An approach to olfactory impairments in the general practice setting.

Background: Olfactory impairment is a common condition, particularly in the geriatric population, which can be underrecognised as a result of clinician and patient unfamiliarity.

Objective: The aim of this article is to bring awareness to olfactory impairment, describe the common aetiologies and provide a framework for its diagnosis and management in the general practice setting, including advice about when to refer.

Discussion: A thorough history and examination can often elucidate the common causes, which include rhinosinusitis, upper respiratory tract viral illnesses and head trauma.

Toxicity evaluation and nasal mucosal tissue deposition of dexamethasone-infused mucoadhesive nasal gelling systems.

To demonstrate safety of a developed intranasal dexamethasone-infused gelling formulation, quantification of a validated clinical biomarker indicative of cytotoxic potential using a human sinonasal explant model was first confirmed. Systematic cytotoxicity studies using the lactate dehydrogenase (LDH) detection assay revealed no elevation from baseline, in LDH levels, with tissue integrity of explanted human nasal mucosa also maintained; this was further corroborated using tissue histopathological examination. Next, with safety confirmed , freshly excised human nasal tissue was utilised to quantify dexamethasone release from the lead sol-gel systems; this being achieved through development and validation of a HPLC-UV analytical method, which reliably quantified controlled therapeutic release and deposition into mucosal tissue.

Differentiating between benign and malignant thyroid nodules: An evidence-based approach in general practice.

Background: The widespread use of imaging techniques has led to more frequent detection of thyroid nodules, and while the majority are benign, the risk of malignancy in an adult ranges from 7% to 15%. General practitioners (GPs) must be able to evaluate thyroid nodules and refer cases when appropriate.

Objectives: The aim of this article is to bring GPs up to date on the evidence-based management of thyroid nodules, with specific focus on neoplastic nodules, while highlighting significant changes in the 2015 American Thyroid Association guidelines.

A general practice approach to Bell's palsy.

Background: Bell's palsy is characterised by an acute onset of unilateral, lower motor neuron weakness of the facial nerve in the absence of an identifiable cause. Establishing the correct diagnosis is imperative and choosing the correct treatment options can optimise the likelihood of recovery.

Objective: This article summarises our understanding of Bell's palsy and the evidence-based management options available for adult patients.

Formulation, functional evaluation and ex vivo performance of thermoresponsive soluble gels - A platform for therapeutic delivery to mucosal sinus tissue.

Mucoadhesive in situ gelling systems (soluble gels) have received considerable attention recently as effective stimuli-transforming vectors for a range of drug delivery applications. Considering this fact, the present work involves systematic formulation development, optimization, functional evaluation and ex vivo performance of thermosensitive soluble gels containing dexamethasone 21-phosphate disodium salt (DXN) as the model therapeutic. A series of in situ gel-forming systems comprising the thermoreversible polymer poloxamer-407 (P407), along with hydroxypropyl methyl cellulose (HPMC) and chitosan were first formulated.

Surgery for adult patients with obstructive sleep apnoea: A review for general practitioners.

Background: Obstructive sleep apnoea (OSA) is a complex disease process that involves collapse of the upper airway during sleep and subsequent reduction or cessation of airflow. Continuous positive airway pressure (CPAP) is the primary treatment for OSA and is the recommended first-line treatment for patients with moderate-to-severe forms of the disease. However, some patients are unable to tolerate CPAP or are unwilling to accept it as a form of permanent management.

Pathologic occult neck disease in patients with metastatic cutaneous squamous cell carcinoma to the parotid.

Objective: The aim of this study was to document the rate of pathologic neck disease in patients presenting with metastatic cutaneous squamous cell carcinoma (CSCC) to the parotid gland following parotidectomy and neck dissection in the clinically and radiologic negative neck.

Study Design: Case series with chart review.

Setting: Tertiary referral center.