GP articles from March 2006, page 2

GP archives from March 2006

Independent Nurse: World Outbreak Information - Week beginning 27 March.(Reports of Epididymitis)(Brief article)
March 31, 2006... BANGLADESH The WHO has reported a case of polio in Chittagong in March. The Ministry of Health is commencing an immunisation campaign. Travellers should take care with food/water hygiene and be immunised against polio. DEMOCRATIC...

Independent Nurse: Scotland - Community nurses must be one force.(Brief article)
March 31, 2006... Scottish community nurses should set aside professional barriers to meet the health needs of the future, according to Scotland's chief nursing officer, Paul Martin. Speaking at the Nursing in the Community in Scotland conference in...

Independent Nurse: Bowel screening scheme put on hold.(new screening programme for bowel cancer )(Brief article)
March 31, 2006... The new screening programme for bowel cancer appears to be a victim of the NHS cash crisis. The new president of the British Society of Gastroenterology, professor Tony Morris, said the programme was meant to start next month 'but the...

Independent Nurse: Software firm issues prescribing software.(service introduction)(Brief article)
March 31, 2006... Software firm iSoft, formerly known as Torex, has issued a new version of its Premier and Synergy software, which includes nurse prescriptions. It was criticised at the Association for Nurse Prescribing conference earlier in the year for...

Independent Nurse: News focus - Northern Ireland - Primary care at forefront of NI plans.(Northern Ireland)
March 31, 2006... Transferring funds from secondary to primary care in Northern Ireland faces challenging problems, says Joe Lepper. Outlining his 20-year plan Caring for People Beyond Tomorrow last October, Northern Ireland's health minister Shaun...

Independent Nurse: Opinion - Editorial - DoH needs to invest in community nurses.(department of health)(Editorial)
March 31, 2006... It was good to see health secretary Patricia Hewitt acknowledging the vital role community nurses have to play. She said that community nurses could help significantly reduce NHS deficits by helping cut the number of emergency admissions for...

Independent Nurse: Opinion - Prescribing helps us grasp opportunities.
March 31, 2006... Nurse prescribing has come a long way since it first started in the early 1990s. It has, at times, been an arduous journey, but we have achieved such a lot. Nurse prescribing will be integral in achieving the aims of the primary care White...

Independent Nurse: Opinion - Campaigning for nurse practitioners.
March 31, 2006... We need to work together to solve the issues surrounding the nurse practitioner role, says Benny Harston. Benny Harston is chair of the RCN's Nurse Practitioner Association and a nurse practitioner in a practice near Norwich in Norfolk....

Independent Nurse: Clinical - Cryotherapy in general practice.
March 31, 2006... DERMATOLOGY Removal of lesions with cryotherapy is effective and simple to do, writes Dr Nigel Stollery. Cryotherapy remains a very effective way of treating a variety of skin conditions. With the right training and supervision, it...

Independent Nurse: Clinical - Travel health - Diseases transmitted by food and water.
March 31, 2006... Travellers should take steps to avoid diseases contracted from infected food and water, explains Dr Mike Townend. Not only can travellers suffer disease as a result of insect bites, they are also in danger of succumbing to food and...

Independent Nurse: Clinical - At a glance - Differential Diagnosis - Guttate psoriasis versus pityriasis versicolor.(care and treatment for guttate psoriasis and pityriasis versicolor )(Brief article)
March 31, 2006... GUTTATE PSORIASIS DISCRIMINATORY SIGNS - Often starts in childhood or young adulthood. - Typically after a streptococcal throat infection. - Other triggers can be stress, skin injury, alcohol and medication - beta-blockers,...

Independent Nurse: Clinical At a glance - Differential Diagnosis - Chronic dermatitis versus palmoplantar pustulosis.(diagnosis for Chronic dermatitis)(Brief article)
March 31, 2006... CHRONIC DERMATITIS DISCRIMINATORY SIGNS - Affects mainly males. - Associated with family history of atopy. - Associated with previous atopic eczema in childhood. - The condition is itchy. - Affected areas are not...

Independent Nurse: Clinical focus - Hyperlipidaemia.(care and treatment for hyperlipidaemia)
March 31, 2006... OVERALL KEY POINTS - All patients with established atheroma or diabetes require treatment. - Those with cardiovascular risk factors and calculated cardiovascular risk >2 per cent need treating. - All patients with familial...

