Displaying items by tag: Volume 5 Issue 3 2011 International Primary Care Association(IPCA) is an international membership-based organisation of doctors, nurses and allied healthcare professionals with special interests, or are thinking of developing one for career advancement. http://ipcauk.org.nmsrv.com/index.php/clinical-focus-primary-care/cf-volume-5-n3/itemlist/tag/Volume%205%20Issue%203%202011 2018-04-20T00:59:01+00:00 Joomla! - Open Source Content Management Editorial 2011-11-14T04:26:37+00:00 2011-11-14T04:26:37+00:00 http://ipcauk.org.nmsrv.com/index.php/clinical-focus-primary-care/cf-volume-5-n3/item/15-editorial IPCA Admin admin@ipcauk.org <div class="K2FeedIntroText"><p><span>Listening and Learning seems to be the order of the day. Before this issue hits your floor mat the government’s, “Listening Exercise”, on the NHS reforms will have been completed and the policy enunciated by Andrew Lansley, and at inception agreed and signed off with Lib/Dem approval, will be dead or marginally watered down for appeasement. If the former I suspect Mr Lansley will have to be politically sacrificed.</span></p> </div><div class="K2FeedFullText"> <p>It has been difficult to square the circle on this one as my straw poll on attitudes to there forms, which is talking to clinicians and other healthcare professionals, indicates a strong feeling of frustration with the present structure of PCTs and SHAs etc. The government, from David Cameron to Andrew Lansley, coalition partners, the opposition and front line staff accepted that the status quo is unacceptable. Why then the fuss! It is the usual suspects of vested interests worried about their little empires, unable or unwilling to see the broader picture that requires addressing. The ageing population, the inexorable rise and rise of Long Term Conditions and clinical management, in many instances, now easily and less expensively delivered in the community.</p> <p>The most important structure that will ensure that GP commissioning functions as envisaged is a robust monitoring organisation. This Monitor should be equipped with very clear and specific powers to sanction those who go beyond the statutory boundaries. The view that GPs will run amok with £60 billion of public money is a cartoon image peddled by detractors of the changes proposed. There are a plethora of checks and balances to prevent this which are already well embedded. Could it be any worse that SHAs and PCTs wasting billions on inappropriate IT systems, selling NHS estates and getting turned over by large suppliers?</p> <p>Most of us at the, “Fron tline”, have to contend with this farrago and manage our patients. I am therefore pleased that we have an array of clinical articles to help us focus on the real job. The UK rag bag of newspapers has been very aggressive at purveying the notion that“Attention Deficit Hyperactivity Disorder” does not exist! Once you have read the article by Drs Katagampula and Banerjee you may appreciate the mythological world that many of our national medical and newspaper journalists inhabit. I have mentioned Long Term Conditions previously and Diabetes is one that will be a major player. Pharma companies seem to launch a new class of drugs for diabetes every week. Berit Inkster and colleagues have provided an overview that cuts through the hyperbole and focuses on exactly what you need to know to best manage your patients.</p> <p>Most GPs will encounter patients with eating disorders with Anorexia Nervosa being not uncommon. Dr Kan and Professor Treasure have provided us with an excellent up to date summary of this condition. Any symptom that involves neurology, and the head/brain inparticular, usually initiates sweats and palpitations in clinicians. Headaches in Children must be such a symptom. Dr Sheikh Nigel Basheer has penned a contribution on this topic that allows the clinician to reduce their worries. Drs Sack and Wilkinson have visited the “Human Papilloma Virus”. It is an organism with protean related medical conditions. The authors have deftly addressed the clinical issues and for spice have also confronted the vexed question of HPV vaccination. Very interesting it is too, with political intrigue in the mix!</p> <p>Finally, I would like to commence a “Correspondence” section in the publication and so comments would be gratefully received. Should anyone wish to contribute please contact me by email.</p> <p>Happy reading.</p> <p>Professor Ram Dhillon<br /><em>Editor</em></p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> <div class="K2FeedIntroText"><p><span>Listening and Learning seems to be the order of the day. Before this issue hits your floor mat the government’s, “Listening Exercise”, on the NHS reforms will have been completed and the policy enunciated by Andrew Lansley, and at inception agreed and signed off with Lib/Dem approval, will be dead or marginally watered down for appeasement. If the former I suspect Mr Lansley will have to be politically sacrificed.