Friday, 09 March 2012 13:01

Contraception in Young People

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Abstract

Friendly, non-judgmental ‘one-stop’ services enable young people to access sexual and reproductive healthcare. Contraceptive advice should be comprehensive, addressing the young person’s needs and priorities with appropriate follow-up. Evaluating competence to consent and discussing confidentiality are core aspects of the adolescent sexual health consultation, in addition to identifying any safeguarding concerns.

Friday, 09 March 2012 13:02

Diabetes and Pregnancy

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Abstracts

Type 2 diabetes is becoming more common, primarily due to increasing levels of obesity in our society. It is also being diagnosed more frequently in young people, so it is now much more often seen in women of reproductive age. Given that people with Type 2 diabetes are now typically managed in primary care, it is important for primary care teams to understand the issues around pre-existing diabetes and pregnancy. For similar reasons, gestational diabetes is also much more common than it used to be and there are now internationally agreed criteria for diagnosis and a greater consensus in the principles of management.

Friday, 09 March 2012 13:03

Genital Ulceration

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Abstract

Full assessment of the individual with genital ulceration should include a sexual history and specialised investigations. Infective and malignant causes need to be excluded before concluding an inflammatory origin. A multidisciplinary approach is often indicated.

Friday, 09 March 2012 13:05

Syncope and Seizures in Children

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Abstract

This article discusses syncope, epileptic and febrile seizures. A careful history will determine whether an attack is provoked or unprovoked, facilitating further evaluation to establish diagnosis and management. It is important always to exclude acute symptomatic causes of seizures and syncope. The majority of children who experience syncope, febrile seizure or a single epileptic seizure will not have epilepsy.

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Background

This paper represents personal reflections on the evolution of urology service provision over the past 30 years and offers a possible scenario for such provision in the future.

I qualified forty years ago; those were the days when consultants were revered and their senior registrars worked hard to ensure that their masters were never disturbed out of hours; now it seems to be the consultants who work hard so that the ‘juniors’ can stay in bed! There were plenty of ‘Sir Lancelot Spratt’ (the senior surgeon in Richard Gordon’s film ‘Doctor in the House’1) characters about; one of whom undertook an open prostatectomy on my father. A few days later, when he found out that I was due to start at medical school later that year, I was summoned to watch him operate. After removing a kidney and leaving his senior registrar to ‘make good and close’, he took me into the senior surgeon’s sitting room and gave me a few pointers for the future. The most memorable ‘tip’ was that as soon as I had a consultant job I should buy a Rolls Royce car. “Borrow the money if you have to” he said but remember you are in the only job in which you will be respected more for it… and you can double your fees straight away!

Monday, 14 November 2011 04:26

Editorial

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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.

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Abstract

Attention deficit hyperactivity disorder (ADHD) comprises a triad of:
• Hyperactivity
• Impulsivity
• Inattention These behaviours are inconsistent with the child’s developmental/chronological age, and are present in multiple settings, over a period of time (>6 months), causing functional impairment. Multidisciplinary management, including behavioural and pharmacological interventions, improves outcome.

Monday, 14 November 2011 04:26

Anorexia

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Abstract

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.

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