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Royal College of GPs
Royal College of Physicians
Royal College of Obstet. and Gynaecol.
Royal College of Psychiatrists
Academy of Medical Royal Colleges
Quality outcome framework
QoF 2013/14
Revalidation
RCGP:Revalidation
Information resources
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Drug information
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Health stats
Nationmaster:UK
Irish College of GPs
Royal College of GPs: ROI faculty
College of Psychiatry of Ireland
Irish Hospital Consultants Association
Royal College of Physicians of Ireland
Royal College of Surgeons in Ireland
Irish Medical Organisation
Irish Medical Journal
Medical Council
Information resources
All Ireland Health Library
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Drug information
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Irish Medicines Board
IPHA, Irish Pharmaceutical Healthcare Association
Medicines.ie
Health stats
Nationmaster:Ireland
HSE:Healthstat
Central Statistics Office
The Practitioner is a PubMed indexed general medical review monthy journal with subscribers throughout the world. The Practitioner and this website are also used by doctors preparing themselves to work in the UK.
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25 Apr 2013
A recent study has potentially identified another risk factor for coronary disease, that of male pattern baldness (androgenetic alopecia).The authors conclude that vertex baldness is associated with an increased risk of coronary heart disease and the strength of this association is dependent on the severity of baldness. This association appears to hold true for younger patients. It should prompt careful evaluation of other cardiovascular risk factors but to what extent it should modify established cardiovascular risk scores is unclear until further evidence is available.
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25 Apr 2013
Prostate cancer is the most common cancer in men in the UK. It accounts for nearly a quarter of all male cancer diagnoses and is the second most common cause of male cancer death. Most patients present with localised disease, but there are still many who present with metastatic disease. Medical castration using LHRH analogues has become the gold standard in managing both locally advanced prostate cancer, in combination with radiotherapy, and metastatic disease. Eventually most men with advanced prostate cancer become resistant to androgen deprivation therapy. This is called castrate refractory prostate cancer, and is associated with a poor prognosis. There is now hope for patients who progress after chemotherapy with the emergence of several new agents that have been shown to benefit patients.
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25 Apr 2013
Epididymitis and orchitis normally co-exist with isolated epididymitis being more common than an isolated orchitis. Sexually transmitted infection is the most common cause in younger men and urinary tract pathogens are the more common culprits in older men. The most common pathogens in the under 35s are N. gonorrhoeae and C. trachomatis and E. coli is the most common cause of acute epididymitis in the over 35s. Acute testicular torsion is the most important differential diagnosis of acute testicular pain especially in younger men. If there is any suspicion of testicular torsion, the patient should be referred to secondary care immediately as surgery is required within four to six hours.
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26 Apr 2013
Children who are the victims of bullying are more likely to experience psychiatric problems as young adults, an American prospective population-based cohort study has found. A total of 1,420 children were recruited from 11 counties in Western Carolina. Participants were assessed annually between the ages of 9 and 16. Both the child and his/her parent were interviewed to identify bullying or bullying others, childhood psychiatric disorders and family hardships. Subsequent follow-up with a structured diagnostic interview took place at the ages of 19, 21 and 24-26.
25 Apr 2013
Robot-assisted radical prostatectomy (RARP) produced better continence and potency rates at three months compared with laparoscopic radical prostatectomy (LRP), in a prospective randomised study from Italy.
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25 Apr 2013
Patients with borderline health should consult a physican before travelling to altitude. The physician will need to know the duration of the trip, ascent profile and how much exercise the patient plans to undertake. The presence of comorbid diseases which reduce oxygenation and ventilation should also be taken into account. Every patient must be assessed on an individual basis, there are no clinical investigations which reliably predict outcome at altitude. Patients should not travel to high altitude immediately after an acute coronary syndrome. Most patients with stable coronary artery disease with a sufficiently high exercise capacity at sea level can go as high as 3,000–3,500 m with only a minimally increased risk.
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21 Mar 2013
There is a worse prognosis for psychosis and schizophrenia when onset is in childhood or adolescence. Better outcomes in terms of symptoms and social function are associated with a shorter duration of untreated psychosis. The detection of psychotic symptoms in primary care therefore warrants an urgent referral to secondary care mental health services for assessment and treatment.
30 Apr 2013
This document can be saved directly into your personal development plan folder on your computer or for review in the PDF reader on your tablet computer
30 Apr 2013
This document can be saved directly into your personal development plan folder on your computer or for review in the PDF reader on your tablet computer.
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21 Feb 2013
Lyme disease, also known as Lyme borreliosis, is caused by infection with Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) complex, a Gram-negative spirochaete bacterium. Infection in humans takes place through tick bites. The work-up of Lyme arthritis should include a careful history including residence in, or time spent visiting, an endemic region, previous history of tick bite(s), and erythema migrans.
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25 Apr 2013
We can only do the best we can with the knowledge we’ve got at the time, so I don’t feel too embarrassed when looking at old notes makes you think you got something wrong. Looking back to today’s diagnoses from 35 years in the future, who knows which ones will have been discarded?
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25 Apr 2013
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21 Mar 2013
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25 Apr 2013
The Practitioner CPD exercise this month is on: treatment of metastatic prostate cancer; epididymo-orchitis; and advising patients with cardiovascular disease on travel to high altitude. Paying subscribers can download the CPD study pack of all the articles needed for the CPD exercise plus the exercise itself into their tablet or other computer. Alternatively, articles can be downloaded one at a time from this page.
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21 Mar 2013
The Practitioner CPD exercise and PDF study pack for the March issue is on: ectopic pregnancy; infertility; and psychosis in young people. Paying subscribers can now download the CPD study pack of all the articles needed for the CPD exercise plus the exercise itself into their tablet or other computer. Alternatively, articles can be downloaded one at a time from this page.
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25 Apr 2013
I ONCE told a lady, who asked me what was her disease, that her brains were blue, and I believe she still regards it as quite a bon mot, for she has sent others of enquiring mind that I might discover the colour of their intellect...
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24 Mar 2013
'A child’s face is frequently a clear index of the severity of the illness, or indeed of the actual complaint...'
