Making Best Practice, Every Day Practice
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This resource provides access to informative articles on the broad spectrum of obstetric and gynaecological issues managed in primary care including sexual and reproductive health.
These materials cover some of the most important topics in daily care including:
Contraception across different age groups
Early detection of gynaecological cancers
Pre-menstrual syndromes
Use of testosterone
Menstruation and abnormal uterine bleeding
Fertility treatment
and much more.
Chronic obstructive pulmonary disease (COPD) is a largely preventable, slowly progressive, inflammatory disease. Rates of COPD are rising faster in women than in men, yet women are less likely to be diagnosed. There is currently no cure, but best-practice management outlined in recently updated NICE guidelines can help to improve patients’ symptoms and quality of life.
Many advanced nurse practitioners (ANPs) are working in innovative ways to enhance patient care in general practice. But little specific training has been available for ANPs in women’s health. This article outlines how a training course was developed specifically to improve and maintain local ANPs’ competencies in managing women’s health in primary care.
Many primary care clinicians worry about how to take an appropriate sexual history. Raising the issue seems straightforward when a woman has symptoms or when contraception or cervical screening feature in a consultation. The challenge occurs when the possibility of sexual health issues may not be so apparent to the patient.
The impact of female hormones on cardiovascular risk is a hot issue. Many nurses working in the NHS, including in general practice, are aged 50 or older. This means that there is a strong possibility that some of us may be experiencing menopausal symptoms, along with our patients. In this article, we look at the use of hormonal therapies at the time of the menopause, with particular reference to cardiovascular risk. We will also touch on the use of oral contraception and associated cardiovascular factors.
In the UK, the last 30 years have seen a significant decline in deaths from coronary heart disease (CHD) in men, but the fall has been less significant in women. This may be because women need a different, more gender-specific approach if they are to benefit fully from recent advances in treatment.
Between 0.2 and 4% of all pregnancies in western industrialised countries are complicated by cardiovascular disease (CVD), and the number of patients who develop cardiac problems during pregnancy is increasing. Knowledge of the risks associated with CVD during pregnancy and their management is of pivotal importance for advising patients before pregnancy.
It is exceedingly uncommon for a woman in the UK to die during pregnancy, with maternal mortality in the region of one death per 10,000 maternities1. Although there have been very significant improvements in antenatal care, such as a marked reduction in the number of deaths due to thromboembolic disease, other areas are trailing behind. One such area is cardiac disease – now the leading cause of maternal death in the UK. These relatively rare deaths also mask the much larger issues of maternal, fetal and perinatal morbidity. The most recent Confidential Enquiries into Maternal Death and the new European Society of Cardiology guidelines summarised in this issue of the PCCJ highlight the major clinical issues and attempt to provide consensus opinion regarding optimal care in what is a relatively evidence-sparse field.
Previous research has shown that routine monitoring appears to add little to the prognostication of incipient statininduced myotoxicity (SIM) in the primary care setting. In view of this, and the fact that there are now millions of patients on statins, it seems of practical value to delve deeper into the symptomatology of SIM. : To estimate the prevalence of SIM in statin users as compared to non-users, and whether family practice is the ideal setting to identify SIM.
Most women think they are at greatest risk of dying from cancer, especially breast cancer, but in fact, women are nine times more likely to die from cardiovascular disease (CVD) than from breast cancer. The menopause has particular significance in CVD risk. In this article we look at what happens to cardiovascular risk at the menopause and opportunities for CVD prevention.
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