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Biomedical subjects

C Del Mar

Publications and source records attributed to C Del Mar.

At least 55 records · Page 3Linked to original sources
PubMed1992

Managing sore throat: a literature review. II. Do antibiotics confer benefit?

OBJECTIVE: To assess the justification for the use of antibiotics in the management of sore throat in general practice. DATA SOURCES: The literature from 1945 to 1990 was systematically screened to identify studies that addressed the question whether antibiotics reduce non-suppurative and suppurative complications and symptoms of sore throat. The key-words, "pharyngitis" and "tonsillitis" were used to identify trials of antibiotics for the treatment of sore throat. STUDY SELECTION: Studies were included in comparison tables if they involved the trial of one or more antibiotics against a control and there was an outcome in terms of reduction in the incidence of acute rheumatic fever, acute glomerulonephritis, acute otitis media, acute sinusitis, quinsy or any symptoms related to the acute illness. RESULTS: The published literature suggests that antibiotic treatment protects patients with sore throat against acute rheumatic fever and some suppurative complications, but not against acute glomerulonephritis. It does not reduce the symptoms. CONCLUSIONS: In Australia, with the exception of socioeconomically deprived Aboriginal communities, the incidence of acute rheumatic fever is probably not high enough to justify the use of antibiotics for sore throat. Protection against suppurative infection seems to be slight and it is difficult to establish the benefit of antibiotic treatment for reducing the symptoms of sore throat. Until more benefits for antibiotic management of sore throat can be demonstrated, it is recommended that infrequent use be adopted.

Acute Disease↗
PubMed1992

Managing sore throat: a literature review. I. Making the diagnosis.

OBJECTIVE: To assess the justification for the routine use of investigations in the diagnosis of bacterial causes of sore throat. DATA SOURCES: The literature from 1945 to 1990 was systematically screened to identify studies that addressed diagnosis of bacterial infection and the efficacy of antibiotics in sore throat, using the key-words "pharyngitis" and "tonsillitis". RESULTS: Difficulties were identified with clinical methods and investigations that identify streptococcal infections. The practice of throat-swab culture--the "gold standard"--appears to have developed as a strategy to protect patients from acute rheumatic fever. However, this method may be limited in its usefulness for protection against acute rheumatic fever because: (i) in many cases in which the streptococcus is isolated from symptomatic patients there is no serological evidence of infection; (ii) there are very high asymptomatic carrier rates of the streptococcus; (iii) even after adequate treatment with penicillin there are high bacteriological failure rates; and (iv) those organisms that can be isolated from the mucosal surface are a poor representation of organisms lying deep in the tissues. Evaluation of other diagnostic techniques such as Gram's stain and rapid antigen testing, as well as decision analysis, has also been hampered by the difficulties encountered with use of this inadequate gold standard. CONCLUSION: There is little indication from the literature that any routine system of identifying bacterial causes of sore throat is helpful to the clinician.

Bacteriological Techniques↗
PubMed1992

Teaching consultation skills by videotaping interviews: a study of student opinion.

The need to teach undergraduate medical students the skills of conducting a consultation now seems well established. Several authors have also established the efficacy of using constructive feedback on videotapes of each student's interaction with a patient to enhance such skills. To date, however, students' perceptions of this process have not been reported. Here we present the results of such a study, together with a review of the relevant literature. In our study we found that students felt that their skill at analysing and evaluating consultations had been enhanced, but that they would have liked to have more than one of their consultations taped and reviewed. This last suggestion is discussed in the light of the literature reviewed, as are the advantages and disadvantages of using real or surrogate patients for this kind of training.

Attitude↗
PubMed1991

Shared antenatal care in Brisbane.

The prevalence of antenatal care shared between general practitioner (GP) and public hospital services in Brisbane, and its acceptability to patients was assessed. Responses to questionnaires put to women in the immediate puerperium of the public wards of 2 major teaching hospitals are presented. Antenatal shared-care was undertaken in 54% of pregnancies. Indications of advantages for women to undergo antenatal shared-care were identified with convenience of appointment time, and decreased travel and waiting time. An important cooperation between GP and hospital obstetric services appears to have evolved in the area of antenatal care that provide benefits at least for patients' convenience.

Adult↗
PubMed1991

Managing viral upper respiratory infections.

The epidemiology of the common cold is reviewed with the aim of providing helpful advice for patients. Future management will include limiting the spread of the cold virus by attention to the mode of transmission and the development of anti-viral drugs, of which interferon holds the most promise.

