Glitazones were rapidly incorporated into the management of patients with type 2 diabetes after their introduction. How do they work and when should we consider using them? And what should we make of recent discussions about the possibility of an increased risk of myocardial infarction with rosiglitazone?
Hands on Hypertension: Getting to Targets in Practice
Hypertension affects one in five people in the UK and is poorly managed despite a range of drug and lifestyle interventions known to be useful and effective. We are constantly reminded about the importance of getting people to target with blood pressure (BP) treatments but this can be easier said than done. In this article, we will look at the challenge of getting blood pressure readings down to target levels and we will work through some case studies to explore possible solutions to achieving the targets in practice.
Monitoring kidney function with eGFR
Around 2.9 million people in the UK have moderate-to-severe kidney disease. Estimated glomerular filtration rate (eGFR) can help to identify patients at high risk of cardiovascular disease (CVD) and improve the prevention and management of chronic kidney disease (CKD). In this article, we explain why it is important to detect CKD early, how eGFR is calculated and how to reduce risk in patients found to have impaired kidney function.
Pass the Salt: How to Cut Down
We’re recommended to eat a maximum of a teaspoon a day but nearly all of us eat more. Salt provides sodium which is needed in small amounts for maintaining water balance and is used in nerve activity – but too much can lead to serious health complications. How can we help our patients to cut down on their salt intake?
Chronic Wounds: Optimising Wound Management
Practice and other community-based nurses play a central role in achieving high quality wound care in patients treated initially in general practice and in those who have been discharged from hospital. This article summarises some of the wound management products available for chronic wounds, and the importance of continued wound care in the primary care setting, before focusing on one of the latest approaches – total negative pressure (TNP).
Winning the Flu Immunisation Campaign
Stable Angina: Making the Most of Cardiac Function
Stable angina is very common. Just under two million people in the UK – over one million men and 840,000 women – have, or have had, angina. In this article we review how new-onset stable angina is assessed, including an update on new investigations, and the latest treatment options including drugs and interventions, based on the most up-to-date guidelines and current practice.
What Happens In Phase III Cardiac Rehabilitation?
The aim of cardiac rehabilitation is to help people who have had a cardiac event recover and resume as full a life as possible and help reduce the risk of further cardiac problems. The ‘cardiac hope and confidence programme’ is a good way of describing the rehabilitation process as many patients tell us that this is what they gain most from the programme. We review what happens in phase III cardiac rehabilitation and what it can achieve in practice.
To Glove or Not to Glove?
With increasing awareness about preventable acquired infections along with ever increasing patient knowledge, it is essential that all healthcare staff understand the principles underpinning infection control. In particular, they need to be clear about hand hygiene and the appropriate use of gloves if they and their patients are to remain safe from the risk of transmission of microorganisms and the infections they cause. We review when gloves are needed and when they are not.
Back to Basics: Making sense of acute coronary syndrome (ACS)
Editorial
“It is no use saying ‘We are doing our best.’ You have got to succeed in doing what is necessary.” So said Winston Churchill. His approach helped win the Second World War, and applies just as well to the war we fight every day against cardiovascular disease.
Diabetes Control During Ramadan: How to Advise our Patients
Fasting is obligatory for all Muslim men and boys over the age of 12 and for Muslim women and girls who have passed puberty. It requires that no food or drink pass the lips during the hours of daylight, including medication – oral or inhaled. Not eating or being unable to take medication during the daytime obviously has major implications for people with diabetes. In this article we review how we should advise our patients – how can they maintain control of their diabetes at the same time as honouring their religious obligations?
