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International Primary Care Association

Clinical Focus Primary Care

Delirium represents a relatively uncommon, but important, presentation within primary care; particularly amongst at risk populations including those with dementia or living in residential care. Recognising delirium effectively is important to provide prompt and effective management to minimise adverse consequences.

Cannabis, in herbal and synthetic forms, is becoming increasingly discussed in and advocated for the management of multiple health conditions. Some of this advocacy comes from both prominent figures and politicians. Alongside this there is significant work being undertaken to bring cannabis and products containing cannabinoids to market. This makes understanding the nature of cannabis, the biological and social pressures associated with its use and the evidence of treatment effectiveness, increasingly important. This paper provides a broad overview of cannabis and its potential uses in medicine.

Dementia is a common clinical syndrome affecting 1 in 14 adults over the age of 65 and a smaller number of younger people. This article explores presentation, assessment, differential diagnosis and management, providing an overview for the generalist and a more in depth insight for those with a special interest.

As global travel becomes more accessible, so is the incidence of diseases in the returning traveller. Secondary to gastrointestinal and fever of unknown origin, dermatological presentations are the most prevalent complaints with which patients present. Dermatoses can be non-infective, such as sunburn or worsening of eczema, or infective, and can be specific to the travelled area, such as Dengue or Zika, or can be also be found at home, such as cellulitis. Dermatological presentations are varied, and result in rashes, blisters, bullae, nodules or plaques, to name a few. This review aims to outline some of the most common conditions seen in the returning traveller; both those with primary and secondary dermatological manifestations, and how to manage them appropriately.

In this article we introduce the key features and health considerations associated with intellectual disability. Although roughly 1% of the population has an intellectual disability, their needs are frequently overlooked, both in medical training and in clinical practice. This contributes to worse clinical outcomes and excess mortality. General Practitioners have an important role in the co-ordination and delivery of high-quality care for this group.

Soft tissue tumours, in particular lipoma, are relatively common with a very high cure rate and low rate of recurrence following excision. They outnumber malignant soft tissue lesions considerably, making identification of aggressive lesions difficult and potentially leading to diagnostic delays. Soft tissue sarcomas are a relatively uncommon group of malignancies arising in mesenchymal tissues, and hence, can occur almost anywhere in the body. In recent years, the investigation and management of these lesions have been centralised to a number of specialist centres throughout the UK in an effort to aid early identification and streamline management of malignant soft tissue tumours.

Early spring brought atrocious weather, The Beast from the East mingled with Storm Emma, putting pressure on public services across the board. It has illustrated again how much on the cusp such services are performing, particularly the NHS, as additional pressures could barely be accommodated.  

Oral health problems are extensive and multi-factorial in nature. Patient outcome will be compromised if there is limited access to trained dental professionals for oral health issues. The increasing number of dental patients going to the General Practitioners (GP) costs the NHS ‡26 million per year. The reasons why patients visit their GP for oral health issues are numerous; however, GPs are not responsible for treating dental patients. GPs do play an important role in identifying patients with undiagnosed dental problems, and being aware of the ones caused by other medical problems. Therefore, inter-professional cooperation is required to reduce the global burden of dental diseases.


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International Primary Care Association
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