BACKGROUND Bipolar disorder affects about 1% of Australians and impacts severely on relationships, careers and general functional capacity. General practitioners are central in the management of patients with bipolar disorder. OBJECTIVE To update clinicians on the recognition, diagnosis and management of bipolar disorder in light of recent research. DISCUSSION There is growing concern about the over-diagnosis of bipolar disorder, and increasing evidence that bipolar depression may present differently to unipolar depression. Antipsychotics are the initial agents of choice for the acute treatment of mania. For preventive treatment, lithium and atypical antipsychotics have the strongest evidence base. Lithium has been shown to be more effective than valproate. The main effect of lithium and most of the atypical antipsychotics is on prevention of manic relapse; only olanzapine and quetiapine also protect against depression. Lamotrigine is an agent with evidence for prevention of depressive relapse, but have minimal activity against mania. The role of antidepressants remains contentious, while there is strong support for quetiapine. Finally, there is growing evidence from randomised controlled trials of the benefit of psychological therapies in conjunction with medications.
{"title":"Bipolar disorder.","authors":"P. Mitchell","doi":"10.1353/book.49280","DOIUrl":"https://doi.org/10.1353/book.49280","url":null,"abstract":"BACKGROUND\u0000Bipolar disorder affects about 1% of Australians and impacts severely on relationships, careers and general functional capacity. General practitioners are central in the management of patients with bipolar disorder.\u0000\u0000\u0000OBJECTIVE\u0000To update clinicians on the recognition, diagnosis and management of bipolar disorder in light of recent research.\u0000\u0000\u0000DISCUSSION\u0000There is growing concern about the over-diagnosis of bipolar disorder, and increasing evidence that bipolar depression may present differently to unipolar depression. Antipsychotics are the initial agents of choice for the acute treatment of mania. For preventive treatment, lithium and atypical antipsychotics have the strongest evidence base. Lithium has been shown to be more effective than valproate. The main effect of lithium and most of the atypical antipsychotics is on prevention of manic relapse; only olanzapine and quetiapine also protect against depression. Lamotrigine is an agent with evidence for prevention of depressive relapse, but have minimal activity against mania. The role of antidepressants remains contentious, while there is strong support for quetiapine. Finally, there is growing evidence from randomised controlled trials of the benefit of psychological therapies in conjunction with medications.","PeriodicalId":8653,"journal":{"name":"Australian family physician","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47571179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Various causes of hoarse voice are briefly discussed in this article. As it is not possible to give a detailed account of all the causes of this important condition affecting the larynx, any patient with persistent hoarseness of more than four weeks' duration should have his larynx thoroughly examined. The head mirror, suitable light source, laryngeal mirror, spirit lamp, pierce of gauze and a local anaethetical spray is all that is required to carry out a mirror examination of the larynx.
{"title":"Hoarse voice.","authors":"P. Dhasmana","doi":"10.2307/j.ctv1c7zg62.18","DOIUrl":"https://doi.org/10.2307/j.ctv1c7zg62.18","url":null,"abstract":"Various causes of hoarse voice are briefly discussed in this article. As it is not possible to give a detailed account of all the causes of this important condition affecting the larynx, any patient with persistent hoarseness of more than four weeks' duration should have his larynx thoroughly examined. The head mirror, suitable light source, laryngeal mirror, spirit lamp, pierce of gauze and a local anaethetical spray is all that is required to carry out a mirror examination of the larynx.","PeriodicalId":8653,"journal":{"name":"Australian family physician","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44853670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action.In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
{"title":"Sexually Transmitted Infections: Adopting a Sexual Health Paradigm","authors":"J. Crowley, A. Geller, S. Vermund","doi":"10.17226/25955","DOIUrl":"https://doi.org/10.17226/25955","url":null,"abstract":"One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action.In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.","PeriodicalId":8653,"journal":{"name":"Australian family physician","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67588620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-09DOI: 10.1002/9781119328124.ch6
J. Gerschman, P. Reade
Pain or discomfort in the orofacial region usually has an organic and easily detectable cause. When an organic cause is absent or its magnitude is less than expected after the degree of concern expressed by the patient, a psychiatric factor must be considered. In such cases psychiatric treatment should be arranged to complement any necessary organic therapy.
{"title":"Orofacial pain.","authors":"J. Gerschman, P. Reade","doi":"10.1002/9781119328124.ch6","DOIUrl":"https://doi.org/10.1002/9781119328124.ch6","url":null,"abstract":"Pain or discomfort in the orofacial region usually has an organic and easily detectable cause. When an organic cause is absent or its magnitude is less than expected after the degree of concern expressed by the patient, a psychiatric factor must be considered. In such cases psychiatric treatment should be arranged to complement any necessary organic therapy.","PeriodicalId":8653,"journal":{"name":"Australian family physician","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/9781119328124.ch6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42400650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-28DOI: 10.1542/9781610024570-ch16
C. Lawlor-Smith, L. Lawlor-Smith
{"title":"Breastfeeding difficulties.","authors":"C. Lawlor-Smith, L. Lawlor-Smith","doi":"10.1542/9781610024570-ch16","DOIUrl":"https://doi.org/10.1542/9781610024570-ch16","url":null,"abstract":"","PeriodicalId":8653,"journal":{"name":"Australian family physician","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47453268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are many more 'family matters' issues worthy of reflection, but the examples represent some of the more common personal dilemmas facing medical practitioners, and in particular women doctors, based on both my own experience and conversations with colleagues. There are no simple or universally appropriate answers to any of the scenarios; I have not attempted to suggest solutions to any of the issues raised, but hope that some situations outlined will evoke empathy and promote thought, discussion or debate about ways that individual doctors could deal with such matters.
{"title":"Family matters.","authors":"D. Lewis","doi":"10.2307/j.ctt183h03t.11","DOIUrl":"https://doi.org/10.2307/j.ctt183h03t.11","url":null,"abstract":"There are many more 'family matters' issues worthy of reflection, but the examples represent some of the more common personal dilemmas facing medical practitioners, and in particular women doctors, based on both my own experience and conversations with colleagues. There are no simple or universally appropriate answers to any of the scenarios; I have not attempted to suggest solutions to any of the issues raised, but hope that some situations outlined will evoke empathy and promote thought, discussion or debate about ways that individual doctors could deal with such matters.","PeriodicalId":8653,"journal":{"name":"Australian family physician","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48768874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reactive Depression","authors":"","doi":"10.32388/mee2uu","DOIUrl":"https://doi.org/10.32388/mee2uu","url":null,"abstract":"","PeriodicalId":8653,"journal":{"name":"Australian family physician","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69636442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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