GP articles from February 2006, page 5

GP archives from February 2006

Clinical: A disagreement over a diagnosis.(meningitis diagnosis)
February 3, 2006... PRACTICE DILEMMA What should you do if you do not agree with your partner's diagnosis of meningitis? A GP'S VIEW - DR LOUISE WARBURTON, A GP IN IRONBRIDGE, SHROPSHIRE This situation requires tactful handling. It might harm my...

Clinical: The PC-compatible pocket glucometer.(Accu-Chek Aviva )(Product/Service Evaluation)
February 3, 2006... EQUIPMENT REVIEW - The Accu-Chek Aviva is ahead of the mainstream, writes Dr Peter Ilves. Blood sugar testing is a regular chore for those affected by diabetes. A blood glucose meter is always helpful and the Accu-Chek Aviva meter fits...

Clinical: The use of transdermal opioids.(pros and cons)
February 3, 2006... VIEWPOINT - Transdermal opioid delivery is gaining popularity. By Dr Ganesan Baranidharan, and Dr Karen Simpson. Drugs remain the mainstay of management for many pain problems. Strong opioids are well accepted for cancer pain and are...

Clinical: Osteoporosis.
February 3, 2006... THE ESSENTIALS - Annual costs of osteoporotic fractures are pounds 1.7 billion in the UK. - A 50-year-old woman has a 50 per cent chance of a future fracture. - NICE guidance for secondary prevention of fracture is now...

Clinical: Websites relating to osteoporosis.
February 3, 2006... Websites related to this week's Clinical Review selected by Dr Keith Barnard. OSTEOPOROSIS SOCIETY The National Osteoporosis Society website is not one I'm that keen on, but it does have a useful A-Z of resources aimed at medical...

Registrar: MRCGP Exam - How to prepare for the MRCGP exam.(membership examination Royal College of General Practitioners)
February 3, 2006... Taking the MRCGP exam is a gratifying experience, says Dr Bill Irish. The MRCGP exam has been around in one way, shape or form since 1965. It has evolved from a minority sport into an exam taken annually by thousands of new GPs across...

Registrar: MRCGP Update - Overview of epilepsy.(membership examination Royal College of General Practitioners)
February 3, 2006... Current situation - Epilepsy affects about 400,000 people in the UK. In 60-70 per cent of patients, seizures can be rapidly controlled. - People with epilepsy are two to three times more likely to die prematurely. However, there...

Registrar: Pictorial - Case Study.(Kawasaki disease)(Brief Article)
February 3, 2006... THE CASE A three-year-old boy presented with a seven-day history of fever. He had a polymorphous rash and bilateral conjunctival infection. On examination he had cervical lymphadenopathy (about 1.5 cm in diameter), red and cracked lips...

Registrar: What They Forgot to Tell You... Cauterising Little's Area.(epistaxes treatment)(Brief Article)
February 3, 2006... Epistaxes arising from Little's area (or Kiesselbach's plexus) often follow infection in the nares. Trying an appropriate topical antibiotic first may help. If this fails, get a good view of the nasal septum with a speculum and identify...

Registrar: A registrar writes... on patient choice.(experiences of a general practice registrar)
February 3, 2006... When it comes to prescribing, I tend to choose something that I am familiar with, or something that has been drummed into me as being the cheapest and most effective option. However, life is not so easy when patients start asking me about...

MedEconomics: GP Finance - How To... earn learning disability points.(register helps the learning disability patients to achieve more)
February 3, 2006... Setting up a learning disabilities register will reveal other problems in these patients, says Donna Wells. While setting up a learning disability register will score a modest four points, this new quality framework domain from 1 April...

MedEconomics: You and your Pension - Investing in the private sector.(pension benefits of general practitioners)
February 3, 2006... Use a personal pension to top up your NHS provision, says Paul Kendall. GPs who want to boost their pension benefits can pay into a private sector personal pension as well as making contributions based on their NHS earnings to the NHS...

MedEconomics: Practice profits fall by 2.3% in 2005.(General Medical Services contracts)
February 3, 2006... The upward surge in profits in the first year of the new GMS contract proves to be short lived. Practice profits have dropped back following an upward surge in 2004/5, the new GMS contract's first year. According to figures compiled...

MedEconomics: Seniority pay, ill health and premises tax.
February 3, 2006... NHS RULES Q: I am 54. I qualified in 1975, but lived abroad from 1977 to 1996. On my return, I completed vocational training as a GP and, after doing a few locum shifts, joined my practice as a salaried doctor until April 2004, when I...

