	3rd September 2010 @ 1:17am

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Special Issues

Volume 2, Number 3, July-Aug-Sept 2010

EDITORIALEditorial
Dr Anne Connolly

Welcome to the brave new world of the NHS, or is it back to the future? GPs are to be the lynchpins of the health service, again taking charge of local budgets and deciding which services – both community and hospital – to fund.

POPULAR
TOPICEVIDENCE IN PRACTICEEvidence in Practice

There are just not enough hours in the day to read all the research journals, even if you wanted to. This section of PCWHJ – Evidence in Practice – will keep you on top of relevant research without having to spend hours in the library or on the worldwide web. Each review gives you a bite-size summary of new research, pulling out key points for primary care and recommending the action that you might consider taking.

POPULAR
TOPICTHERAPEUTICS REVIEWNexplanon: the next step for the contraceptive implant
Dr Martyn R Walling

The contraceptive implant Implanon was introduced into the UK in 1999, and has proved itself over the last 11 years, with over 280,000 insertions last year. Careful insertion technique is important to avoid difficulties with removal, but the risk of these problems should be reduced following the introduction of the new insertion device, Nexplanon.

DISEASE FOCUSTaking a positive approach to fibromyalgia
Dr Louise Warburton

Adiagnosis of fibromyalgia on a patient’s record will immediately produce a negative reaction in health professionals whom they meet for the first time. This reflects the difficulty in managing some of these patients. But most people with fibromyalgia benefit from a clear explanation of their symptoms and a management plan.

POPULAR
TOPICCHANGING BEHAVIOURPromoting contraceptive choice in the south Asian community
Sue Capstick, Imtiaz Patel

Lack of awareness of contraceptive choices has fuelled rising abortion rates among women of Asian heritage. By engaging and empowering women themselves and developing community partnerships, one PCT has increased the take-up of long-acting reversible contraception (LARC) and reduced the number of abortions.

POPULAR
TOPICBACK TO BASICSCauses of vaginal discharge

POPULAR
TOPICQUALITY MATTERSWhy is there such a fuss about chlamydia?
Jennifer Hopwood

At first sight it is difficult to understand the controversy about chlamydia. It is the commonest sexually transmitted bacterial infection. It is easy to acquire. If untreated, it can have devastating consequences. There is an easy test for it, and effective treatment. But there are important reasons why screening has become such a controversial issue.

MONITORINGCould she have painful bladder syndrome?
Dr Susan Nicholas, Dr Carmel Rouge

How many times have you been to the toilet today? Where’s the nearest toilet? Why does it always hurt when I need the toilet? These questions are all too familiar to patients with painful bladder syndrome (PBS). By considering the condition when women present with bladder symptoms, GPs and practice nurses can ensure prompt referral for appropriate treatment.

WHILE I'M HERESexual problems in women
Dr Elphis Christopher

Aconsultation in which a woman reveals a sexual problem can be challenging for her GP or practice nurse. But a sympathetic and systematic approach to history and examination usually reveals the likely source of the problem and the right approach to appropriate treatment.

POPULAR
TOPICPATHWAYS IN PRACTICEHeavy menstrual bleeding: no need for hang-ups in primary care
Dr Anne Connolly, Dr Siân Jones, Helen Ludkin

Clinical guidelines and technological advances mean that most women with heavy menstrual bleeding (HMB) could be managed outside hospital. One primary care trust has developed a patient pathway, based on a unique primary care service that offers hysteroscopic diagnostic and treatment procedures, including endometrial ablation under local anaesthesia.