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?
Venous thrombosis and thromboembolism
Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major public health problem affecting around 100 per 100,000 population per year and causing thousands of deaths annually. Large population-based studies have shown that factors associated with hospitalisation account for half of the attributable risk of VTE.
When to use aspirin in CVD prevention: acting on the latest evidence
What do Patients Want from Asthma Therapy?
More than half of people with asthma in the UK have inadequate symptom control,
despite the range of effective therapies now available. Rather than blaming
patients when they fail to take their medications as prescribed, we need to
examine the way we conduct asthma consultations and ask whether we are failing
to meet the needs of individual patients. How can we gain greater understanding about what
people with asthma want from healthcare professionals and treatments, so we can achieve a
more patient-centred approach to care?
Still a breath of fresh air: 20th anniversary for the General Practice Airways Group (GPIAG)
The BJPCN interviewed Dr Steve Holmes (Chairman of the GPIAG) and
Stephanie Wolf (GPIAG General Committee member) on the 20th anniversary
of the organisation.
Oral Allergy Syndrome
Did you know…. that a large number of your hayfever patients may have a
condition known as oral allergy syndrome? In this article we explore what
causes oral allergy syndrome, why it occurs, the symptoms that patients may
suffer and how to manage the problem.
How Can I Assess and Manage Cough in Children?
Children with a cough commonly present to practice nurses. All children cough and often
cough repeatedly, with the majority of episodes associated with self-limiting viral
infections for which there are no effective treatments. Coughing can be highly
distressing for the child and their family members, and can have a significant impact on
a child’s sleep, play and performance in school. Although cough may often be related to
diagnosis of asthma, this is by no means the only cause. The British Thoracic Society recently
published guidelines for the assessment and management of cough in children up to 12 years of
age without known lung disease. Practice nurses and their GP colleagues will find these new
guidelines valuable for diagnosis and management of cough. This article summarises the main
recommendations.
Diagnosing allergy in asthma and allergic rhinitis
Patients with allergic asthma, intermittent (seasonal) or persistent (perennial) allergic
rhinitis, represent a significant proportion of primary care consultations. There is
growing awareness of allergy and the possibility of an allergic component as the cause
of a wide variety of symptoms. It is important to understand how to diagnose atopy to
ensure appropriate management and care of our patients. Diagnosing allergy is initially about
asking the right questions, followed by confirming or refuting the diagnosis by objective testing.
In this article, we explore history taking and objective testing that will help us to manage and
advise patients appropriately.
Reducing Hayfever Havoc: Keeping Symptoms at Bay
Hayfever affects around one in ten adults, and an even higher proportion of children and teenagers. Chronic symptoms may lead to poor concentration, impaired learning ability and school absenteeism in children, amongst other problems. In the run-up to the hayfever season, therefore, it is important to identify teenagers or young adults with persistent or severe hayfever symptoms and to treat their symptoms aggressively to prevent poor performance at school and in examinations. Given that approximately 80% of patients with asthma also have rhinitis, asking your asthma patients about their possible hayfever symptoms is a good starting point.