Independent Nurse: Clinical Infection - A-Z Chickenpox.(care and treatment chickenpox )
March 31, 2006... CHICKENPOX In healthy individuals, managing chickenpox is simple, but some groups of patients need extra care, says Sarah Eades. Chickenpox is a common, highly infectious disease most often seen in children. It is caused by varicella...

Independent Nurse: Professional - Providing choice in end-of-life care.
March 31, 2006... Investment in community-based palliative care must be supported with adequate training programmes and resources for nurses, writes Karen Daniel. Palliative, according to the Shorter Oxford English Dictionary, is 'anything which provides...

Independent Nurse: Professional Teamwork - Enhancing the strengths of teams in general practice.(reports of health care teams)
March 31, 2006... An effective team can foster a sense of belonging and self-worth for its members, writes Kathie Applebee. When teams work well, they are able to share expertise, minimise personal weaknesses and create a sense of belonging that nurtures...

Independent Nurse: Professional - Career development - Career Profile - Lynne Hughes, Colchester, Essex.
March 31, 2006... Why did you become a nurse? I wanted to be a nurse for all of my childhood (except for a brief period when I decided to be an astronaut!). How has your career developed since you started nursing? Before starting training I spent...

Independent Nurse: Jargon buster.(Brief article)
March 31, 2006... Community matrons What are they? First mentioned in 2004's NHS Improvement Plan, these community-based senior nurses with advanced level clinical skills use case management to cater for patients with complex, long-term conditions. A...

Independent Nurse: Worth a look.(Brief article)
March 31, 2006... Book Tuberculosis Survival Handbook Launched to mark World TB Day last week, the second edition of the Tuberculosis Survival Handbook, written by Paul Mayho, aims to help patients and healthcare professionals understand modern...

Exclusive: No MPIG rights for ex-PMS GPs.(Premenstrual Syndrome)
March 24, 2006... PMS practices have been warned that they have no guarantee of an MPIG if they return to GMS. At least 1,250 PMS practices in England are facing income cuts as PCTs follow DoH orders to cut costs (GP, 17 March). DoH guidance says PMS...

Flu falls below threshold for antiviral scrips.(general practitioners advised to stop prescribing)(Brief article)
March 24, 2006... GPs have been advised to stop prescribing antivirals this winter, because levels of circulating flu virus have dropped below the NICE threshold for their use. Across the UK, consultation rates were just over 15 per 100,000 in the week...

Lab-grown islets for diabetes.(bioreactors )(Brief article)
March 24, 2006... Large volumes of insulin-producing cells from pig islets have been successfully generated by US researchers using a 'bioreactor'. They have also cultured small preparations of human islet cells, and intend to scale up production. They...

GPs to screen new patients for TB.(general practitioners serve for tuberculosis)(Brief article)
March 24, 2006... Patients registering with GP practices will have to be assessed for TB risk and those in certain high-risk groups sent for a chest X-ray, under the NICE clinical guideline on the identification, prevention and treatment of TB. NICE wants...

Asthma in women is linked to leptin.
March 24, 2006... High levels of an inflammatory protein produced by fat cells may increase the risk of asthma in pre-menopausal women, according to a US study. Women with asthma were found to have significantly higher blood serum levels of leptin than...

Lipid metabolism of brain key to obesity.(over activity appetite to treat diet induced obesity)(Brief article)
March 24, 2006... Restoring the balance of lipid metabolism in the hypothalamus could reset an over-active appetite to treat diet-induced obesity and insulin resistance, US researchers say. Researchers found that rats that binged on fatty food had a...

Research brief: Angina common in women too.
March 24, 2006... Women have a similar incidence of angina to men, but are less likely to have their diagnosis confirmed by angiogram or electrocardiogram, UK researchers have found. A population study including 100,000 patients with angina, aged between 45...

Research brief: Why people don't transmit avian flu.(comparative analysis of human flu viruses and avian flu viruses)(Brief article)
March 24, 2006... Avian flu viruses and human flu viruses attach themselves to different parts of the human airway, US researchers say. This could explain why transmission of avian flu viruses between humans is rare. The viruses bind to different versions of...

