Wednesday, 29 February 2012 11:32

Plantar Heel Pain

Rate this item
(0 votes)

Abstract

Plantar Heel pain is one of the most commonly encountered problems of foot pain in active adults over the age of 40. One in ten people will experience heel pain, and for many the problem will have a significant impact upon their daily activities. This article focuses on the differential diagnosis, investigations and management of plantar heel pain in primary care. An evidenced based approach is presented for the treatment of plantar fasciitis, especially considering the multitude of treatment modalities available.

Wednesday, 29 February 2012 11:38

Dizziness, Vertigo and Imbalance

Rate this item
(0 votes)

Abstract

Whilst dizziness, vertigo and imbalance may be due to systemic disease, they commonly originate from the vestibular system. The presence of vertigo, in particular, implies vestibular involvement. This article will address the diagnosis and management of vestibular dysfunction in adults, highlighting the three commonest causes which can be diagnosed and treated in a primary care setting, and stressing the “red flags” that should trigger referral to more specialist services.

Rate this item
(0 votes)

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!

Thursday, 01 March 2012 11:54

Editorial

Rate this item
(0 votes)

Globally, cervical cancer is the second most common cancer in women with half a million new cases diagnosed annually and a quarter of a million deaths. The UK has one of the best cervical cancer screening programmes in the world, but even with this there are three thousand new cases of cervical cancer each year in the UK and a thousand deaths. Six percent of these deaths are in women under thirty.

Thursday, 01 March 2012 12:00

What is HPV?: an overview

Rate this item
(0 votes)

Human papillomaviruses are DNA viruses that infect epithelial (skin or mucosal) cells. They are described as “genotypes” and numbered in order of their discovery.

HPV – structure

The virus particle or virion consists of a protein coat encapsidating a circular DNA molecule about 8000 base pairs (8kb) in size. High resolution electron microscopy reveals the virion to be a particle of about 55nm in diameter

Rate this item
(0 votes)

The psychosocial effects of HPV-related disease may be related to the disease itself, its treatment and the knowledge that the disease is caused by HPV, a sexually transitted infection. There are also psychosocial consequences from the cervical screening programme, even among women who do not have disease.

Rate this item
(0 votes)

Genome structure

The papillomavirus particle or virion consists of a protein coat encapsidating a circular DNA molecule about 8000 base pairs (8kb) in size. The genome can be divided into three domains. The first is a short stretch of DNA (the length differs between different HPV types) known by various names – the non coding region, NCR, the long control region, LCR, or the upstream regulatory region, URR. As these names indicate this region does not encode any genes but controls the expression of the eight viral genes that make up the remainder of the genome. To do this the NCR contains short DNA sequences or motifs that bind both cellular and viral proteins known as transcription factors; this binding can either turn on or turn off gene expression by activating or repressing the promoter of the gene.

Thursday, 01 March 2012 12:07

HPV Vaccines

Rate this item
(0 votes)

Two HPV prophylactic vaccines have been developed, these are Cervarix®, a bivalent HPV16/18 VLP vaccine from GlaxoSmithKline, and Gardasil® a quadrivalent HPV16/18/6/11 VLP vaccine from Sanofi Pasteur MSD. The details of these vaccines and their trials are shown in Table 1. The vaccines are sub unit vaccines consisting of virus-like particles or VLPs – synthetic shells composed of the L1 coat protein. These VLPs are morphologically identical to the virus coat but consist only of 1 protein, contain no DNA and are therefore not infectious. Gardasil® was licensed in many countries including the USA and Europe in 2006 and Cervarix® in late 2007.

Page 10 of 23

Get in Touch

IPCA
73 Newman Street
London
W1T 3EJ

T: +44 207 580 7759
E: This email address is being protected from spambots. You need JavaScript enabled to view it.
 

Copyright © 2019 International Primary Care Association. All Rights Reserved.