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Clinical

Chronic kidney disease: the canary in the coal mine

The guardian of cost-effective care in the UK (except Scotland) is NICE, which has recently been very active in this area, producing new and updated CKD (NICE, 2021a) and type 2 diabetes guidelines...

Allergic rhinitis: classification, diagnosis and treatment

Allergic rhinitis can be classified depending on the frequency and severity of symptoms as per the World Health Organisation Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. Intermittent...

Uncontrolled asthma in primary care: part 1

The British Guideline on the Management of Asthma (BTS/SIGN, 2019) defines the aim of asthma management as being to gain control of the disease, while the guideline from the National Institute for...

A brief guide to immunisation and the immunocompromised child or young person

During immunosuppression, the normal function of the immune system is inhibited. Treatments, such as chemotherapy, disrupt the normal function of the cell cycle, which consequently causes...

Breastfeeding and medication for long-term conditions

When prescribing to breastfeeding women we need to be aware that some of the drug which she takes is likely to pass to the baby via breastmilk. The British National Formulary (BNF) is not always a...

Consultation in out-of-hours practice: a clinical review of Lyme disease

Consultation models were originally developed as a means to explore and understand the psychological aspects of doctor-patient consultations, in addition to providing a structure to the process...

SGLT2 inhibitors in type 2 diabetes: time to flozinate?

SGLT2 inhibitors, sometimes also referred to as ‘gliflozins’ or ‘flozins’ are an established class of medications, which are licensed for the treatment of (Table 1):.

Red legs: how to differentiate between cellulitis, venous eczema and lipodermatosclerosis

Cellulitis is an acute infection of the dermal and subcutaneous layers of the skin, often occurring after a local skin trauma (Bailey and Kroshinsky, 2011)..

How to relate progestogen-only pill guidance to clinical practice

There will soon be four different POPs available in the UK. Most clinicians will be familiar with the desogestrel (DSG) 75 µg POP and the two ‘traditional’ POPs, levonorgestrel (LNG) 30 µg and...

Understanding autoimmune diseases: part 2

The basic underlying process of autoimmune diseases was discussed in part 1 of this series (Perry, 2022). In a healthy person, the immune system is able to destroy any invading organisms before they...

Skin cancer: getting back to basics

All skin types can develop skin cancer and at any age. It is more common among people with light (fair) skin (Fitzpatrick type 1 and 2 skin). Skin cancer can affect both men and women. Even teenagers...

Female sexual dysfunction: what the practice nurse needs to know

Female sexual dysfunction (FSD) can affect women of any age and the causes are varied and complex. Perhaps the most widely adopted diagnostic criteria for female sexual dysfunction are contained in...

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