From the RACGP Health of the Nation report; depression, anxiety, and sleep disturbances are amongst the most commonly seen presentations of mental disorders in general practice. About 1 in 8 people in the world live with a mental disorder which often involves significant disturbances in thinking, emotional regulation, or behaviour. 

From the RACGP Health of the Nation report; depression, anxiety, and sleep disturbances are amongst the most commonly seen presentations of mental disorders in general practice. About 1 in 8 people in the world live with a mental disorder which often involves significant disturbances in thinking, emotional regulation, or behaviour. 

Chronic pain affects about 1 in 5 people in Australia and is a common reason for patients to see their doctor and to seek treatment. As patients seek ever increasingly strong pharmacological therapies they may become increasingly depressed, fatigued and dislocated from society.

Non-melanotic skin cancers and melanoma are the most common cancers affecting humans. At least two in three Australians will be diagnosed with skin cancer before the age of 70 years and the risk is higher for men than women. Whilst basal cell carcinomas and squamous cell carcinomas are more common they are not as lethal as melanomas which are referred to as Australia’s “national cancer”. Indeed in 2020 it is estimated that 16,200 will be diagnosed with melanoma, that is one new case every half hour and a death every five hours.

The western world faces a very significant obesity epidemic. In Australia, two-thirds of our population or 12.5 million are either overweight or obese and as a consequence may experience many medical sequelae including development of the metabolic syndrome, type 2 diabetes, cardiovascular disease, cerebrovascular disease, osteoarthritis and depression, contributing significantly to our health burden. In the first part of this series, we were joined by Joseph Proietto, Professor Emeritus at the University of Melbourne, the Department of Medicine at Austin Health and an endocrinologist specialising in diabetes and obesity to discuss why we become obese. Professor Proietto joins us again to guide us through a strategy of how to treat and manage obesity and direct our patients toward a healthy body mass index (BMI).

Up to two thirds of Australians are either overweight or obese as defined by body mass index (overweight: BMI 25-29.9, obese: BMI >30) with subsequent significant medical consequences including cardiovascular disease, type 2 diabetes, cerebrovascular disease (metabolic syndrome), osteoarthritis and depression. Becoming overweight and obese involves complex interactions between neurohormonal systems of the gut, neurobiology of the brain (particularly the hypothalamus) and leptin production from adipose sites coupled with an environment where there is an abundance of high glycaemic energy dense foods. Science demonstrates that the overarching controls of obesity are genetic (70%) rather than environmental (30%). Adoption studies relating to monozygotic twins demonstrate this. In view of the metabolic consequences of obesity, understanding why we get fat is extremely important to medical practitioners.

The spleen performs a large number of important functions including processing and removal of opsonized pathogens, cellular maintenance, immunoglobulin production and the removal of effete worn out red blood cell. When removed either through trauma or for therapeutic indications the risk of overwhelming post splenectomy infection (OPSI) increases significantly; up to 58 times the general population in the setting of trauma and up to 1,100 times increased risk when for thalassaemia.