GP Life: Early drive of new S-Class.(Mercedes S-Class)(Product/Service Evaluation)
February 3, 2006... Given the outstanding ability of the new Mercedes S-Class, it can still be described as good value. The new S-Class will be arguably the most advanced production car in the world when it reaches the showrooms in March. Mercedes claims the...

GP Life: GP Book Group.(Hippocratic Oaths, Medicine and Its Discontents)(Brief Article)(Book Review)
February 3, 2006... Hippocratic Oaths, Medicine and its Discontents Author: Raymond Tallis Published by Atlantic Books, pounds 19.99 ISBN 1-84354-126-2 On dissatisfaction with medicine, it says: 'The curious dissociation between what medi- cine has...

GP Life: Have Your Say.
February 3, 2006... We have five copies of Hippocratic Oaths to give away. Email: GPbookgroup@haynet.com, using the book title as the subject, for your chance to be sent a copy. If you have already read it, you can email your comments, however short, by 20...

GP Life: Team time - A Grand day out.(celebrations of general practitioners)(Brief Article)
February 3, 2006... It was a hard year of quality points, Choose and Book, PCT debts, and a cancelled summer barbecue, so we treated ourselves to a day trip to Brighton. The partners and Caroline, our practice manager, sorted out the budget and itinerary....

Plain Tales from the Surgery.(medical humor of physicians)
February 3, 2006... A BIT OF PEACE I have just received a letter from our local cardiologist, which raised a smile. It read as follows: 'This gentleman attended for his elective permanent peacemaking system implant.' I think that this could well be...

Rules made to be broken.(care taken for cardiac problems)
February 3, 2006... I owe thanks to a colleague for this extraordinary tale of resilience, determination, and man's ability to follow the rules in the face of overwhelming opposition from all that is rational. The story (with minor embellishments) follows. ...

Independent Nurse: Nurses set to face greater workload if annual flu jab is extended to toddlers.(Joint Committee on Vaccination and Immunisation)(Brief Article)
February 3, 2006... Practice nurses have warned of a large increase in workload if the DoH decides to include toddlers in the annual flu campaign. Last summer, the Joint Committee on Vaccination and Immunisation (JCVI) looked at proposals for including all...

Independent Nurse: NICE guidance will widen use of statins.(National Institute for Health and Clinical Excellence)(Brief Article)
February 3, 2006... An additional 3.3 million people will become eligible for statin therapy, after NICE issued new guidance that could cost the NHS pounds 82 million. Last week's guidance recommends that statins are used either where there is clinical...

Independent Nurse: Increased risk of male osteoporotic fractures.(risk factors of the medication warfarin)(Brief Article)
February 3, 2006... Long-term use of warfarin may increase the risk of osteoporotic fractures in men with atrial fibrillation, a US study has found. Researchers compared 7,587 patients not prescribed warfarin with 4,461 on long-term warfarin therapy and...

Independent Nurse: Journals Watch - Unplanned quit attempts more likely to succeed.(quiting smoking)(Brief Article)
February 3, 2006... Over 1,900 smokers and ex-smokers in England were interviewed about their attempts to quit. Almost half of all attempts involved no previous planning and unplanned quit attempts were more likely to succeed. The authors concluded that smokers...

Independent Nurse: Journals Watch - Level of childhood obesity does not predict co-morbidities.(childhood obesity and impaired glucose tolerance)(Brief Article)
February 3, 2006... Testing done on children attending an obesity clinic found 10 per cent had impaired glucose tolerance (IGT), not identified by fasting glucose alone. They also found a link between low birth weight and the metabolic syndrome. However the...

Independent Nurse: Journals Watch - Echinacea may treat a cold, but will not prevent it.(Brief Article)
February 3, 2006... A review of 16 trials found that nine showed some evidence that alcoholic extracts and pressed juice preparations from the aerial parts of the echinacea plant helped treat the common cold. But the researchers said there was no evidence the...

Independent Nurse: Journals Watch - A golden cure of Alzheimer's.(new treatment for Alzheimer's disease)(Brief Article)
February 3, 2006... Small particles of gold could form the basis of a new treatment for Alzheimer's disease, according to research carried out in Spain and Chile. Researchers attached gold nano-particles to beta amyloid fibrils in test tubes and exposed them to...

