Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of abnormal liver function tests. Current advice is simply to monitor patients’ liver function, but is this really correct? And how do we identify and manage people at risk of developing NAFLD?
Is sugar the new villain? Putting the evidence on trial
For years dieters have been trying to avoid fat, and low-fat products have been promoted as the healthier option. But there is now a great deal of publicity around sugar and its toxic effects on our health, including claims that it is the ‘new tobacco’. The sweet white stuff is being blamed for the obesity epidemic and with it diseases such as diabetes and heart disease. So what is the evidence behind the hype, and what should we as health professionals be advising patients?
Obesity: The harsh reality and new solutions
Practice nurses are in the frontline of the fight against obesity, yet they face a moving target. Around 10 years ago, the ‘centre ground’ of the battle comprised patients with around 10 kg to lose; today, it is 20 kg. This has profound implications for weight management and a range of related conditions, but recent research is highlighting new solutions for this group of patients.
Why and when to test for potassium
The World Health Organization has recommended that everyone should be eating more foods that contain potassium, and we routinely measure this electrolyte as part of the standard U&Es blood test. But why is potassium important for our health, and why do we need to worry if a patient’s levels are too high or too low?
NICE Guidelines: A changing approach to atrial fibrillation
Atrial fibrillation (AF) is the commonest cardiac arrhythmia seen in primary care and, if left untreated, is a significant risk factor for stroke. New guidelines from the National Institute for Health and Care Excellence (NICE) include some practice-changing recommendations on diagnosing AF, the role of aspirin and the novel oral anticoagulants (NOACs), and shared decision-making to ensure patient-centred care.
Editorial
A few weeks ago I was out shopping, and bumped into Alan. On a very hot day, he was dressed up as ‘Artie Beat’ for a photo shoot outside a supermarket to promote fundraising for the British Heart Foundation. I was being nosey, as you might expect, and went over to see what was happening. When I congratulated Alan, he said: ‘I am only a cashier’. But no one is an ‘only’ when it comes to caring and making a difference. So thank you, Alan, and thank you, ASDA. I then started thinking about compassion on that large social scale and then about compassion from individuals.
Injection technique: Passing on best practice to patients
In the UK, an estimated 1 million people with diabetes use injectable therapies, and these patients are increasingly being managed in primary care. As a result, more primary care nurses are taking responsibility for the initiation and continuing management of injectable therapies, including advising on and reviewing an individual patient’s injection technique.
Ensuring the safe use of insulin in diabetes
Insulin therapy is life-saving for people with type 1 diabetes, and a key component of the treatment regimen for many people with type 2 diabetes. At the same time, insulin is a major cause of adverse drug events, some of which are so severe that they cause emergency admission to hospital. There is therefore much that needs to be done to improve the safe use of insulin in order to reduce medication errors and hospitalisation associated with hypoglycaemia.
The impact of the NHS Health Check: Asking the right questions
A recent study concluded that in general practices providing NHS Health Checks, the change in reported prevalence of diabetes, hypertension, coronary heart disease (CHD) and chronic kidney disease (CKD) does not differ from practices that provide usual care. Although the study was not randomised and was not powered to support this conclusion, it is of interest because it raises a number of important questions about the delivery of the NHS Health Check.
Flu jabs: Why you should be the first person on your list
The 2013 measles epidemic in Wales came as a salutary reminder of the importance of immunisation in preventing communicable diseases. Similarly, it took an outbreak of bird flu in 2010 to act as a wake-up call for people who had become somewhat laissez-faire about protecting themselves against the influenza virus. In this article we look at the dangers of flu, why the immunisation programme is important, and what you can do to reduce the impact of the flu bug on your patients’ health and well-being.
CVD mortality: A retrospective audit of disease registers
A retrospective audit of premature deaths (aged under 75) from cardiovascular disease (CVD) in Leeds showed that patients diagnosed with CVD and placed on disease registers lived on average eight years longer than patients who had not been diagnosed prior to their deaths. If innovations like the NHS Health Check can be used to identify CVD patients in a more equitable manner, there is likely to be a major impact in reducing premature mortality with the potential to reduce health inequalities for disadvantaged groups in the population.
Why do we need new options for managing FH?
In patients with both homozygous and heterozygous familial hypercholesterolaemia (FH), statins with or without ezetimibe are now the mainstay pharmacological therapy for lowering low-density lipoprotein cholesterol (LDL-C) levels, combined with lipoprotein apheresis in homozygotes and statin-refractory heterozygotes. These therapies have helped to improve outcomes, but new treatment options areurgently needed, as FH patients continue to be at high risk of premature death due to cardiovascular disease (CVD).
HEART UK – The Cholesterol Charity – has provided editorial support and review of this sponsored FH series.This article was made possible by an unrestricted educational grant by Sanofi, who had no control over content.