Common Cold↗
PubMed1991

Quality assurance and general practice in Australia.

The initiation of a Quality Assurance (QA) Programme for general practitioners in Australia was initiated in 1987. It has had to meet the challenges of a diverse and independent group, but participation has been good after the first three years. The theoretical basis for the types of QA activity undertaken is discussed, as well as the political climate under which general practice QA is being established in Australia and abroad.

Australia↗
PubMed1990

Helping patients to stop smoking.

Public opinion is increasingly opposed to smoking and more and more smokers wish to stop. This article offers a practical, 10 point strategy for general practitioners to use to identify patients who smoke and to help them overcome their addiction.

Family Practice↗
PubMed1989

The place of routine urine testing on admission to hospital.

An audit of routine urine testing by dipsticks at a large private provincial hospital analysed 2294 patient records. No result was recorded in 12% of records. Abnormal but expected results were obtained in 9% of cases. Of the 4% of unexpectedly abnormal results, in only one-third of patients was the attending practitioner aware of these results and, in fewer than one-fifth of the patients, were further diagnostic tests performed. In not one case was treatment altered.

Diagnostic Tests, Routine↗
PubMed1987

Consumer obstetrics.

OBJECTIVE: To investigate the perceptions of patients about delivery of their babies. METHOD: One hundred and forty four out of 200 surveyed women answered consumer orientated questions before and after delivery. RESULTS: They were on the whole satisfied with antenatal classes (there seemed to be a need for more information in the form of an on-the-ward postnatal class), disliked the practice of perineal shaves (but did not object to enemas or rupture of membranes) and felt they had adequate analgesia (although not for after-pains or the discomfort of haemorrhoids in the puerperium). Women who intend to deliver in the more (western) conventional positions are less likely to be disappointed. Women expressed the desire to be more actively involved in some aspects of delivery such as cutting the cord, putting the baby to the breast and being alone with partner and baby immediately after delivery. Cardiotocography (CTG) is more reassuring than frightening. A "Birthing Room" is seen as a satisfactory alternative to home delivery.

Anesthesia, Obstetrical↗
PubMedDate not supplied

Would general practitioners support a population-based colorectal cancer screening programme of faecal-occult blood testing?

BACKGROUND: The success of a population-based screening for colorectal cancer (CRC) is determined to a large extent by general practitioner (GP) attitudes, beliefs and support. The extent to which GPs support population-based CRC screening remains unclear. AIMS: To assess the knowledge, attitudes and practices of GPs in relation to CRC screening, and to identify the determinants of GP support for population-based faecal-occult blood testing (FOBT). METHODS: A cross-sectional postal survey was conducted with a random sample of 692 GPs in Queensland, -Australia. We assessed GP knowledge, attitudes and practices concerning CRC screening in relation to their stance on population-based FOBT screening. RESULTS: Although the response rate was low (41%), participants were representative of Queensland GPs in general. Of 284 participating GPs, 143 (50.5%) indicated that they would support a population-based FOBT screening programme, 42 (14.8%) would not and 98 (34.6%) were unsure. Belief in FOBT test efficacy (P <0.001), possession of CRC guidelines (P <0.05) and belief in earlier stage detection (P <0.05) were major determinants of support for population-based FOBT screening. No significant association was observed for doctor's sex, location of practice, age, year completed medical training, membership of a Division of General Practice, number of weekly consultations, number of patients investigated for CRC per month, size of practice, own family history of CRC, interest in further information on CRC screening or treatment, and current use of FOBT with asymptomatic patients aged > or =40 years. CONCLUSIONS: GP support for FOBT population-based screening appears to have increased over recent years. The knowledge and attitudes/beliefs of GPs are key determinants of their support.

Adult↗
PubMedDate not supplied

A descriptive study of nurses employed by general practitioners in south-east Queensland.

The aim of this study was to describe the demographic and occupational characteristics of a sample of nurses employed by general medical practitioners and the factors perceived to be influential in their role development. Telephone and mail surveys were undertaken within one general practice division in South-East Queensland. Thirty-seven of the 67 (55%) practice nurses responded to the mailed questionnaire. Of these respondents, ten were collectively interviewed to elaborate on the survey results. Findings indicated that the primary work of these nurses is one of assistant to the doctor. Autonomous nursing initiatives are largely opportunistic. Perceived barriers to role expansion included Medicare restrictions, inadequate basic and ongoing education programs, financial and space limitations of the practice, reluctance of general practitioners, and a lack of professional support.

Adult↗