Lowering LDL cholesterol (LDL-C) with statins for the prevention of cardiovascular disease (CVD) has rightly become a core activity for primary care health professionals. However, despite effective lowering of LDL-C, many patients still suffer cardiovascular events. Experts have called this ‘the residual risk’ and have speculated whether further cardiovascular events can be prevented by attention to other lipoprotein fractions, particularly HDL cholesterol (HDL-C).
Helping patients with diabetes to win the battle to control their weight
Many people with type 2 diabetes are overweight or obese at diagnosis and continue to struggle to control their weight. This article looks at why people with diabetes find weight control more of a challenge than the rest of us and how practice nurses can help patients to remain positive, particularly when starting insulin to optimise blood glucose control.
What factors influence what we choose to eat and how can we improve choices?
Obesity is, quite literally, the big health problem of the 21st century, with rapidly increasing rates in both adults and children. In this article we explore why obesity is such a challenge and the role of primary healthcare professionals in addressing the problem. We try to unravel the wide range of factors that cause obesity before focusing on why people eat what they do and how we can help patients to review their eating habits, introduce changes to eat more healthily and then sustain those changes.
Swollen ankles: preventing, detecting and managing oedema
It is Friday afternoon and, checking your screen, you see your last free appointment has been given to a patient you have seen in the past for routine blood tests. This time when she enters the room you observe that her legs are covered with what looks like kitchen roll, and she is wearing supermarket carrier bags over her feet to protect her shoes. For many of us, this is a ‘heart sink’ patient – with heavy, wet and oedematous legs that are difficult to manage. To be able to manage this type of condition we first need to understand the possible causes of oedema, to identify patients who may be at risk for developing the problem, and to be aware when early intervention could be of benefit.
What is the evidence for statins in the secondary prevention of stroke?
The Stroke Association estimates that about 150,000 people suffer a stroke in the UK each year. Stroke is the third commonest cause of death in developed countries and the leading cause of disability. So can we reduce this burden? In this article, we look at the evidence for statins in the secondary prevention of stroke.
Back to Basics: Urine tests for renal function
Urine tests for renal function: What tests detect different levels of damage?
Back to Basics: Anaphylaxis and adrenaline auto-injector pens
The Evaluation and Management of Cough in Adults
Cough as a symptom results in significant impairment of quality of life for patients. Its
wide and varied causes and presentations make diagnosis and management complex.
Many sets of guidelines have been produced to help clinicians in the evaluation and
management of acute and chronic cough. This article uses the British Thoracic Society
(2006) guidelines to provide a summary of the evaluation and management of cough.
Respiratory causes of breathlessness
The development of shortness of breath (SOB) is an expected outcome of overexertion,
as normally occurs after strenuous exercise. SOB occurring at rest or during marginal
exertion is considered abnormal. Multiple organ systems are involved in the differential
diagnosis of SOB but for the purpose of this article, we concentrate on the pulmonary
system and include chronic obstructive pulmonary disease (COPD), asthma, pneumonia,
pneumothorax, interstitial lung disease, lung cancer and dysfunctional breathlessness. This is
the second in a series of three articles focusing on diagnosis of the breathless patient.
How to write a business case
Skills in developing a business case may at first seem to be something far removed from
what a nurse would need. After all we are clinicians, we do the clinical things and
managers do things like business cases. How wrong could you be? This article shows
just how important business planning can be to both nurses and our patients.
Editorial: BJPCN End Of Year
As we reach the end of the year, BJPCN looks back at the challenges that
have been met in the care of patients with respiratory and allergic disease
over the past few years and looks forward to the new situations we will
have to face in the coming year. I have really enjoyed launching this
exciting journal and wish Monica Fletcher, Chief Executive of Education for Health, the very best as she takes on the editor’s role from the next issue.
Symbicort® (budesonide/formoterol) Maintenance and Reliever Therapy – Symbicort SMART® – A new approach to asthma management
Nurses know from first-hand experience that although asthma treatment has come a long way over the past few years, many patients with asthma remain uncontrolled. This results in unscheduled hospital appointments for patients and unnecessary limitations on their lifestyle.