Research brief: Overweight diabetics overestimate healthy weight.(comparative analysis of overweight and healthy weight)(Brief article)
March 24, 2006... Overweight diabetics are more likely to be mistaken about what is a healthy weight than diabetics with a healthy bodyweight. A survey of 2,461 US diabetes patients found that 41 per cent gave a 'healthy' weight for their height that was in...

Research brief: Deadly peanut kisses.(Peanut allergy takes four hours to get controlled )(Brief article)
March 24, 2006... Teenagers with nut allergy need to be more aware of the risks of kissing someone too soon after they have eaten nuts, according to US research presented at the 2006 annual meeting of the American Academy of Allergy Asthma and Immunology in...

Investment vital for care of long-term conditions.(long term care insured for patients)
March 24, 2006... Plans to shift the care of patients with long-term conditions from hospitals into the community could be doomed to failure without a significant increase in funding and staffing levels. GPs who helped develop the template for such a...

Warsaw pact.(Dr.Nigel Fraser, contributing money for Marie Curie Cancer cure)(Brief article)
March 24, 2006... A Scarborough GP and his wife plan to cycle 300 miles across Eastern Europe to raise money for Marie Curie Cancer Care. Dr Nigel Fraser (pictured second from left with other fund raisers) will cycle from Vilnius in Lithuania to Warsaw in...

Call for DDRB awards to be paid from April.(Data Requirements Review Board)(Brief article)
March 24, 2006... The GPC has called for GP pay rises recommended by the Review Body to be implemented from 1 April, following fears that the DoH might try to delay the rises. The Review Body, which recommends pay levels for GP registrars, GP trainers,...

IT system choice 'not compatible' with new GMS.(information technology, not compatible with General Medical Services)(Brief article)
March 24, 2006... The GPC says that proposals to increase the choice of IT systems available to GP practices set out by Connecting for Health this week are not compatible with the GMS contract. A document released from the IT agency defines what types of...

Third of London premises 'poor'.(increasing hospital economy)
March 24, 2006... A third of GP premises in London are substandard, according to the DoH. The total number in substandard accommodation has risen from 306 in March 2004 to 517 in March 2005. Minimum standards take into account issues such as ease of...

Poetry cutback.(poems cutdown surgeries)(Brief article)
March 24, 2006... Poems in the Waiting Room, a charity that provides poetry leaflets to GP surgeries, is to cut the number of surgeries it supplies from 1,382 to 400. The charity blames a cut in funding from the Arts Council of England because of a...

Bowel screening scheme roll-out may face delays.(Screening roll-out due to lack of funding)(Brief article)
March 24, 2006... The national bowel screening programme, due to be rolled out next week, is unlikely to go ahead as planned, the president of the British Society of Gastroenterology has warned. This comes weeks after the DoH denied the bowel screening...

Kidney mortality greater for men.(treatment of Glomerular filtration reduces kidney failure)(Brief article)
March 24, 2006... Women with chronic kidney disease (CKD) survive longer, are less likely to suffer kidney failure and experience a slower decline in glomerular filtration rate (GFR) than men with the condition, a Norwegian study has found. Researchers...

Bisphosphonates benefit over-80s.
March 24, 2006... Congress on Osteoporosis Treatment for elderly patients and questions for assessing fracture risk. Treatment for the secondary prevention of osteoporosis is as successful in very elderly patients as it is in the 65-75 age group,...

Targeting pain.(Paget's Disease)(Brief article)
March 24, 2006... A single injection of bisphosphonate can eliminate the painful symptoms of Paget's disease for nearly three years. Researchers compared 152 patients who received a 15-minute infusion of 5mg zoledronic acid with 115 patients who were given...

Ways to identify fracture risk.(age and body mass index )(Brief article)
March 24, 2006... Three simple questions, together with information on age and BMI, can identify a nine-fold variation in the risk of hip fracture, according to UK research presented at the congress. Professor John Kanis, from the Centre for Metabolic Bone...

NICE obesity advice favours drugs.(National Institute for Clinical Excellence )
March 24, 2006... GPs face a significant increase in workload under draft NICE recommendations that they should offer drug treatment to adult patients with a BMI of 30 or above who do not lose weight after dietary and exercise advice have been given. The...