Independent Nurse: Falling practice profits could freeze nurse salaries.(Nurse Practitioner Association)
February 3, 2006... Practice nurses could face little or no pay rise this year if practice profits take a downturn, a leading specialist medical accountant has warned. However, nurses have cautioned against such a move, pointing out nurses will vote with...

Independent Nurse: Job advisers piloted in practices.(national health service)(Brief Article)
February 3, 2006... Employment advisers will be based in GP surgeries across the UK as part of a government crackdown on people claiming incapacity benefit (IB). The scheme will be piloted this week in Bridgend, Wales, and in Paisley, Scotland, with four...

Independent Nurse: Nurse-led centres open.(commuter walk in centres)(Brief Article)
February 3, 2006... Health secretary Patricia Hewitt, with nurse practitioner Vanessa Jones, officially opened the first NHS commuter walk-in centres at London's Liverpool Street and Manchester's Piccadilly stations last week. The nurse practitioner-led centres...

Independent Nurse: What the Papers Said.(Swimming is an excellent form of exercise for children with asthma)(Brief Article)
February 3, 2006... 'Pools can double a baby's risk of asthma' - Daily Mail 'Baby pools may increase asthma danger' - The Daily Telegraph What did the press say? Taking a baby to swimming classes before the age of two may harm their health,...

Independent Nurse: Nurses struggling to find places on vital yellow fever training courses.(National Travel Health Network and Centre)
February 3, 2006... Practice nurses across the UK are struggling to find places on mandatory training sessions for administering yellow fever vaccinations. As part of a move to improve standards, the National Travel Health Network and Centre (NaTHNaC) at...

Independent Nurse: Patients support nurse prescribing.(Brief Article)
February 3, 2006... Possible side-effects top the list of what patients want to know when they are prescribed drugs, new research into nurse prescribing shows. The survey of 74 people aged between 20 and 85 years found that patients are next most interested...

Independent Nurse: Call for review of nursing education.(practice learning)(Brief Article)
February 3, 2006... A total review of the nursing education system is needed to overcome a 'reality gap' between theory and practice, according to a leading academic. Professor Jill Macleod Clark, chair of the council of deans and heads of UK faculties for...

Independent Nurse: Vital Statistics - Morbidity in Britain.(statistical information on diseases)(Brief Article)(Illustration)
February 3, 2006... 1,400 people die from asthma each year in Great Britain 40% more men than women over the age of 75 suffer epilepsy 15% more professional men than men in general consult for cancer Source: Office of National Statistics: Focus on Health.

Independent Nurse: World Outbreak Information - Week beginning 30 January.(disease spread across countries and safety measures)(ross river infections)(Brief Article)
February 3, 2006... Australia Health authorities have reported an increasing incidence of Ross River virus in New South Wales and South Australia in the last two months. This unpleasant viral disease is transmitted by infected mosquitoes and can lead to...

Independent Nurse: Nurses welcome allergy training pilot.(clinical management plans)(Brief Article)
February 3, 2006... School nurses in Bradford, West Yorkshire, have taken part in a pilot training project that aims to help schools deal better with allergies. The training is provided by the Anaphylaxis Campaign, which is also taking part in a DoH review...

Independent Nurse: Non-medical review has publication delay.(non-medical regulation )(Brief Article)
February 3, 2006... A DoH review of non-medical regulation has been completed and sent to ministers. However, the findings of the review, led by NHS head of workforce Andrew Foster, have not been revealed to anyone else, including interested bodies such as...

Independent Nurse: Judicial review backs DoH under-16 guide.(High Court's views on abortion)(Brief Article)
February 3, 2006... The High Court upheld DoH's guidance to nurses ensuring under-16s seeking advice on contraception and abortion can do so in confidence. Manchester mother Sue Axon sought a review claiming parents must be informed if their daughters...

Independent Nurse: News focus - Big business eyes up general practice.(British Medical Journal)
February 3, 2006... As a US healthcare giant prepares to take over two GP practices, Tamsin Snow looks at the implications for nurses. The US's largest healthcare company, UnitedHealth, made its first move into the profitable primary care market last month...

Independent Nurse: Letter - Difficult to intervene when we are off duty.(child abuse management)(Brief Article)
February 3, 2006... I think Barbara Stuttle is brave to highlight the problem of whether we should intervene when off duty (IN, 23 January). As health professionals we often see cases of child abuse that really disturb us, where individuals and systems have...

