Volume 9 Issue 3 - 2016
A very Merry Xmas and A Happy and Prosperous 2016 to all our readers.
We leave 2015 with the Chancellor agreeing to pump in an extra £6 billion into the NHS and the government retreating from the unnecessary confrontation with junior doctors. The cash is welcome to ease general and the upcoming winter pressures but unless there is a concomitant restructure to minimize the bureaucracy much of the money will not be directed at frontline services but on bean counters. Bean counters incentivized to attain, and generally failing, the meaningless central government health targets, and being paid very well to do so. This smacks of and mirrors in many respects what we all loath about the financial industry which almost single-handedly ruined the UK economy, but purportedly was working in the public’s best interests!
Cerebral Palsy (CP) describes a group of permanent disorders of movement and posture, attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. It is commonest cause of physical impairment in children. With recent advances in medical and surgical care, many children with previously fatal problems are now surviving to adulthood. Many of these conditions until recently have been unfamiliar to those working predominately in adult practice. Transition is defined as a “purposeful, planned process that addresses the medical, psychosocial, educational/vocational needs of adolescents and young adults with chronic physical and medical conditions as they move from child centered to adult oriented health care systems”.
Acute kidney injury (AKI) is common and serious. While it is usually cared for in hospital, it is no less important in primary care. AKI typically arises first in the community and is often not completely resolved at hospital discharge. Primary care has a role both in prevention and follow up of AKI. Surveillance for new chronic kidney disease (CKD) is recommended in guidelines. In this article we compare the diagnostic criteria for AKI and CKD, what a diagnosis means in primary care, and the role of primary care in monitoring for CKD after AKI.