Family Medicine Update

Epididymitis and orchitis: an overview.

Am Fam Physician. 2009 Apr 1;79(7):583-7

Authors: Trojian TH, Lishnak TS, Heiman D

Epididymitis and orchitis are commonly seen in the outpatient setting. Men between 14 and 35 years of age are most often affected, and Chlamydia trachomatis and Neisseria gonorrhoeae are the most common pathogens in this age group. In other age groups, coliform bacteria are the primary pathogens. Men with epididymitis and orchitis typically present with a gradual onset of scrotal pain and symptoms of lower urinary tract infection, including fever. This presentation helps differentiate epididymitis and orchitis from testicular torsion, which is a surgical emergency. Typical physical findings include a swollen, tender epididymis or testis located in the normal anatomic position with an intact ipsilateral cremasteric reflex. Laboratory studies, including urethral Gram stain, urinalysis and culture, and polymerase chain reaction assay for C. trachomatis and N. gonorrhoeae, help guide therapy. Initial outpatient therapy is empirical and targets the most common pathogens. When C. trachomatis and N. gonorrhoeae are suspected, ceftriaxone and doxycycline are recommended. When coliform bacteria are suspected, ofloxacin or levofloxacin is recommended.

19378875

More: continued here

The 45 year old health check – Feasibility and impact on practices and patient behaviour.

Aust Fam Physician. 2009 May;38(5):358-62

Authors: Amoroso C, Harris MF, Ampt A, Laws RA, McKenzie S, Williams AM, Jayasinghe UW, Zwar NA, Powell Davies G

BACKGROUND: The 45 year old health check (MBS item 717) for patients aged 45-49 years was introduced in 2006. This study evaluated its impact on preventive care and patient reported risk factors. METHODS: A quantitative and qualitative study was conducted in eight general practices in Sydney, New South Wales. It involved follow up surveys of 118 patients taken both before the check and 3 months after. Practice staff were trained and supported to conduct the health checks and appropriate interventions. RESULTS: There was ambivalence among some of the general practitioners toward the health check, but most found it feasible. The reported frequency of GP advice relating to each of the SNAP (smoking, nutrition, alcohol, and physical activity) risk factors increased; patient referrals, however, were infrequent. Patients’ readiness to change their diet and exercise habits improved as a result of the check, with respondents showing an increase in both the consumption of vegetables and the frequency of physical activity. There was no change in body mass index, smoking or alcohol consumption. DISCUSSION: The health check was associated with a short term improvement in diet and physical activity behaviours. Mechanisms to enhance referral need to be developed.

19458808

More: continued here

Guideline development process for the Health for Kids in the South East project.

Aust Fam Physician. 2008 Jun;37(6 Spec No):2-5

Authors: Harris C, Turner T, Mazza D, Wilkinson F,

Health for Kids in the South East (HFK) was a project funded by the Victorian Government Department of Human Services, Hospital Admission Risk Program. The project aimed to improve health outcomes for children in southeast Melbourne (Victoria) by building partnerships between child health clinicians and implementing best practice.

19142263

More: continued here