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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.

 

Editorials

Bullying in adolescence linked to depression in young adults

05 Aug 2015Registered users

Children who are frequently bullied during adolescence are more than twice as likely to experience depression as young adults, a UK prospective cohort study has found.

 

Symposium articles

Managing the child with a fever

05 Aug 2015Registered users

Most illnesses associated with fever are self-limiting and children recover with no specific treatment. However, fever can also be the presenting feature of serious illness, which may be life threatening if not diagnosed and treated appropriately. If the diagnosis is unclear, potentially serious, and specific treatment may be needed to prevent deterioration, the child should be referred.

Optimising the management of bronchiolitis in infants

05 Aug 2015Registered users

Bronchiolitis shows a seasonal pattern with peak incidence occurring in the winter. Around 2-3% of children require admission to hospital. Admission rates are highest in infants less than three months old and those with underlying comorbidities. Infants will have a coryzal prodrome lasting one to three days before developing a persistent cough.

 

Special reports

Improving detection of non-melanoma skin cancer

05 Aug 2015Registered users

Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are clinically and pathologically distinct and both are locally invasive. However, while BCCs rarely metastasise, SCCs have the potential to do so especially when they arise on the ears or lips. Patients with one NMSC have a higher risk of developing another NMSC and of malignant melanoma.

Early intervention can improve outcomes in acute kidney injury

22 Jun 2015Registered users

The incidence of acute kidney injury (AKI) is rising reflecting an increasingly elderly at-risk population, with multiple comorbidities, coupled with improved detection. AKI is potentially reversible so improvements in its recognition and early interventions could have a major impact on patient outcomes. Potential clues in the history for AKI include reduced fluid intake and/or increased fluid losses, urinary tract symptoms and recent drug ingestion.

Dr Kathryn E Larmour MB BCh MRCP, Specialist Trainee in Renal Medicine; Professor Alexander P Maxwell MD PhD FRCP, Consultant Nephrologist, Regional Nephrology Unit, Belfast City Hospital, Belfast, UK

 

A hundred years ago

Eclampsia and its treatment

05 Aug 2015Registered users

In New York city itself, the deaths registered from eclampsia in 1902 numbered only 97, but in 1912 they numbered 171. Today in England and Wales, out of every 2,000 confinements one woman dies and seven, roughly speaking, are the subjects of eclampsia, while, strange to say, in Scotland this ratio is nearly doubled.

‘Pensionitis’ in a seaman

22 Jun 2015Paid-up subscribers

In reporting him unfit I detailed the circumstances, and ventured to predict that, after receiving his pension, he would be at work within six months…[And] that was the exact period at which he did in fact return to work, with, of course, his pension of twenty-five shillings a week for life!

 

HASLAM's view

We need to learn how to stop medication

05 Aug 2015Registered users

It was about 30 years ago, but I can still tell you every detail. I can picture his living room, the state of the front garden, every irrelevant pixel of the whole picture. I was doing a routine home visit to a 70-year-old patient of mine. Bill suffered from COPD but had also amassed a host of other conditions. Today we would have described this as multimorbidity. Back then we called them all chronic illnesses. Indeed, I don’t think we had such a thing as COPD – it was simply called chronic bronchitis. Anyway, as I looked at the extraordinary number of medications that my patient had accumulated over the preceding years, I vowed that it was time to try to rationalise them. Surely they weren’t all really necessary?...

 

Practitioner newsletters

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PHOTOGUIDE

Sun damage

05 Aug 2015Registered users

• Actinic keratosis • Photodermatitis • Polymorphic light eruption • Sunburn • Solar lentigenes • Malignant melanoma

Psoriasis

22 Jun 2015Registered users

• Facial psoriasis • Guttate psoriasis • Nail psoriasis• Scalp psoriasis • Palmoplantar pustulosis

 

CPD exercises associated with each issue

CPD exercise - July/August 2015

05 Aug 2015Paid-up subscribers

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. The study pack contains this month’s CPD exercise plus all the relevant articles: • Optimising the management of bronchiolitis in infants • Managing the child with a fever • Improving detection of non-melanoma skin cancer

CPD exercise - June 2015

22 Jun 2015Paid-up subscribers

The study pack contains this month’s CPD exercise plus all the relevant articles: • Diagnosis and treatment of gallstone disease • Managing irritable bowel syndrome in primary care • Early intervention can improve outcomes in acute kidney injury. 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.