Point of care testing for C-reactive protein

Copyright © 2006 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: New approaches are needed to reduce antibiotic usage in respiratory tract infections in general practice without compromising patient safety. Point of care tests for C-reactive protein (CRP) are now being used for this purpose in some European countries. OBJECTIVE: Current knowledge about the CRP response in respiratory tract infections is presented, as well as the usefulness of applying the test when sinusitis and pneumonia may be suspected. DISCUSSION: A promising ability of the test in ruling in or out severe infection has been demonstrated in clinical studies. There are still controversies about the use of the CRP test in respiratory tract infections, however clinical research supports its use for some conditions, and therefore introduction into Australian general practice should be considered. Further evaluation of its utility is needed.H. Melbye and N. Stock

The treatment of acute bronchitis by general practitioners in the UK - Results of a cross sectional postal survey

Copyright © 2002 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.The treatment of acute bronchitis by general practitioners in the UK. Results of a cross sectional postal survey.Nigel P Stocks, Tom Fahe

Stochastic resonance in electrical circuits—II: Nonconventional stochastic resonance.

Stochastic resonance (SR), in which a periodic signal in a nonlinear system can be amplified by added noise, is discussed. The application of circuit modeling techniques to the conventional form of SR, which occurs in static bistable potentials, was considered in a companion paper. Here, the investigation of nonconventional forms of SR in part using similar electronic techniques is described. In the small-signal limit, the results are well described in terms of linear response theory. Some other phenomena of topical interest, closely related to SR, are also treate

Stochastic resonance in electrical circuits—I: Conventional stochastic resonance.

Stochastic resonance (SR), a phenomenon in which a periodic signal in a nonlinear system can be amplified by added noise, is introduced and discussed. Techniques for investigating SR using electronic circuits are described in practical terms. The physical nature of SR, and the explanation of weak-noise SR as a linear response phenomenon, are considered. Conventional SR, for systems characterized by static bistable potentials, is described together with examples of the data obtainable from the circuit models used to test the theory

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

Optimal coding of a random stimulus by a population of parallel neuron models

Copyright © 2007 SPIE - The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only. Copyright 2007 Society of Photo-Optical Instrumentation Engineers. This paper was published in Noise and Fluctuations in Biological, Biophysical, and Biomedical Systems, edited by Sergey M. Bezrukov, Proc. of SPIE Vol. 6602, 66020R and is made available as an electronic reprint with permission of SPIE. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited.We examine the question of how a population of independently noisy sensory neurons should be configured to optimize the encoding of a random stimulus into sequences of neural action potentials. For the case where firing rates are the same in all neurons, we consider the problem of optimizing the noise distribution for a known stimulus distribution, and the converse problem of optimizing the stimulus for a given noise distribution. This work is related to suprathreshold stochastic resonance (SSR). It is shown that, for a large number of neurons, the SSR model is equivalent to a single rate-coding neuron with multiplicative output noise.Mark D. McDonnell, Nigel G. Stocks and Derek Abbot

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

Noise-Induced Linearisation and Delinearisation

It is demonstrated, by means of analogue electronic simulation and theoretically, that external noise can markedly change the character of the response of a nonlinear system to a low-frequency periodic field. In general, noise of sufficient intensity {\it linearises} the response. For certain parameter ranges in particular cases, however, an increase in the noise intensity can sometime have the opposite effect and is shown to {\it delinearise} the response. The physical origins of these contrary behaviours are discussed.Comment: 17 pages. No special macros. Figures on reques