrals to otolaryngologists. There are a handful of proposed causes, with treatments often able to be initiated in the primary care setting. Although most causes are benign, it is important for clinicians to maintain suspicion for malignancy, because this is often the patient's main concern.
{"title":"An approach to globus pharyngeus.","authors":"Fang Joe Chen, Jae Hong Park","doi":"10.31128/AJGP-04-23-6819","DOIUrl":"https://doi.org/10.31128/AJGP-04-23-6819","url":null,"abstract":"<p><strong>Background: </strong>Globus pharyngeus, or globus, is characterised by the sensation of a lump or tightness in the throat. Symptoms can be persistent, difficult to treat and often reoccur. Globus is a common issue in the community, with lifetime prevalence occurring in up to 45% of the population.</p><p><strong>Objective: </strong>This article aims to provide a narrative review of potential causes of globus, as well as a suggested guideline for work-up and management in the primary care setting.</p><p><strong>Discussion: </strong>Causes for globus remain uncertain; however, current opinion focuses on a mixture of muscle tension and mucosal irritation. It is estimated that globus makes up 4% of all primary care referrals to otolaryngologists. There are a handful of proposed causes, with treatments often able to be initiated in the primary care setting. Although most causes are benign, it is important for clinicians to maintain suspicion for malignancy, because this is often the patient's main concern.</p>","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"August 2024 correspondence.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Book review: From hurting to healing: Delivering love to medicine and healthcare.","authors":"Marita Jones","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.31128/AJGP-08-24-1234e
David Wilkinson
{"title":"Editorial.","authors":"David Wilkinson","doi":"10.31128/AJGP-08-24-1234e","DOIUrl":"https://doi.org/10.31128/AJGP-08-24-1234e","url":null,"abstract":"","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.31128/AJGP-10-23-6986
Kevin Ng, Atifur Rahman
Background: Cardiovascular diseases (CVDs) pose significant global health challenges, with genetics increasingly recognised as a key factor alongside traditional risk factors. This presents an opportunity for general practitioners (GPs) to refine their approaches.
Objective: This article explores the impact of genetics on CVDs and its implications for GPs. It discusses monogenic disorders like inherited cardiomyopathies and polygenic risks, as well as pharmacogenetics, aiming to enhance risk assessment and personalised care.
Discussion: Monogenic disorders, driven by single gene mutations, exhibit predictable inheritance patterns, including inherited cardiomyopathies and channelopathies such as Long QT syndrome. Polygenic risks involve multiple genetic variants influencing CVD susceptibility, addressed through polygenic risk scores for precise risk assessment. Pharmacogenetics tailor drug interventions based on genetic profiles, though challenges like accessibility and ethical considerations persist. Integrating genetics into cardiovascular care holds promise for alleviating the global CVD burden and improving patient outcomes.
{"title":"Genetics in relation to cardiac diseases: Implications for general practitioners.","authors":"Kevin Ng, Atifur Rahman","doi":"10.31128/AJGP-10-23-6986","DOIUrl":"10.31128/AJGP-10-23-6986","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) pose significant global health challenges, with genetics increasingly recognised as a key factor alongside traditional risk factors. This presents an opportunity for general practitioners (GPs) to refine their approaches.</p><p><strong>Objective: </strong>This article explores the impact of genetics on CVDs and its implications for GPs. It discusses monogenic disorders like inherited cardiomyopathies and polygenic risks, as well as pharmacogenetics, aiming to enhance risk assessment and personalised care.</p><p><strong>Discussion: </strong>Monogenic disorders, driven by single gene mutations, exhibit predictable inheritance patterns, including inherited cardiomyopathies and channelopathies such as Long QT syndrome. Polygenic risks involve multiple genetic variants influencing CVD susceptibility, addressed through polygenic risk scores for precise risk assessment. Pharmacogenetics tailor drug interventions based on genetic profiles, though challenges like accessibility and ethical considerations persist. Integrating genetics into cardiovascular care holds promise for alleviating the global CVD burden and improving patient outcomes.</p>","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.31128/AJGP-02-23-6710
Joshua Meyerov, Catherine Guo, Leon Tan
{"title":"Improving awareness of cardiovascular risk factors in young Australian adults: We can do better.","authors":"Joshua Meyerov, Catherine Guo, Leon Tan","doi":"10.31128/AJGP-02-23-6710","DOIUrl":"https://doi.org/10.31128/AJGP-02-23-6710","url":null,"abstract":"","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.31128/AJGP-08-23-6923
Norma B Bulamu, Alline Beleigoli, Danny Haydon, Ken Kamau Wanguhu, Lemlem G Gebremichael, Sarah Powell, Billingsley Kaambwa, Robyn A Clark
Background: Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is integrating CR into primary care OBJECTIVE: To propose a business model for primary care providers to implement CR using current Medicare items.
Discussion: Using the chronic disease management plan, general practitioners (GPs) complete four clinical assessments at 1-2 weeks, 8-12 weeks, and 6 and 12 months after discharge. The net benefit of applying this model, compared with claiming the most used standard consultation Item 23, in Phase II CR is up to $505 per patient and $543 in Phase III CR. The number of rural GPs providing CR in partnership with the Country Access To Cardiac Health (CATCH) through the GP hybrid model has increased from 28 in 2021 to 32 in 2022. This increase might be attributed to this value proposition. The biggest limitation is access to allied health services in the rural areas.
