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Respiratory tract and sleep disorders – including obstructive sleep apnoea, difficult-to-treat asthma in adults, and insomnia – are commonly encountered in general practice.
Clinical
Despite the availability of effective therapies and a national medicines subsidy scheme, a significant burden of disease still exists in Australia, with high mortality by international standards.
Medicare Benefits Schedule rules regarding sleep study eligibility have recently changed and incorporate validated questionnaires of obstructive sleep apnoea risk and subjective sleepiness.
Various contributing factors to obstructive sleep apnoea have resulted in the development of a number of potential treatment modalities, some of which are in evolution.
It is important that a high level of clinical suspicion is maintained when paediatric patients present with a vague history or symptoms that may represent airway foreign bodies.
Diagnosis of insomnia is facilitated by the use of self-report measures to characterise the sleep disorder and elucidate comorbidities.
Effective insomnia treatment requires a multidisciplinary team that is centred on the patient’s preference and personal goals.
Editorial
The connection between sleep and health has been recognised for centuries, but it is only relatively recently that the treatment of sleep disorders has developed as a medical specialty.
Letters
Readers express their opinions on published articles and topics of interest.
Palpitations are one of the most common presentations to general practice, and while they are usually benign, they may also have life-threatening significance.
A summary of associated psychopathology and comorbidity, diagnostic challenges and treatment recommendations for paruresis and parcopresis.
Paracetamol allergy is uncommon and, as a result, may be overlooked as a cause for immediate hypersensitivity, which can lead to a significant delay in diagnosis.
Research
Skin cancer follow-up is most effective when general practitioners establish follow-up strategies suited to the rural populations and supported by evidence-based guidelines for skins cancers.
Effective clinical triage of referrals relies on provision of adequate clinical information (‘red flags’) and investigations.
This paper quantifies the burden of high psychological distress in primary carers of Australians with disability and identifies modifiable factors to improve mental healthcare in this population.
Clinical challenge
This clinical challenge is based on this month’s Focus articles. To complete this activity, go to gplearning and log in with the username and password you use to log in to the RACGP website.