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Clinical

You know where you can stick that … or do you? Where to inject the deltoid and why

Finding the important landmarks of the deltoid in the living is not difficult and can soon be learned with a little practice on yourself, your partner and patients; having a clear mental picture...

Hormone replacement therapy: update and practical prescribing

Symptoms are experienced by around 70-80% of women during the perimenopause and menopause (O'Neill and Eden, 2012). The symptoms are varied and include vasomotor symptoms, such as flushing and night...

Managing otalgia in general practice

A thorough history is needed to guide clinicians towards making an accurate diagnosis. A detailed history of the degree and severity of pain, any discharge from the ear (otorrhea), hearing loss,...

Supporting people with dementia during the COVID-19 pandemic

‘Dementia is a syndrome – usually of a chronic or progressive nature – in which there is deterioration in cognitive function (ie the ability to process thought) beyond what might be expected from...

Management pathways for erectile dysfunction in primary care

Epidemiological evidence suggests that 8% of men in their 40s report moderate or complete ED and this increases to 40% of men in their 60s (McKinlay, 2000). Risk factors for developing ED are shown in...

Dermatology prescribing update: eczema

Emollients are first line therapy in eczema, this is evidence-based UK guidance (NICE, 2007; 2018; PCDS, 2019). Complete emollient therapy should always be advised, this is: ‘everything that goes on...

Understanding skin infections in older adults

Hahnel et al (2017) investigated the prevalence of skin diseases in older nursing home residents while also exploring the possible associations of these with demographic and medical characteristics....

Improving physical health in people with severe mental illness

How a person is affected by their mental illness will have an impact on their behaviour, communication and ability to take on board information and advice. Understanding the symptoms will be helpful...

Increasing physical activity in people with COPD

The fundamental mechanisms of physical inactivity in COPD are poorly understood, with a number of published theories available (Barnes and Celli, 2009; Troosters et al, 2013). One widely accepted...

Insulin safety: what is all the fuss about?

When a clinical decision is made to commence insulin therapy, the initial assessment and discussion with the person with diabetes is paramount, and using this framework will provide the reader with a...

Understanding COVID-19 in at-risk patients

Because COVID-19 is a new disease, there is still a huge amount to learn, and scientists are desperately trying to uncover many of the unknown elements. What is known is that there are a number of...

Asthma guidelines: which is the best of three?

The GINA report of 2020 (GINA, 2020) is the only guideline so far to have published guidance during the pandemic, although both the BTS and NICE have published separate documents on the subject. GINA...

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