Bariatric surgery first line if BMI is over 50.(body mass index)(Brief article)
March 24, 2006... Bariatric surgery should be offered as first-line therapy to adults with a BMI of 50 or above, and should be considered for all severely obese patients, according to draft NICE recommendations. Roux-en-Y gastric bypass, laparoscopic...

'Unworkable' IT policy scrapped.(Information Technology)
March 24, 2006... Connecting for Health has scrapped its user policy for the national patient record database, after GPs said it was unworkable. GP leaders have said that general practice would 'grind to a halt' if practices followed the acceptable use...

Program aims to increase the PBC savings for GPs.(Practice based commissioning for General Practitioners)(Brief article)
March 24, 2006... An internet-based program to help GPs increase their practice-based commissioning savings has been launched by Dr Foster Intelligence. The company, a collaboration between healthcare data specialist Dr Foster and the DoH, is selling the...

Commissioning good for GI care.(Gastrointestinal care)(Brief article)
March 24, 2006... Practice-based commissioning (PBC) should be used to improve the management of dyspepsia and coeliac disease in primary care, the British Society of Gastroenterologists (BSG) and GP specialists have said. A BSG report released last week...

Anorexia is heritable.(genetically affected )(Brief article)
March 24, 2006... A genetic predisposition accounts for more than half the risk of developing anorexia nervosa, according to a Swedish study. Researchers found that narrowly defined anorexia nervosa, according to DSM-IV criteria, was 56 per cent heritable....

Community hospitals win temporary reprieve.(short term budget problem )(Brief article)
March 24, 2006... Two community hospitals in Suffolk have been granted a temporary reprieve because their cases have been referred to the health secretary. The hospitals in Eye and Felixstowe were due to close this month, despite a directive from health...

Medical display.(display on medical museum)(Brief article)
March 24, 2006... The Science Museum in London is adding an exhibition of medical objects from around the world to its collection. The priceless exhibits include a 16th-century ivory Indian enema syringe. The exhibition, 'Living Medical Traditions', joins the...

Clinical DESs agreed in Scotland.(Directed enhanced Services)
March 24, 2006... Four directed enhanced services (DESs) worth pounds 12,000 for the average practice have been agreed in Scotland. The bulk of the pounds 12.6 million funding will go towards a DES for a cardiovascular disease (CVD) risk register, with...

GP concern over PCT mergers.(general practitioners)(primary care nursing)
March 24, 2006... GPs believe that some SHAs' proposals on how PCTs should be reconfigured could mire them in bureaucracy. They say creating PCTs that straddle SHA and local authority boundaries, such as those proposed in Doncaster and Wessex, would...

Calcium may cut complications of pre-eclampsia.
March 24, 2006... Calcium supplements in pregnancy could help to reduce mortality and severe complications associated with pre-eclampsia, a large WHO trial has found. The researchers studied 8,325 pregnant women without hypertension from seven countries,...

PMS must prove it is cost-effective.(Pre Menstrual syndrome)
March 24, 2006... Will financial constraints force PMS to merge with GMS? From Marks & Spencer to Alliance & Leicester, throughout history, company mergers have created great institutions. But where PMS and GMS contracts are concerned, the prevailing...

Behind the Headlines: Is exercising alone bad for you?
March 24, 2006... Running on your own might be less beneficial than exercising with other people. What is the story? Last week's newspapers reported good news for those who never quite make it out of bed for their morning run - psychologists have...

Letter: Correction.(Correction notice)
March 24, 2006... The photograph of Dr John Parry on the letters page last week was of Dr Parry of Keighley, West Yorkshire. It should have been of Dr Parry of Market Drayton, Shropshire. GP apologises for the confusion.

Leader: Is this the beginning of the end for PMS?(personal medical services )
March 24, 2006... Many GPs working under PMS contracts will have been contemplating their futures this week, following the latest financial guidance from the DoH. The officials at Richmond House have never been shy about putting their best and biggest...

Leader: There are ways of trimming the fat.(Brief article)
March 24, 2006... The government wants to tackle obesity because it has realised that inaction will create future problems. From April, practices will be rewarded under the GMS quality framework for producing a register of patients whose BMI is above 30. In...

