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The Practitioner

The Practitioner is a PubMed indexed general medical review monthly journal with subscribers throughout the world. The Practitioner and this website are also used by doctors preparing themselves to work in the UK.

 

Symposium articles

New developments in metastatic prostate cancer therapy

23 Apr 2015Registered users

Advanced prostate cancer remains an incurable and lethal disease. Innovation continues to provide new hope for patients with advanced disease, with improved survival while maintaining quality of life. As patients live longer with increasing treatment options, education of all healthcare professionals involved in their care is crucial in ensuring holistic care for this complex disease.[With external links to the current evidence base]

Careful assessment key in managing prostatitis

23 Apr 2015Registered users

Prostatitis is a common condition estimated to affect up to 30% of men in their lifetime, it is most prevalent in men aged between 35 and 50. Prostatitis is subclassified into: acute bacterial prostatitis, chronic bacterial prostatitis, chronic pelvic pain and asymptomatic inflammatory prostatitis. Clinical assessment includes a thorough history and examination. A digital rectal examination should be performed after a midstream urine sample has been collected for urine dipstick, microscopy and culture. The prostate should be checked for nodules.

 

Editorials

Smoking-related deaths linked to a wider range of diseases

23 Apr 2015Registered users

Taking data from five large US cohort studies, the authors of this present study posed the question: ‘Do current official estimates underestimate the deaths caused by smoking?' Overall, the excess mortality for smokers within the study population was 2.8 times that of never smokers and 17% of excess mortality was related to diseases not formally associated with smoking.

 

Special reports

Improving the diagnosis and management of GORD in adults

23 Apr 2015Registered users

Gastro-oesophageal reflux disease (GORD) is defined as a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Many patients with GORD complications such as oesophagitis and up to a third of patients with Barrett's oesophagus have no reflux or heartburn symptoms. Conversely, patients can be symptomatic even when normal reflux levels are found and there is an absence of mucosal damage.

Improving detection and management of drug allergy

23 Mar 2015Paid-up subscribers

Adverse drug reactions need to be meticulously recorded and the patient kept fully informed. Documentation should include: date of reaction; drug name (chemical and generic); route of administration; time interval between first dose and event; and nature and severity of symptoms. Written guidance should be provided on which other chemically related drugs also need to be avoided. Specialist referral is indicated for: suspected anaphylaxis; severe/life-threatening episodes e.g. Stevens-Johnson syndrome; severe NSAID reactions with ongoing need for NSAID therapy; suspected penicillin allergy (if alternative antibiotics are not available); and problems related to general and local anaesthesia.

 

A hundred years ago

Underuse of sublingual medication

23 Apr 2015Registered users

He believed the patient was dead, for he had ceased to breathe, and no pulsation could be detected. By way of a last chance, I inserted a strychnia and two apomorphia discs under his tongue, and rolled him over on to his left side. Well within a minute he made a valiant effort, and vomited, and finally recovered.

Obstetric mutilations

23 Mar 2015Registered users

WRITTEN IN 1915:A considerable number of women admitted into the London Hospital as obstetric cases have, to an almost inconceivable extent, a lacerated and bruised lower genital tract, cervix, vagina, and perineum. A combination of lack of experience and judgement, lack of adequate time to devote to a midwifery case, and a mistaken sense of pride in refusing to take advantage of skilled advice which is nowhere remote in the London area, still renders some of our metropolitan midwifery a blot on the reputation of modern obstetrics.

 

Letters to the editor

Education is not the filling of a pail but the lighting of a fire

22 Jan 2015Registered users

Primary and secondary care colleagues meeting to discuss topics, local patient pathways, significant events and altering ways of working can be immensely valuable, and delve deeper than just written words or PowerPoint presentations, argues GP Dr Nicole Howse.

 

HASLAM's view

How my dog influenced the way I practise

23 Apr 2015Registered users

In a long professional lifetime, a huge number of people have affected me but one of the most profound influences was my very first dog. A Welsh terrier called Stan, an animal with the brains of a rocking horse.

 

Medico-legal work

We are looking for general practitioners to undertake medico-legal work at various locations throughout the country, specifically in Kent, Berkshire, Bedfordshire and the South West.

We would undertake to find you instructions and carry out the administration on your behalf, by making the appointments, typing the medical reports etc. Apply with CV to:
Windsor Medico-Legal
PO Box 4529
Windsor SL4 9DN
or email info@windsormedico.co.uk

 

Practitioner newsletters

  • Monthly Contents
  • Practitioner CPD News
  • Special Interest
  • UK Sessional GPs
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PHOTOGUIDE

Acne

23 Apr 2015Registered users

•Late onset acne •Acne agminata •Exogenous acne •Acne rosacea •Acne conglobata •Folliculitis

Pruritus

23 Mar 2015Registered users

•Cholestatic pruritus •Phytodermatitis •Insect bites •Chickenpox •Urticaria •Hypertrophic lichen planus

 

CPD exercises associated with each issue

CPD exercise - April 2015

23 Apr 2015Paid-up subscribers

The study pack contains this month’s CPD exercise plus all the relevant articles: • Careful assessment key in managing prostatitis • New developments in metastatic prostate cancer therapy • Improving the diagnosis and management of GORD in adults. This CPD study pack can be saved directly into your personal development plan folder on your computer or for review in the PDF reader on your tablet computer

Practitioner CPD exercise - March 2015

23 Mar 2015Paid-up subscribers

The study pack contains this month’s CPD exercise plus all the relevant articles: • GPs have key role in early diagnosis of endometriosis • Be vigilant for perinatal mental health problems • Improving detection and management of drug allergy. This CPD study pack can be saved directly into your personal development plan folder on your computer or for review in the PDF reader on your tablet computer