Resources

Migraine is a common neurological disorder that is extremely disabling and often misunderstood. It is a primary headache disorder, meaning it is not due to an underlying
pathology, trauma, infection or systemic disease. Migraine is therefore the disorder itself

There are 2.2 million Armed Forces veterans in England. That’s similar to the number of people living with cancer (Macmillan Cancer Support, 2021). Yet, despite the fact that veterans sometimes have different healthcare needs, around half of GP practices do not know how many veteran patients they have — simply because they are not aware of the process to capture this information. 

The Royal College of General Practitioners’ (RCGP) veteran friendly GP practice accreditation scheme gives GP practices the training, information and resources to identify and support their veteran patients. It starts with asking, ‘have you served?’.

Cow’s milk allergy (CMA) symptoms present in 2–3% of all infants versus 0.5% of breastfed infants in the first year of life and can impact on growth and quality of life of the child (Venter et al, 2017; National Institute for Health and Care Excellence [NICE], 2021). Once CMA is diagnosed, hypoallergenic formulas are recommended if exclusive breastfeeding is not possible or the mother chooses a mixed feeding approach (Venter et al, 2017; Fox et al, 2019; NICE, 2021). This product snapshot reviews the diagnosis and management of CMA and focuses on Alimentum® and EleCare®, hypoallergenic infant formulas that are clinically effective at the best value price (price per 100ml) (Sicherer et al, 2001; Data on File, 2020; MIMS, 2021).

Self-harm has increased significantly over the past few years. The restrictions due to the Covid pandemic are thought to be a contributing trigger for an individual to self-harm. Patients who present to healthcare systems with self-harm injuries can be met with indifference and lack of understanding by healthcare professionals who do not have the knowledge and skills to deal with individuals who have complex mental health needs. General practice nurses (GPNs) who care for patients with self-harm injuries should be able to offer empathy, understanding, and know how to refer and signpost to ensure that timely intervention can be made to the most appropriate mental health team or allied worker. This article explores how Covid-19 has impacted on self-harm, the important aspects of assessment to consider when a patient presents with a self-harm injury, and discusses interventions that may assist in the management of such wounds in clinical practice 

Management of venous leg ulcers and use of compression therapy as early as possible have been identified as a priority (Atkin et al, 2021). However, selecting the correct wound dressing to use under compression therapy has not received the same attention, despite being crucial in the application of correct levels of pressure on the limb. This article reviews venous leg ulcers, how and why we use compression therapy, and the assessment needed before treatment starts. It also explores the attributes of dressings used under compression and the decision-making process for selecting correct dressings for each individual patient, while considering opportunities for promoting supported self-care.

Inflammation occurs when the body tries to protect itself from infection by foreign organisms, such as bacteria and viruses. It involves several processes in the body, including action by white blood cells (cytokines). The whole process is known as an immune response. A short sharp immune reaction is called an acute inflammatory response, such as a bee sting, while other immune responses can go on for some time and are known as chronic inflammation. Chronic inflammation is caused by a number of factors, such as carrying extra weight, pollution in the environment, and also poor diet and lifestyle. Long-term chronic inflammation can lead to diseases such as heart disease, cancers, Alzheimer’s disease, arthritis and even depression. Inflammation is also linked to metabolic changes and metabolic disorders, such as diabetes. This article looks at how diet and lifestyle can help to alleviate inflammation, with emphasis on chronic inflammation.

When most people think of a pharmacist, they immediately think of a person who stands behind a counter and dispenses medicines with instructions for use. But, the role of the pharmacist is changing. They have been identified as having a key role in delivering the NHS Long Term Plan. Within the speciality of wound care and compression therapy, pharmacists are ideally placed to offer advice and support in the management of simple wounds, such as cuts and grazes, blisters, lacerations and minor burns. They are also able to support the delivery of venous leg ulcer management by supplying compression therapy as first-line treatment as soon as possible.This article explores recent developments for pharmacists and how their role could free up general practitioner (GP), general practice nurse (GPN) and community nurse time.

In the treatment of chronic, hard-to-heal wounds, managing destructive chronic wound exudate, removing devitalised tissue and addressing wound biofilm/infection are high priorities (Atkin et al, 2019). To optimise the rate and likelihood of a chronic wound healing, it is important to identify its cause and any factors that may impede the healing process (Wounds UK, 2018). This can only be achieved by undertaking holistic wound assessment followed by effective wound management — having a logical set of actions, or pathways to follow, aids this (Atkin et al, 2019; Box 1). When managing lower limb ulcers, accurate diagnosis is crucial so that they can be categorised as venous, arterial or mixed aetiology. The case study presented here highlights the care pathway of a mixed aetiology leg ulcer, including wound bed preparation.

Pelvic organ prolapse (POP) and urinary incontinence are common problems experienced by women of all ages. With the publication of Seizing the opportunity to improve patient care: Pelvic floor services in 2021 and beyond (Pelvic Floor Society, 2021) comes recognition of how common pelvic floor disorders are but how little investment has been put into these services. Such publications highlight the need for services to be provided which encourage women to come forward to be assessed and treated. This article, the first in a two-part series, discusses the signs and symptoms of POP and urinary incontinence. It details important issues to consider and remember when assessing a patient with either of these conditions in primary care. The second article will explore treatment options which should be started in primary care before considering onward referral.

Salbutamol is the most widely prescribed bronchodilator belonging to a class of drugs known as beta-2 adrenoceptor agonists, more commonly known as short-acting beta agonists (SABA). Their role is to relax airway smooth muscle (ASM), thereby reducing symptoms of wheeze, shortness of breath or cough in airways diseases such as asthma and chronic obstructive pulmonary disease (COPD). Salbutamol is generally regarded as a safe medication when used correctly. This article looks at the history of this class of medications, how they work at a cellular level, and the associated risks if they are overused or incorrectly used. It includes a discussion on the most commonly used SABA-containing device — the pressurised metered dose inhaler (pMDI). An understanding of the clinical and potential cellular effects of overuse will be discussed in the context of associated risks, as well as discussion on the drive to reduce greenhouse gases to care for the planet, and how this can be achieved while providing best care for patients