Opinion: This is an Orwellian nightmare.
March 24, 2006... For GPs, Room 101 ain't big enough. We'd need room 102 and 103 as well, maybe the whole floor, maybe the whole Ministry of Light. My list is growing all the time; the Loop of Henle, instructive articles by consultants which conclude 'GPs...

Opinion: Efficiency, the NHS's panacea.(National Health Service)
March 24, 2006... Why is the NHS so hopelessly overspent? The accountant's answer is that the NHS is very labour-intensive, it has a huge workforce and many of its workers have recently received large pay rises. This is all very true, and very appropriate,...

Clinical: Journals Watch - Puberty, breastfeeding and faints.
March 24, 2006... Too busy to read the journals? Let Dr Suzanne Hunter guide you through the latest findings. Changing rooms for children - Arch Dis Child 2006; 91: 177 Traditionally boys and girls in primary schools would change for PE together....

Clinical: Clinical Q&A - Flutter and separation anxiety.
March 24, 2006... Our team of experts answers your questions on separation anxiety and flutter. A man in his seventies has a regular tachycardia of 150 beats per minute (bpm). His ECG shows atrial flutter. He has no symptoms, is taking no medication...

Clinical: Viewpoint - Access to contraception via community pharmacy.
March 24, 2006... Mr Paul Bissell addresses concerns on access to emergency contraception via pharmacies. In response to concerns about unwanted and teenage pregnancies, a series of developments aimed at enhancing access to emergency contraception (EC)...

Clinical: Practice Dilemma - Is an elderly patient being abused?
March 24, 2006... You suspect an elderly woman is being abused, but access is refused. What should you do? THE DILEMMA Mrs Murray is 76 years old and has been chair-bound and aphasic since having a stroke four years ago. She lives with her divorced...

Clinical: Managing Parkinson's disease in the long term.
March 24, 2006... GPs need a modern approach to treating Parkinson's disease, says Dr George Rhind. Parkinson's disease is a chronic progressive neuro-degenerative condition which results from dopaminergic neuronal loss in the substantia nigra. By...

Clinical: Equipment Review - The advantage of a sturdy speculum.(Product/service evaluation)
March 24, 2006... The Comfispec is an efficient and unobtrusive speculum, says Dr Gwen Lewis. These days, everywhere I look in the surgery there are boxes upon boxes of disposable specula. And then there are also the disposable packs of IUD fitting packs...

Clinical: Viewpoint - Maternal mental health and the child.
March 24, 2006... A mother's mental health problems can affect a child's development, suggests Dr Linda Miller. The risk of teratogenicity is a major concern for women on medication for long-term mental illness. Lithium, carbamazepine and sodium...

Clinical: Treating OAB for quality of life.(Overactive bladder syndrome)
March 24, 2006... Examination is essential for the diagnosis of overactive bladder syndrome, says Dr Julian Spinks. Overactive bladder syndrome (OAB) is the presence of urinary urgency (with or without urge incontinence) and usually with increased urinary...

Clinical: Websites on motor neurone disease.(reports of disease)
March 24, 2006... Websites related to this week's Clinical Review selected by Dr Keith Barnard. AMYOTROPHIC LATERAL SCLEROSIS They are fond of calling this Lou Gehrig's disease in the US, but I suppose we can't complain seeing as this excellent...

Clinical: Motor neurone disease - part one.(analysis of Motor neurone disease and amyotrophic lateral sclerosis)
March 24, 2006... THE ESSENTIALS - A large group practice will see one case of ALS every two or three years. - Most patients present with muscle weakness, fasciculations and cramps. - Suspicion of the diagnosis warrants urgent outpatient...

Registrar: The Registrar Year - Leave, allowances and accounts.(benefits of general practitioners )
March 24, 2006... Dr Kevin Brown looks at special leave and allowances for GP registrars. Maternity leave Maternity leave rules for GP registrars are similar to those for hospital doctors. To qualify for payments a registrar must have completed at...

Registrar: MRCGP Exam Update - Patient information on the web.(Membership of the Royal College of Physicians)
March 24, 2006... Current situation - The internet is a common and increasingly used resource for medical and health information. - Typing the word 'health' into a well-known search engine throws up over 3.9 million relevant websites. - Surveys...

