Lower respiratory tract infections and community acquired pneumonia in adults

Copyright © 2004 Royal Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.BACKGROUND: Lower respiratory tract infections--acute bronchitis and community acquired pneumonia (CAP)--are important causes of morbidity in Australia. Acute bronchitis is often treated with antibiotics, although the cause is usually viral. Community acquired pneumonia may be fatal, particularly in the elderly, therefore appropriate assessment and management is essential. OBJECTIVE: This article describes the aetiology, clinical assessment, investigations and management of acute bronchitis and CAP in the community. DISCUSSION: Clinical assessment is important for acute bronchitis and CAP, with investigations such as C reactive protein, serology, and chest X-ray informing diagnosis and management of the latter. Causative organisms are usually not identified, but are presumed to be viral for acute bronchitis, and Streptococcus pneumoniae for CAP; although 'atypicals' are also important. Antibiotics should generally not be prescribed for acute bronchitis, however, there is some evidence they may provide limited benefits in patients who have chest signs, are very unwell, are older, have comorbidities, or smoke. In patients with CAP, treated outside of hospital, the combination of amoxycillin and doxycycline/roxithromycin is the treatment of choice.Nigel Stocks; John Turnidge; Alan Crocket

Class 1 PI3K clinical candidates and recent inhibitor design strategies: a medicinal chemistry perspective

Phosphatidylinositol 3-kinases (PI3Ks) are a family of lipid kinases that phosphorylate the 3-OH of the inositol ring of phosphoinositides, and deregulation of this pathway has implications in many diseases. The search for novel PI3K inhibitors has been at the forefront of academic and industrial medicinal chemistry with over 600 medicinal chemistry-based publications and patents appearing to date, leading to 38 clinical candidates and the launch of two drugs, idelalisib in 2014 and copanlisib in 2017. This Perspective will discuss medicinal chemistry design approaches to novel isoform-selective inhibitors through consideration of brief case histories of compounds that have progressed into clinical development or that have revealed new structural motifs in this highly competitive area of research

Management of hyperlipidaemia

Copyright © 2005 Royal Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.BACKGROUND: Hyperlipidaemia is a general term for elevated concentrations of any or all lipids in the plasma. An elevated cholesterol is one of several risk factors for coronary heart disease (CHD). In Australia, the use of cholesterol lowering drugs, mainly statins, consumes over $880 million or 16% of the Pharmaceutical Benefits Scheme drug budget and is growing. OBJECTIVE: This article focusses on primary hypercholesterolaemia, its relationship with CHD, and its management in the community setting. DISCUSSION There is strong evidence that treating middle aged men with statins who have established CHD will reduce overall mortality, CHD morbidity, or mortality and stroke. There is weaker but reasonable evidence for treating men aged over 65 years and women of any age who have CHD, or people without CHD but at high risk. There may be some benefits for patients with stroke and peripheral vascular disease who are at risk of CHD. While discontinuation rates are high, the occurrence of serious adverse reactions are infrequent.Nigel Stocks, James Allan and Peter R. Mansfiel

Improving the learning needs survey by using four approaches

Copyright © 2005 Royal Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.BACKGROUND: Learning needs analyses are often undertaken to plan continuing education programs. They usually use questionnaires that have shortcomings regarding validity, relevance, breadth and detail. We tested a questionnaire using four questioning strategies to approximately 1762 general practitioners. METHOD: Our questionnaire listing 104 topics asked open ended questions and specific information about desired topics. It was distributed by The Royal Australian College of General Practitioners and divisions of general practice in South Australia and the Northern Territory. RESULTS: The survey yielded 578 responses (33%). The different survey strategies highlighted different areas of learning need. Overall, the highest ranked topics were dermatology, complementary medicine, psychiatry, and business and practice management. Participating divisions were generally satisfied with the feedback. DISCUSSIONS: Despite a poor response rate, the survey provided interesting information, and a set of broad learning topics.J.A. Allan, D. Schaefer and N. Stock

Study of MAS practice and knowledge and bibliographic references for management advisory services : MASPAK

https://egrove.olemiss.edu/aicpa_guides/2309/thumbnail.jp