Deaths from cardiovascular disease have fallen over the last 20 years but people with schizophrenia and bipolar illness have not shared in these benefits. At the end of last year the first National Audit of Schizophrenia highlighted important deficiencies in management. A systematic care pathway, and straightforward screening, treatment and follow-up in primary care could reduce the continuing health inequalities experienced by people with severe mental illness.
Lifestyle modification for people at high cardiovascular risk includes positive changes to their diet. The portfolio diet is a new approach to lowering cholesterol that builds on a conventional cardioprotective diet by including specific foods that are known to target abnormal lipids.
Alcohol forms part of the diet for over 90% of adults in the UK and is unusual in being both a nutrient and a drug. For many of us, alcohol is a safe and pleasurable part of the diet. However, there is growing concern that many people who see themselves as social drinkers are consuming levels that may cause harm. Understanding how to assess safe levels of alcohol consumption and identify strategies for cutting down can help us to advise our patients how to moderate their intake.
Clots are life-saving in the right place at the right time, when they can stop us bleeding to death. But a clot in the wrong place can spell disaster, leading to heart attack, stroke, deep vein thrombosis or pulmonary embolism. This article explains why life-threatening clots can develop so quickly, what can be done to prevent them, and how each type of clot is treated.
UK guidelines recommend hands-only cardiopulmonary resuscitation (CPR) as an option for untrained people, or when ventilation is difficult. But standard CPR with ventilation remains best practice, and it is vital to ensure that everyone in the practice knows how to use basic life support to save a patient's life after cardiac arrest.
Sending samples to the laboratory for investigation is so routine in primary care that it is easy to take these tests for granted. But, as this new series highlights, it is important to understand the purpose of each test and how to act on the results. This article examines thyroid function tests (TFTs), which are an essential part of diagnosing and treating thyroid disease.
Acute kidney injury (AKI) is becoming increasingly common. Patients at greatest risk are the elderly with chronic kidney disease (CKD) and other long-term conditions such as hypertension, diabetes and cardiovascular disease. AKI carries a poor prognosis yet 30% of cases are preventable. In primary care we can help prevent AKI by empowering patients to take drug holidays—that is, temporarily stopping medications that become harmful to the kidneys during episodes of acute illness.
Dapagliflozin (Forxiga) is the first in a new class of oral antidiabetic drug that has been given the go-ahead for marketing in Europe, including the UK. Described as a sodium glucose cotransporter 2 (SGLT2) inhibitor, this new preparation works on the kidneys to lower blood glucose. What does this new drug have to offer and how can it potentially help our patients with type 2 diabetes?