A comparison of morbidity in the Australian Defence Force with Australian general practice.

This study was designed to examine morbidity patterns among Australian Defence Forces members and to compare them with civilian general practice. The study was conducted in the outpatient departments of the Royal Australian Air Force (RAAF) No. 6 Hospital, Melbourne, Australia. The patients studied were male and female members of the RAAF (66%), Army (25%), and Navy (9%). The problems managed at all primary care consultations during 1993 and 1994 were coded using the Ninth Revision of the International Classification of Diseases (Clinical Modification). The codes were grouped and compared against a major study of Australian general practice. In the 6 Hospital study, 21,910 problems were managed at 19,909 consultations. The main differences found between the two studies were that service personnel had more medical examinations, more musculoskeletal and respiratory problems, and fewer psychological and cardiovascular problems. Most of the differences observed may reflect the Defence Force's recruitment selection criteria and the emphasis on physical fitness and diet.

An approach to the assessment of falls in the elderly.

In assessing the elderly it should be remembered that about 75% of falls are unreported. It is essential therefore to inquire about falls and balance problems in any assessment of the aged. Falls are common during a severe acute illness such as stroke, pneumonia or any condition causing hypotension or severe pain; the elderly having little reserves to meet such stress. Vigilance on the part of the carer to prevent falls is essential at such times. Although trips or falls are inevitable in the elderly and are usually inconsequential, each reported fall needs careful evaluation. In many cases causes can be identified and corrected. This in turn will improve the quality of life by reducing the fear of falling and in so doing help avoid a serious fall with its possible long term consequences.

Oral ulceration. Things are not always what they seem.

Oral ulceration is a common complaint and is usually inconsequential. Nevertheless, when it appears for the first time in adult life, it may represent the manifestation of systemic disease. A full history and examination should be carried out and a full blood examination and ESR done. Any ulcer persisting for more than three weeks without responding to treatment should be biopsied.