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IPCA

International Primary Care Association
 
 
 

Clinical Focus Primary Care

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!

Abstract

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”.

Abstract

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.

Abstract

Alcohol is a leading cause of physical, psychological and social harm. In this review, we explain the current categorisation of alcohol use disorders in the context of these harms. We then discuss the rationale and recommended methods for screening for these disorders in primary care, and the principles of treatment.

Abstract

Teenage pregnancy is frequently encountered by general practitioners who are often the teenager’s first encounter with the health services. Despite falling rates and intense government initiatives over the past decade to address high rates of teenage pregnancy, the United Kingdom continues to have one of the highest teenage birth rates in Western Europe. Teenagers have unique social and medical issues in pregnancy which require careful management from their general practitioners to help optomise pregnancy outcomes and reduce recurrence of repeat pregnancy.

Trust! Defined by the OED as, “Firm belief in the reliability, truth, or ability of someone or something”. This month’s healthcare news is deluged with the “loss in trust between clinical staff and the government”. It is the words, truth and reliability, which interest me in the definition.

 

Abstract

Anaemia is frequently encountered in general practice. Anaemia is not a diagnosis but a presentation of an underlying cause. Although iron deficiency anaemia is the one that is most commonly recognised; there are various classifications of anaemia with numerous causes. It is important for primary care physicians to recognise, diagnose and appropriately manage all types of anaemia.
The article sets to deliver a concise overview of anaemia for the general physician with clear systematic pathways for common anaemias that can be adopted for use during a busy surgery.

Abstract

The causes of chronic cough in children are extensive and the majority of respiratory conditions may present with cough. It is, however, important to establish the correct diagnosis and to manage the underlying cause. We outline a clinical approach to the management of a child presenting to primary care with a chronic cough. Highlighted are the specific diagnostic pointers, red flag features and when to refer for specialist investigations.

 
 

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