{"title":"An innovative business model using established Medicare items for delivery of cardiac rehabilitation: A value proposition for primary care.","authors":"Norma B Bulamu, Alline Beleigoli, Danny Haydon, Ken Kamau Wanguhu, Lemlem G Gebremichael, Sarah Powell, Billingsley Kaambwa, Robyn A Clark","doi":"10.31128/AJGP-08-23-6923","DOIUrl":"https://doi.org/10.31128/AJGP-08-23-6923","url":null,"abstract":"<p><strong>Background: </strong>Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is integrating CR into primary care OBJECTIVE: To propose a business model for primary care providers to implement CR using current Medicare items.</p><p><strong>Discussion: </strong>Using the chronic disease management plan, general practitioners (GPs) complete four clinical assessments at 1-2 weeks, 8-12 weeks, and 6 and 12 months after discharge. The net benefit of applying this model, compared with claiming the most used standard consultation Item 23, in Phase II CR is up to $505 per patient and $543 in Phase III CR. The number of rural GPs providing CR in partnership with the Country Access To Cardiac Health (CATCH) through the GP hybrid model has increased from 28 in 2021 to 32 in 2022. This increase might be attributed to this value proposition. The biggest limitation is access to allied health services in the rural areas.</p>","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.31128/AJGP-04-23-6810
Atifur Rahman
Background: Chest pain is a common symptom in the community, with underlying causes ranging from benign musculoskeletal pain to life-threatening cardiac events. It is a challenging presentation for healthcare providers, because the aetiology is not always immediately apparent. Chest pain can also cause significant anxiety for patients, leading to increased healthcare utilisation and costs.
Objective: The objective of this discussion is to emphasise the importance of accurately describing the nature of chest discomfort and using appropriate terminology to facilitate an appropriate diagnostic work-up. The discussion also highlights the differences between typical and atypical chest pain and provides information about the aetiology of chest pain and management in the community.
Discussion: Accurately describing the nature of chest discomfort by using appropriate terminology is crucial in identifying the underlying cause of the symptom. Healthcare providers should be aware of the different terms patients might use to describe their chest discomfort and use precise and informative terms to describe the potential underlying cause of the chest pain. Atypical chest pain is often used to describe non-cardiac chest pain, but it lacks specificity. Using the terms 'cardiac,' 'possibly cardiac' or 'non-cardiac' is the preferred terminology.
{"title":"Chest pain.","authors":"Atifur Rahman","doi":"10.31128/AJGP-04-23-6810","DOIUrl":"https://doi.org/10.31128/AJGP-04-23-6810","url":null,"abstract":"<p><strong>Background: </strong>Chest pain is a common symptom in the community, with underlying causes ranging from benign musculoskeletal pain to life-threatening cardiac events. It is a challenging presentation for healthcare providers, because the aetiology is not always immediately apparent. Chest pain can also cause significant anxiety for patients, leading to increased healthcare utilisation and costs.</p><p><strong>Objective: </strong>The objective of this discussion is to emphasise the importance of accurately describing the nature of chest discomfort and using appropriate terminology to facilitate an appropriate diagnostic work-up. The discussion also highlights the differences between typical and atypical chest pain and provides information about the aetiology of chest pain and management in the community.</p><p><strong>Discussion: </strong>Accurately describing the nature of chest discomfort by using appropriate terminology is crucial in identifying the underlying cause of the symptom. Healthcare providers should be aware of the different terms patients might use to describe their chest discomfort and use precise and informative terms to describe the potential underlying cause of the chest pain. Atypical chest pain is often used to describe non-cardiac chest pain, but it lacks specificity. Using the terms 'cardiac,' 'possibly cardiac' or 'non-cardiac' is the preferred terminology.</p>","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.31128/AJGP-08-23-6935
Fahaz Yusuf Nazer, Arman Babajanyan, Habib Bhurawala
{"title":"An unusual case of congenital torticollis.","authors":"Fahaz Yusuf Nazer, Arman Babajanyan, Habib Bhurawala","doi":"10.31128/AJGP-08-23-6935","DOIUrl":"10.31128/AJGP-08-23-6935","url":null,"abstract":"","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.31128/AJGP-05-23-6836
Atifur Rahman, Matthew K Rowe
Background: Aortic stenosis (AS) remains one of the most commonly encountered valvular pathologies. Medical management does not alter the progression of the disease, making assessment of severity and timing of referral for valve replacement the most important aspects of caring for patients with AS.
Objective: To review the contemporary management of AS, including signs and symptoms, echocardiography and decision making in management.
Discussion: Severe symptomatic AS is frequently accompanied by dyspnoea, chest pain or syncope and a physical examination might reveal the presence of an ejection systolic murmur. Echocardiography is the first and most useful investigation to stratify risk and determine requirement for valve replacement by assessing valve gradients and left ventricular function. Surgical and transcatheter options now exist for treatment of AS and decision making is usually multidisciplinary and based on individual patient parameters.
{"title":"Aortic stenosis: Update in monitoring and management.","authors":"Atifur Rahman, Matthew K Rowe","doi":"10.31128/AJGP-05-23-6836","DOIUrl":"https://doi.org/10.31128/AJGP-05-23-6836","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis (AS) remains one of the most commonly encountered valvular pathologies. Medical management does not alter the progression of the disease, making assessment of severity and timing of referral for valve replacement the most important aspects of caring for patients with AS.</p><p><strong>Objective: </strong>To review the contemporary management of AS, including signs and symptoms, echocardiography and decision making in management.</p><p><strong>Discussion: </strong>Severe symptomatic AS is frequently accompanied by dyspnoea, chest pain or syncope and a physical examination might reveal the presence of an ejection systolic murmur. Echocardiography is the first and most useful investigation to stratify risk and determine requirement for valve replacement by assessing valve gradients and left ventricular function. Surgical and transcatheter options now exist for treatment of AS and decision making is usually multidisciplinary and based on individual patient parameters.</p>","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}