Independent Nurse: Letter - Youth sexual health guidance praised.(child protection protocols review)(Brief Article)
February 3, 2006... The RCN welcomes the outcome of the recent judicial review, which upheld the DoH's guidance on confidentiality for under-16s seeking advice on sexual matters. The guidance addresses the greatest deterrent for under 16s seeking advice on their...

Independent Nurse: Letter - NICE has let down Alzheimer's patients.(National Institute for Clinical Excellence)(Brief Article)
February 3, 2006... We are pleased to learn that NICE has revised its position on the use of acetyl-cholinesterase inhibitors for the treatment of Alzheimer's disease. However, we are disappointed it has recommended that these drugs only be made available...

Independent Nurse: Opinion - How big businesses might affect nurses.(primary care nurses contract)
February 3, 2006... With the government bent on increasing competition and private sector involvement in the NHS, the news that multinational company UnitedHealth has won contracts to run two GP practices in Derbyshire will probably come as no surprise to...

Independent Nurse: Opinion - Why clinical engagement is important.(National Health Services)
February 3, 2006... We hear a lot about clinical engagement. Everyone thinks they are doing it and some think they are doing it brilliantly. But, are they? To me clinical engagement is about the people who directly deal with patients, the clinicians, being...

Independent Nurse: Opinion - Investing in children reaps benefits.(investment for disadvantaged background children)
February 3, 2006... A recent evaluation of Sure Start was disappointing, but long-term analysis is required, says Gill Devereaux. The initial evaluation of the Sure Start programme by Birkbeck College London1 was, according to the media, not as positive as...

Independent Nurse: Clinical - Asthma - Prescribing asthma drugs.(Brief Article)
February 3, 2006... Guidelines recommend stepwise prescribing of asthma medication for children and adults. Dr David Morris explains. About one in five children up to the age of 15 years are diagnosed with asthma. Although asthma has a tendency to resolve...

Independent Nurse: Clinical - Top 50 - Osteoarthritis.(joint disorder, its symptoms, care and treatment)
February 3, 2006... OVERALL KEY POINTS - About 80 per cent of over-75s have X-ray evidence of osteoarthritis (OA) - Obesity is clearly associated with the development of OA. - Paracetamol is the recommended first-line analgesic. - Topical therapies...

Independent Nurse: Clinical - Mental health - Seasonal affective disorder.(seasonal affective disorder, its symptoms, care and treatment)
February 3, 2006... DEPRESSION Lack of sunlight in winter can instigate an annual depression in sufferers, says Melanie Rogers. Seasonal affective disorder (SAD) is a type of depression in which the symptoms usually occur at the same time each year. In...

Independent Nurse: Clinical - Oral health - A-Z Aphthous ulcers.(aphthous ulcers, otherwise mouth ulcers, its symptoms, causes, care and treatment)
February 3, 2006... In the first of a new monthly series examining common conditions in primary care, Debra Sprague outlines how recurrent ulcers may suggest an underlying cause, which should be investigated. Aphthous ulcers, or mouth ulcers, are experienced...

Independent Nurse: Professional - Looking into the future for prison nursing.
February 3, 2006... With PCTs taking responsibility for healthcare in prisons, more opportunities are becoming available for nurses working in this area, writes Joe Lepper. The announcement in 2002 that the DoH would be taking over responsibility for prison...

Independent Nurse: Professional - Media skills - Spreading the word.(nurses in media)
February 3, 2006... Patients can become ambassadors for healthcare initiatives. Kate Brudenell outlines five important steps that can prepare service users for a media role. For nurses who wish to publicise positive initiatives, asking appropriate patients...

Independent Nurse: Professional - Career development - Career Profile - Christine Forgan, Edinburgh.(Nurses curriculam and their career development)(Interview)
February 3, 2006... Why did you become a nurse? I first went to work in an insurance company to please my mother, but I found it boring so applied for nurse training. It was one of my better decisions! How has your career developed since you started...

Independent Nurse: Jargon Buster - Local Improvement Finance Trust (LIFT).(Brief Article)
February 3, 2006... What is LIFT? LIFT - like PFI - is a form of public private partnership, involving the private sector in financing health infrastructure. Unlike PFI, it is designed to help smaller scale projects in primary care, particularly one stop...

Independent Nurse: Worth a look.(book on primary care mental health)(Institute of Health Sciences)(www.HIM-link.com launched)(Brief Article)
February 3, 2006... BOOK - The Institute of Health Sciences Primary Care Mental Health Information on the latest primary care mental health research has been published by the Institute of Health Sciences (IHS), a networked organisation of groups within the...