</span></p> </div><div class="K2FeedFullText"> <p>It has been difficult to square the circle on this one as my straw poll on attitudes to there forms, which is talking to clinicians and other healthcare professionals, indicates a strong feeling of frustration with the present structure of PCTs and SHAs etc. The government, from David Cameron to Andrew Lansley, coalition partners, the opposition and front line staff accepted that the status quo is unacceptable. Why then the fuss! It is the usual suspects of vested interests worried about their little empires, unable or unwilling to see the broader picture that requires addressing. The ageing population, the inexorable rise and rise of Long Term Conditions and clinical management, in many instances, now easily and less expensively delivered in the community.</p> <p>The most important structure that will ensure that GP commissioning functions as envisaged is a robust monitoring organisation. This Monitor should be equipped with very clear and specific powers to sanction those who go beyond the statutory boundaries. The view that GPs will run amok with £60 billion of public money is a cartoon image peddled by detractors of the changes proposed. There are a plethora of checks and balances to prevent this which are already well embedded. Could it be any worse that SHAs and PCTs wasting billions on inappropriate IT systems, selling NHS estates and getting turned over by large suppliers?</p> <p>Most of us at the, “Fron tline”, have to contend with this farrago and manage our patients. I am therefore pleased that we have an array of clinical articles to help us focus on the real job. The UK rag bag of newspapers has been very aggressive at purveying the notion that“Attention Deficit Hyperactivity Disorder” does not exist! Once you have read the article by Drs Katagampula and Banerjee you may appreciate the mythological world that many of our national medical and newspaper journalists inhabit. I have mentioned Long Term Conditions previously and Diabetes is one that will be a major player. Pharma companies seem to launch a new class of drugs for diabetes every week. Berit Inkster and colleagues have provided an overview that cuts through the hyperbole and focuses on exactly what you need to know to best manage your patients.</p> <p>Most GPs will encounter patients with eating disorders with Anorexia Nervosa being not uncommon. Dr Kan and Professor Treasure have provided us with an excellent up to date summary of this condition. Any symptom that involves neurology, and the head/brain inparticular, usually initiates sweats and palpitations in clinicians. Headaches in Children must be such a symptom. Dr Sheikh Nigel Basheer has penned a contribution on this topic that allows the clinician to reduce their worries. Drs Sack and Wilkinson have visited the “Human Papilloma Virus”. It is an organism with protean related medical conditions. The authors have deftly addressed the clinical issues and for spice have also confronted the vexed question of HPV vaccination. Very interesting it is too, with political intrigue in the mix!</p> <p>Finally, I would like to commence a “Correspondence” section in the publication and so comments would be gratefully received. Should anyone wish to contribute please contact me by email.</p> <p>Happy reading.</p> <p>Professor Ram Dhillon<br /><em>Editor</em></p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> Attention Deficit Hyperactivity Disorder in Children 2011-11-14T04:26:33+00:00 2011-11-14T04:26:33+00:00 http://ipcauk.org.nmsrv.com/index.php/clinical-focus-primary-care/cf-volume-5-n3/item/14-attention-deficit-hyperactivity-disorder-in-children IPCA Admin admin@ipcauk.org <div class="K2FeedIntroText"><h3><strong>Abstract</strong></h3> <p><br />Attention deficit hyperactivity disorder (ADHD) comprises a triad of:<br />• Hyperactivity<br />• Impulsivity<br />• Inattention<br /><br /> These behaviours are inconsistent with the child’s developmental/chronological age, and are present in multiple settings, over a period of time (&gt;6 months), causing functional impairment. Multidisciplinary management, including behavioural and pharmacological interventions, improves outcome.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> <div class="K2FeedIntroText"><h3><strong>Abstract</strong></h3> <p><br />Attention deficit hyperactivity disorder (ADHD) comprises a triad of:<br />• Hyperactivity<br />• Impulsivity<br />• Inattention<br /><br /> These behaviours are inconsistent with the child’s developmental/chronological age, and are present in multiple settings, over a period of time (&gt;6 months), causing functional impairment. Multidisciplinary management, including behavioural and pharmacological interventions, improves outcome.