Registrar: Pictorial Case Study.(case study of upper eyelids)(Brief article)
March 24, 2006... THE CASE A 48-year-old woman presented concerned about the appearance of lesions on both of her upper eyelids. These lesions had been present for at least 12 months but had enlarged and she now found them cosmetically unappealing. ...

MedEconomics: GP Finance - How to ... deal with patient complaints.(general practitioners)
March 24, 2006... Taking a few simple steps should enable GPs to resolve most complaints at practice level. When patients complain about the service they have received, defusing the situation tactfully and without reacting emotionally increases the...

MedEconomics: Health and safety for your practice team.(responsibility of general practitioners )
March 24, 2006... Ensure staff understand and implement all the required policies, says Dr Ruth Chambers. Your practice staff are required by law to complete certain statutory training each year. But many practices either ignore their legal requirements...

MedEconomics: Your questions on pensions answered.(rules of national health service)
March 24, 2006... PROTECTION I would be grateful for further advice to help me to decide whether to ask for 'protection' before A-Day for pensions. You have previously mentioned that when one exceeds the allowances (pounds 1.8 million in 2010) there...

MedEconomics: Boost self care to cut consultations.(general practice )
March 24, 2006... Join forces with a local pharmacy to help reduce unnecessary consultations, suggests, Dr Paul Stillman. Consulting rates in general practice have always increased throughout the NHS's history. More recently, the move from a...

MedEconomics: White Paper sees GPs enter world of marketing.(General Practitioners)
March 24, 2006... GPs' surgeries are becoming consumer environments, reports Jane Feinmann. Now that the White Paper has formally identified patients as 'healthcare consumers', the new priority for GPs seems to be the marketing of their wares. This...

MedEconomics: Benefits of on-site hearing tests.
March 24, 2006... A hearing test clinic in the surgery cuts referrals and eases workload, according to Dr Michael Davies. It is estimated that approximately nine million people in the UK suffer from some degree of hearing loss. A recent survey carried...

GP Life: A stylish dessert for Mother's Day.(General practitioners)(white chocolate parfait receipe)
March 24, 2006... This white chocolate parfait is simple to make, but sure to impress on special occasions. Some cynics might comment that events like this week's Mother's Day are mainly the invention of the greetings card industry. But rather like...

GP Life: I need a ... last minute present for Mother's Day.
March 24, 2006... Arrgh, how did 26 March creep up? Only 48 hours to go, so let's look at those things that are easily obtainable within the time left. Let's start with flowers. Usually a good option and appropriately last minute if you can deliver them...

GP Life: Join the GP who is on the road to Morocco.(General Practitioners)
March 24, 2006... Adventurous GPs are needed to join driving expeditions. It was a patient who got me involved. A Land Rover manager, he nominated me to provide medical support for the company's international customer expeditions. Little did I know...

GP Life: Differential Planting - Syringa vulgaris vs Ceanothus thyrsiflorus.(General Practitioners)(Brief article)
March 24, 2006... SYRINGA VULGARIS - CHARLES JOLY - Common lilac, prefers full sun - Deciduous shrub, up to 4.5m - Heart-shaped dark green leaves - Dense, fragrant, dark purple flowers - Blooms May to June, on previous year's wood - Fully hardy....

Plain Tales from the Surgery.
March 24, 2006... CAUSE FOR CONCERN A patient was worried she had hit an early menopause following her hysterectomy, so I sent an FSH/LH sample to the laboratory. I quoted the following information on the request form: 'Patient concerned, menopausal...

Mary Selby: The chicken pie machine.(management of pie-making machine )
March 24, 2006... We're sitting, funereally, watching Chicken Run - in which the rooster Mel Gibson and his intrepid chickens escape the evil farmer's giant pie-making machine - because the fox got our chickens. He dug into their run, as he often does, but on...

Independent Nurse: Report suggests adding dyspepsia and coeliac disease to QOF targets.(Quality of Frameworks)(Brief article)
March 24, 2006... Dyspepsia and coeliac disease should be included in the next round of changes to the quality and outcomes framework, according to the British Society of Gastroenterology (BSG). In its report, Care of Patients with Gastrointestinal...