Australian Family Physician audio

David Humphries, MBBS (Hons), FACSP, FFSEM (UK) is a sport and exercise medicine (SEM) physician and Past President, Australasian College of Sports Physicians (ACSP). He talks to Kath O'Connor the role of the SEM physician. Most sports and exercise related injuries and problems in the GP setting are relatively straightforward; GPs can contact a SEM physician for more complex issues. Most have specific areas of expertise, listed in the 'Find a Sports Physician' section of the ACSP website (www.acsp.org.au).

Dr Stella Heley talks to Dr Jenni Parsons about the ongoing need for routine PAP screeing in young women.

This article looks at why a substantial number of young women who have been vaccinated with the HPV vaccine will still have Pap test abnormalities.

Prof Terry Bolin talks to Dr Rachel Lee about the relationship between food and irritable bowel symptoms.

In addition to the long standing implication of lactose in lactase deficient patients together with very low carbohydrate diets, have been increasingly recognised as important in the causation and treatment of irritable bowel syndrome.

Dr Wendy Brown discusses the LAGB procedure and the importance of follow up and a multidisciplinary approach to achieve sustained weight loss and manage problems and complications.

The laparoscopic adjustable gastric band is a useful tool in the treatment of severe obesity. It is a safe and durably effective procedure, however, optimal results depend upon the patient participating in a process of lifelong care.

Dr Claire Dendle is an infectious diseases physician in the Department of Infectious Diseases at Southern Health, Melbourne, Victoria. In this podcast, she talks to Dr Kathryn O’Connor about what GPs need to know the assessment and management of mammalian bites.

Mammalian bites are a significant public health problem in Australia, with the majority of bites coming from dogs. Complications include tissue damage from the bite itself, infection and post-traumatic stress disorder.

Dr Stella Heley talks about the ongoing need for routine PAP screeing in young women, despite the good overall takeup of the quadrivalent HPV vaccine in this cohort. The free 'catch up' HPV vaccination program for women under 27 in Australian ended on 31/12/2009. Despite the good uptake of this vaccination program, this cohort of women will continue to require PAP test screening as per the routine schedule and we will continue to see a substantial number of these women with both high and low grade changes on their PAP smears. Many of these women will have been already sexually active prior to vaccination and therefore been exposed to HPV. Some may not have completed the course, or missed out on vaccination. Many may be exposed to one of the oncogenic strains not covered by the vaccination.The ongoing HPV vaccination program for 12-13 year old girls will ultimately lead to decreased abnormalities due to vaccination prior to sexual activity and greater response to vaccination when vaccines are administered at a younger age. When these young women are in their 20s and 30s it is likely that a different cervical screening program and schedule will be appropriate.

Prof Terry Bolin talks about the relationship between food and irritable bowel symptoms. Prof Bolin highlights that many of the symptoms of IBS are exacerbated by foods and that dietary review has an important role in managing IBS. Prof Bolin describes the effects of different carbohydrates such as lactose and fructose and emphasizes that symptoms are more common with excessive consumption. This podcast and the article provide information to the GP about how to assess and treat dietary components to IBS.

Wendy Brown discusses the LAGB procedure and the importance of follow up and a multidisciplinary approach to achieve sustained weight loss and manage problems and complications. Sustained weight loss and improved quality of life following a LAGB procedure depends on a multidisciplinary team (including surgeon, GP, nurse, dietician and psychologist) to meet patient needs of band adjustments, ongoing education about food choices and exercise, monitoring for nutritional and device complications and coping with psychological issues. Roles for the GP in the team include monitoring for ‘alert symptoms’ of volume reflux, nocturnal aspiration, regular regurgitation or vomiting which may indicate a complication; reinforce healthy eating and exercise messages; and adjusting the doses of antihypertensive and diabetic medications as weight loss occurs. When the amount of fluid in the band is optimal the patient feels satisfied with 2-3 small meals per day of solid food with weight loss of about 0.5-1kg per week and does not experience adverse symptoms.

Dr Andrew Beattie is a GP in Coffs Harbour who decided to look back at the diagnosis of breast cancer over 20 years in his practice. He discusses why he did this and what he found

Dr Danille Esler is a general practitioner and Senior Public Health Registrar at Cairns Public Health Unit in Cairns, Queensland. In this podcast, she talks to Dr Kathryn O’Connor about what GPs need to know about the clinical and public health ramifications of Dengue. The epidemiology of Dengue fever has changed in recent years and there has been a recent outbreak of the disease in northern Queensland.

Dengue virus infection is spread by the mosquito vector Aedes aegypti and causes significant morbidity and mortality worldwide. In Australia, it is an important cause of fever in the returned traveller and recent outbreaks have occurred in northern Queensland. A comprehensive understanding of the clinical and public health ramifications of dengue infection is essential for general practitioners.