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> Anorexia 2011-11-14T04:26:28+00:00 2011-11-14T04:26:28+00:00 http://ipcauk.org.nmsrv.com/index.php/clinical-focus-primary-care/cf-volume-5-n3/item/12-anorexia IPCA Admin admin@ipcauk.org <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>Anorexia nervosa (AN) can be a challenging illness for a primary care team to detect and manage in the community. Early diagnosis and effective treatment of patients with AN has been shown to improve prognosis. General practitioners can play a vital role in diagnosis and providing medical support for AN patients.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>Anorexia nervosa (AN) can be a challenging illness for a primary care team to detect and manage in the community. Early diagnosis and effective treatment of patients with AN has been shown to improve prognosis. General practitioners can play a vital role in diagnosis and providing medical support for AN patients.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> Headaches in Children 2011-11-14T04:24:46+00:00 2011-11-14T04:24:46+00:00 http://ipcauk.org.nmsrv.com/index.php/clinical-focus-primary-care/cf-volume-5-n3/item/8-headaches-in-children IPCA Admin admin@ipcauk.org <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>This article summarizes idiopathic headaches in childhood, differentiating the clinical characteristics from those of intracranial hypertension. There is a discussion on migraine treatment, the importance of environmental influences and the less well recognized risk posed by analgesic overuse leading to chronic refractory headaches.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>This article summarizes idiopathic headaches in childhood, differentiating the clinical characteristics from those of intracranial hypertension. There is a discussion on migraine treatment, the importance of environmental influences and the less well recognized risk posed by analgesic overuse leading to chronic refractory headaches.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> Preventing the sequelae of Human Papillomavirus Infection 2011-11-14T04:21:25+00:00 2011-11-14T04:21:25+00:00 http://ipcauk.org.nmsrv.com/index.php/clinical-focus-primary-care/cf-volume-5-n3/item/6-preventing-the-sequelae-of-human-papillomavirus-infection IPCA Admin admin@ipcauk.org <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>Sexually acquired oncogenic Human Papillomavirus (HPV) types are important co-factors in the development of anogenital tract malignancies. HPV vaccines are a major primary prevention strategy against cervical cancer, other HPV-associated malignancies, cervical dysplasia and genital warts. Improving vaccination uptake is key to the future success of the HPV vaccination programme, and could potentially be achieved by involving GPs, sexual health services and providers in its delivery.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>Sexually acquired oncogenic Human Papillomavirus (HPV) types are important co-factors in the development of anogenital tract malignancies. HPV vaccines are a major primary prevention strategy against cervical cancer, other HPV-associated malignancies, cervical dysplasia and genital warts. Improving vaccination uptake is key to the future success of the HPV vaccination programme, and could potentially be achieved by involving GPs, sexual health services and providers in its delivery.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> Seeing through the plethora of medications for diabetes 2012-02-17T15:13:32+00:00 2012-02-17T15:13:32+00:00 http://ipcauk.org.nmsrv.com/index.php/clinical-focus-primary-care/cf-volume-5-n3/item/22-seeing-through-the-plethora-of-medications-for-diabetes IPCA Admin admin@ipcauk.org <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>Type 2 diabetes is increasingly prevalent, and is associated with increased morbidity and mortality. Studies have shown the benefit of tight glycaemic control in reducing complications, but with many conventional treatments this can result in weight gain and hypoglycaemia. Newer treatments may lessen these problems, but evidence of their long term efficacy is lacking.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div> <div class="K2FeedIntroText"><h3><strong>Abstract </strong></h3> <p>Type 2 diabetes is increasingly prevalent, and is associated with increased morbidity and mortality. Studies have shown the benefit of tight glycaemic control in reducing complications, but with many conventional treatments this can result in weight gain and hypoglycaemia. Newer treatments may lessen these problems, but evidence of their long term efficacy is lacking.</p></div><div class="K2FeedTags"><ul><li>Volume 5 Issue 3 2011</li><ul></div>