Category: Clinical

Confronting the urinalysis tyrant

As GPs we know a lot about recurrent urinary tract infections. James Malone-Lee is Emeritus Professor of Medicine, University College London. His research suggests that most of what we think we know is wrong. Here he explains the evidence.

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Asking about suicide and self harm: moving beyond clinician discomfort

“I ask them – but I’m not asking them in a way that invites a ‘yes'” – It can be difficult to broach the subject of self-harm or suicidal thoughts during a consultation. After altering her practice since reading Ford et al’s recent study on clinician discomfort, Dr Claire Norman, GPST3, reflects on the real-life consequences of reframing those difficult questions.

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Non-biopsy diagnosis of coeliac disease: increased diagnosis and how dietitians can help

With the incidence rate of coeliac disease in the UK increasing four-fold between 1990 and 2011, it is essential that patients with coeliac disease continue to receive appropriate support and management during the COVID-19 pandemic. Here, Yvonne Jeanes et al. outline how dietitians can assist patients with coeliac disease, and provide resources for both patients and practitioners.

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A different kind of ‘safety net’ for the new members of our primary care workforce

With COVID-19 forcing a shift to predominantly remote consulting, how do we ensure that physician associates are fully supported in their role in primary care? The Sheffield Physician Associate (PA) Preceptorship scheme may be one way, offering a formalised support package for both the PA and employer. Here, Ria Agarwal and Julie Hoskin provide an overview.

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Diabetes: Is it time to flatten the curve?

Half of patients with elevated blood sugars, with an HbA1c greater than 42, are not clinically obese. As well as the usual measures Sarah Blake asks whether we need to pay more attention to post prandial blood sugar spikes – is it time to flatten the curve?

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Physical health checks for people with severe mental illness in England during COVID-19

People living with severe and prolonged mental illness in England die 15-20 years earlier than the general population. Richard Armitage alerts us to the fact that there has been a marked decrease in the proportion of such patients who have had a physical health check in following the first COVID-19 lockdown. We cannot afford to let this stay on the back burner for ever.

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Drugs for chronic pain — we still need them

Chronic primary pain is a relatively new concept. Ensuring its definition is consistent within new guidelines is key. Here, members of the National Advisory Committee for Chronic Pain provide a number of observations on the use of drugs in chronic pain management, and emphasise the importance of having more tools for care.

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