Transient ischaemic attack (TIA) is a powerful warning sign of an impending, and potentially disabling, stroke. It is important to understand differences between stroke and TIA, how the FAST test can help you recognise the signs, and the use of the ABCD2 score to assess the level of stroke risk. Treating TIAs as emergencies is critically important in preventing a full stroke so urgent referral to your local TIA service is best practice.
Supporting people with communication problems after stroke
Communication problems are one of the most common after-effects of stroke, affecting about one in three people. Losing the ability to speak or understand language – aphasia – is frightening and frustrating. This article offers insights and practical tips to aid communication.
What is motivating about motivational interviewing?
Have you ever felt like it is groundhog day? You are having the same conversation with the same patient and with the same outcomes. You are being very sympathetic and trying hard to help the patient make positive changes. But every suggestion you make garners the response: “Yes but I can’t do that because…”, “Yes but I’ve tried that”, “Yes but my friend said there was a tablet I could take”. That “yes but” is an indicator that motivational interviewing (MI) is likely to be helpful.
Measuring your blood pressure: what you need to know about ambulatory blood pressure monitoring
The new NICE guideline on hypertension: using ambulatory blood pressure monitoring in practice
All change: Using ambulatory blood pressure monitoring to diagnose hypertension in primary care
Measuring blood pressure (BP) is one of the commonest tests we carry out in primary care – generally taking several measurements with a digital BP monitor on at least two clinic visits before diagnosing hypertension. Ambulatory blood pressure monitoring (ABPM) has traditionally been used in secondary care hypertension clinics, and in some larger general practices. But new guidelines from the National Institute for Health and Clinical Excellence are making ambulatory monitoring part of routine practice for the diagnosis of hypertension in primary care. What are the new guidelines recommending and why the change to ABPM?
Thromboprophylaxis to prevent hospital-acquired thrombosis: an important opportunity for primary care
It is clear that hospital admission causes many preventable deaths from venous thromboembolism (VTE) yet the general public and, I would suggest, primary care health workers, still think of air travel as the main risk factor. Is there a role for primary care in helping to reduce the numbers of patients with hospital-acquired VTE?
Editorial
It looks like it is going to be a long hard winter. The media have already been reporting restrictions on referrals and rising waiting times. It is likely that things can only get worse given the pressures on primary care trusts and local authorities. At times of economic stringency, women’s sexual and reproductive health can seem an easy target. But this is short-sighted and probably not costeffective given the UK’s high rates of teenage pregnancy and sexually transmitted infections. It is time for an approach to service configuration that goes beyond knee-jerk slash and burn.
Colposcopy after cervical screening
Colposcopy – detailed examination of the cervix under magnification – remains the standard assessment tool for cervical abnormalities found on screening. An invitation to attend the colposcopy clinic can cause anxiety, but women can be reassured that it is a safe procedure and that many problems can be treated in just one visit.
Chlamydia in women
Challenging the rule of halves in osteoporosis
Half of post-menopausal women will suffer a fracture during their lifetime, mainly because of osteoporosis. Currently available medication can halve the risk of future osteoporotic fractures. Yet many at-risk women are still unidentified, and only half of all patients persist with treatment for more than a year.
Age no barrier: Contraception in the perimenopause
Although there is a natural fall in fertility with age, women still need reliable contraception to avoid unintended pregnancies during the perimenopause. No contraceptive method is contraindicated by age alone, but women must be individually assessed, based on the risks and benefits of each method.
