Swallowing really is a life or death matter. Nearly half of people who have had a stroke will initially experience difficulty swallowing. This is called dysphagia. In this article, we look at the anatomy and physiology of swallowing, what can go wrong in people who have had a stroke, and what can help. Explanations are given clearly, using simple language that you can use with patients and their family members.
Proteinuria: replacing cholesterol as a key risk factor for revealing patients with CVD?
We have all seen paintings of early physicians looking at flasks of urine to give an indication of a person’s health. And most of us can remember days of rows of urine pots lined up to test for new patients in primary care and in hospital outpatient clinics. We may assume that those days have gone in the era of blood testing and CT scans. So why do we have a cluster of urine pots on the cover of this issue of BJPCN and why are we suggesting that urine testing has a central role in finding patients with previously undiagnosed cardiovascular disease?
Editorial
Are you sitting comfortably? Then I’ll begin. Once upon a time… Telling stories is something that many of us do with our children. But what about with our patients, and what about encouraging patients to tell their stories? In this issue of BJPCN, we share some exciting new research showing that patients with high blood pressure can learn from each others’ stories. And we help you to fill in the gaps so you’ve got a clear story to tell during routine consultations with patients with cardiovascular disease and diabetes.
EUROPEAN SOCIETY OF CARDIOLOGY CONGRESS 2010
Keeping on track for good concordance with CVD and diabetes drugs
What is important when a nurse and patient are together in a consultation? Most of us have had consultations where the discussion did not appear to achieve anything, while, on other occasions, both parties seemed to be working well together. This article looks at how to share the process of planning treatment with a patient to improve health outcomes; it examines what concordance is, and how to achieve it, looking at how this might work out in practice.
Managing patients with recent onset chest pain: key steps
Chest pain and discomfort are common symptoms that account for 1% of visits to primary care, 5% of visits to accident and emergency departments and 25% of emergency hospital admissions. Coronary artery disease (CAD) is one of many causes of chest pain and is the commonest cause of death in the UK. However, there are treatments available that can improve symptoms and prolong life, making prompt assessment and diagnosis essential. The National Institute for Health and Clinical Excellence (NICE) has recently published a new guideline on the assessment and investigation of patients presenting with acute chest pain suggestive of acute coronary syndrome (ACS) and stable chest pain suggestive of angina. It includes recommendations that will mean some changes to the way these patients are managed in practice. This article looks at how we can put these changes into action.
How to use the GRASP-AF tool to reduce stroke risk in patients
Eating healthily on a tight budget
Save the Children, a charity well known for its work helping children in war-torn or faminestruck countries, recently announced that it is now handing out grants to struggling UK families who cannot afford to feed themselves. In a recent report, the charity suggests that the credit crunch has led to an increase of 11.3% in cost of food over the last year. It is not surprising that many parents have now cut back on food expenditure, with the poorest of families spending less on their weekly shop than ever before. How can we provide patients with tips on eating healthily on a tight budget?
Treating erectile dysfunction safely and effectively
Erectile dysfunction (ED) and vascular disease share the same risk factors and commonly co-exist. The presence of ED in otherwise asymptomatic men is, therefore, often a useful early warning sign of silent vascular disease. This fundamental concept highlights the importance of ‘looking beyond the penis’ in the evaluation of the ED patient, and challenges practice nurses to consider ED and sexual activity as part of their routine evaluation of patients. Once diagnosed, there is a range of effective treatments for ED, and guidance on how to use them safely in patients with cardiovascular disease (CVD).
Managing chronic obstructive pulmonary disease and cardiovascular disease together
Chronic clinical conditions have traditionally been regarded as individual disease categories within individual patients, although there is often considerable overlap across clinical systems. The monitoring of patients with long-term conditions has historically centred around a traditional model of a nurse-led clinic, utilising an appropriate level of skill mix. The disease categories and associated clinical indicators of the Quality and Outcomes Framework (QOF) have encouraged this approach, but for those managing these patients the presence of various co-morbidities is all too apparent
Cholesterol conundrums: juggling patients’ risk factors to optimise lipid lowering therapy
*The British Journal of Primary Care Nursing approached Merck Sharp & Dohme Limited to fund the production of this supplement following a meeting the company supported at the Primary Care Cardiovascular Society (PCCS) Conference 2009. The company was not involved in development, although it was asked to review the supplement for technical accuracy just prior to printing. Editorial control has remained with the British Journal of Primary Care Nursing at all times.
Omega-3 fatty acids: optimising their use in cardiovascular disease and diabetes
*The British Journal of Primary Care Nursing approached Abbott Healthcare Products Limited to fund the production of this supplement. The company was not involved in its development, although it was asked to review it for technical accuracy just prior to printing. Editorial control has remained with the British Journal of Primary Care Nursing at all times.
