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Latest Updates

Acute knee pain (traumatic)

It does not look as if Tariq has a minor sprain or strain, and, at the age of 19, osteoarthritis is unlikely! After fleetingly wishing Tariq had just gone to A&E last night, you start your evaluation....

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Ask WHY before HOW

“Our practice recently joined a Federation. It sounded like a good idea – on paper. We thought it would give us greater ‘clout’ with the commissioners and the local acute care trust. Each practice put quite a bit of money...

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Thrombocytosis and cancer

When NICE issued its referral guidelines for suspected cancer, the use of a raised platelet count as a marker for lung, endometrial, gastric and oesophageal cancer came as a surprise to many of...

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HRT choosing preparations and bio-identical hormones

She will need progesterone as well as oestrogen. But, what do you recommend about conventional or conjugated equine oestrogens? What if she asks about plant-based ‘bioidentical’ hormones? What...

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But ‘chemotherapy’ is a collective term used to cover increasingly complex and diverse medical treatments for malignancy. Most patients having chemotherapy will be given a complex regime of treatments....

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Leg ulcers

Aetiology is different depending on whether the leg (70% venous insufficiency) or the foot (85% neuropathy) is affected. Anyone with a suspected arterial ulcer should have an ABPI. It is good practice...

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Insomnia management: something better than a drug?

In trials, Z-drugs reduced  the time to getting off to sleep by only 22min (CI 11–33min) compared with placebo. This minimal benefit is worth sharing with patients. 

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