Cystic fibrosis (CF) is the most common inherited genetic disease in the UK.
Improvements in both diagnosis and treatment over the last 30 years have resulted in
increased survival with children born in the 1990s now likely to live into their forties.
Although much of the treatment is delivered in hospitals, healthcare professionals in
primary care should be aware of management principles and understand the impact of the
condition on patients and their families. This article provides an overview of CF and shows how
to support patients and families in primary care.
Cystic Fibrosis: What do we need to know?
The breathless patient: Is it asthma or COPD?
Breathlessness is a very common problem in the patients we see in general practice, and
there is a range of possible causes. In this article – the first in a series of three looking
at how to diagnose what’s wrong with a breathless patient – we explore how to
distinguish between two of the commonest respiratory causes of breathlessness,
asthma and chronic obstructive pulmonary disease.
Back to Basics: Key steps in resuscitation
Treatments for Hayfever
Over the next few months practice nurses are likely to see many patients with hayfever
(also known as seasonal allergic rhinoconjunctivitis). Although it may appear to be a
minor complaint, hayfever can result in considerable suffering for the individual, who
may or may not seek professional help and advice. Practice nurses play an important
role in improving the management of this condition. In this article, we describe the impact of
hayfever on patients and provide a comprehensive review of the treatments currently available
for hayfever.
Respiratory causes of breathlessness
The development of shortness of breath (SOB) is an expected outcome of overexertion,
as normally occurs after strenuous exercise. SOB occurring at rest or during marginal
exertion is considered abnormal. Multiple organ systems are involved in the differential
diagnosis of SOB but for the purpose of this article, we concentrate on the pulmonary
system and include chronic obstructive pulmonary disease (COPD), asthma, pneumonia,
pneumothorax, interstitial lung disease, lung cancer and dysfunctional breathlessness. This is
the second in a series of three articles focusing on diagnosis of the breathless patient.
How can I measure airways inflammation in asthma?
Asthma affects more than 5 million
people of all ages in the UK today.
The vast majority of asthma is
diagnosed and managed in primary
care and most people with asthma rarely need
to see a hospital specialist. Until recently it
has been difficult to measure the level of
inflammation seen in asthma accurately in
general practice. However, new techniques
such as exhaled nitric oxide measurement are
now available for use and this article provides
GP and nurse perspectives on the potential of
such techniques in primary care.
Cough as a Presenting Symptom in General Practice
Cough is a common presenting symptom in primary care. It has a prevalence of 30% in
the general European population, and in a US National Medical Case Survey in 1991
cough was the commonest presenting complaint. Between 10% and 38% of all new
patient referrals to UK hospital chest clinics are for chronic cough. This article covers
the physiological nature of cough and its role as an essential protective reflex, focuses on the
differential diagnosis of cough in general practice in both adults and children, and discusses the
use of treatment as a diagnostic tool.
Scoring Top QOF Points for COPD
Back to Basics: How to use a small volume spacer
Travel tips for patients with respiratory conditions and allergy
Many of your patients will be planning their holidays, but some may be worrying
unnecessarily about their respiratory condition. There are a host of resources and
information available for them, and practice nurses can make sure they provide the
right information about travelling with asthma, COPD or allergies. This article
provides practical tips on how best to advise patients who are thinking of going on holiday.
Representative sampling – take your pick
How Can I Assess and Manage Cough in Children?
Children with a cough commonly present to practice nurses. All children cough and often
cough repeatedly, with the majority of episodes associated with self-limiting viral
infections for which there are no effective treatments. Coughing can be highly
distressing for the child and their family members, and can have a significant impact on
a child’s sleep, play and performance in school. Although cough may often be related to
diagnosis of asthma, this is by no means the only cause. The British Thoracic Society recently
published guidelines for the assessment and management of cough in children up to 12 years of
age without known lung disease. Practice nurses and their GP colleagues will find these new
guidelines valuable for diagnosis and management of cough. This article summarises the main
recommendations.