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METABOLIC SYNDROME KEY POINTS

1.Metabolic syndrome is increasing but often goes unrecognised. 2.Measuring insulin resistance is unnecessary – measuring waist circumference is simpler and more important. 3.Ethnicity needs to be considered when cut-off points for waist measurement are used to screen for patients at risk of metabolic syndrome. 4.Risk factors for metabolic syndrome often cluster together, and the increase in risk is multiplied rather than added. 5.Modest weight loss (5kg) and/or increased physical exercise reduce the risk of developing diabetes in patients with metabolic syndrome.

Waist Target Parameters

Country/ethnic group Waist circumference Europids Male 􀀪 94 cm In the US, the Female 􀀪 80 cm ATP III values (10 cm male; 88cm female) are likely to continue to be used for clinical purposes. South Asians Male 􀀪 90 cm Based on a Female 􀀪 80 cm Chinese, Malay and Asian-Indian population Chinese Male 􀀪 90 cm Female 􀀪 80 cm Japanese Male 􀀪 90 cm Female 􀀪 80 cm Ethnic South and Use South Asian Central Americans recommendations until more specific data are available. Sub-Saharan Use European data until Africans more specific data are available. Eastern Use European Mediterranean data until more specific and Middle East data are available.

Preventing Recurrent DVT

A patient with successfully treated DVT remains at increased risk of DVT or PE for life and will need prophylaxis at times. Prophylaxis (with, for example, enoxaparin 40mg daily) should begin 12 hours before elective surgery. In orthopaedic surgery, it should be continued at this dose for three weeks after discharge from hospital2. Early remobilisation and compression stockings should be used routinely for all surgery. Intra-operative calf compression machines are often used in prolonged elective surgery. High-risk medical patients (eg, those likely to be inpatients for more than five days) should receive routine prophylaxis whether or not they have had a prior DVT. Seek advice if the patient has renal impairment because LMW heparins accumulate quickly in patients with moderate to severe renal failure. All women with previous DVT or artificial heart valves should receive daily heparin prophylaxis during pregnancy. Haematological review is recommended in tho...

HEALTH INSURANCE

HEALTH INSURANCE IS ONE OF THE MOST IMPORTANT THING YOU NEED TO HAVE WHEN YOU ARRIVE IN AUSTRALIA.IT IS A MUST I WOULD SAY.THERE ARE MANY OPTIONS TO SELECT FROM
BOX 1: Asthma Control Questionnaire 5-item version Circle the number of the response that best describes how you have been during the past week 1. On average, during the past week, how often were you woken by your asthma during the night? 0. Never 1. Hardly ever 2. A few times 3. Several times 4. Many times 5. A great many times 6. Unable to sleep because of asthma 2. On average, during the past week, how bad were your asthma symptoms when you woke up in the morning? 0. No symptoms 1. Very mild symptoms 2. Mild symptoms 3. Moderate symptoms 4. Quite severe symptoms 5. Severe symptoms 6. Very severe symptoms 3. In general, during the past week, how limited were you in your activities because of your asthma? 0. Not limited at all 1. Very slightly limited 2. Slightly limited 3. Moderately limited 4. Very limited 5. Extremely limited 6. Totally limited 4. In general, during the past week, how much shortness of breath did you experience because of your asthma? 0. None...
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able 1. Primary features of each rosacea subtype and their specific therapies 4 Rosacea subtype Clinical features Therapies available Erythematotelangiectatic Transient erythema and persistent centrofacial erythema with or without telangiectasia. Topical brimonidine Oral isotretinoin Laser/light therapy Papulopustular Persistent centrofacial erythema with transient centrofacial papules and/or pustules Topical metronidazole/ azelaic acid/ivermectin Oral doxycycline/erythromycin/minocycline Oral isotretinoin Phymatous Thickened skin and irregular surface nodularities, most commonly involving the nose (rhinophyma) though it can involve other facial convexities and the ears as well Oral isotretinoin Surgical intervention Ocular Foreign body sensation in the eye; burning or stinging sensation; dryness; itching; ocular photosensitivity; blurred vision; scleral telangiectasia; and/or periorbital oedema Eyelid hygiene and lubricant eye drops Topical cyclosporin/metr...
BOX 1. CONCUSSION CLINICAL DOMAINS Somatic Headache Nausea/Vomiting Sensitivity to light/noise Visual problems Fatigue Dazed, Stunned Dizzy, Balance problems Cognitive Feeling mentally 'foggy' Feeling slowed down Answer questions slowly Forgetful of event Repeats questions Drop in academic performance Emotional Irritability Sadness/Depression Personality change Anxiety/Panic More emotional Less emotional (apathy) Sleep Drowsy Sleeping more Sleeping less Difficulty falling/staying asleep