Volume 4, Number 6, November-December 2007

POPULAR
TOPICBACK TO BASICSChoices in smoking cessation pharmacotherapy
Bev Cox

DISEASE FOCUSWhy is cardiac mortality higher around Christmas and New Year?
Mike Kirby

Higher cardiac mortality in the winter has long been recognised. It may be due to colder temperatures, which have been associated with depression of heart rate variability and increases in vascular resistance, coronary vasospasm, blood pressure and haemostasis. The peak in cardiac mortality around Christmas and New Year is likely to be compounded by factors that accompany the holiday season: overindulgence in food, salt and alcohol, emotional stress or depression, exposure to particulates from fireplaces, holiday-induced delays in seeking medical attention and reduced staffing of healthcare facilities. How can we help our patients to reduce their risk?

EDITORIALEditorial
Jan Procter-King

Well, I hope that I am not the first – or last – to wish you a happy festive season. With the bulk of the flu campaign over – and, I trust, successful – let us take a tentative look into the future. The new Secretary of State for Health, Alan Johnson, set the scene in his first speech. Can we look forward to a Happy New Year for primary care in 2008?

POPULAR
TOPICFOOD FOR THOUGHTMending the growing problem of childhood obesity
Alison Oldam, Helen Aylott, Paul Sacher

There is no argument about the fact that childhood obesity in the UK is a serious problem. According to the Department of Health, childhood obesity affected 14.3% of 2-10 year olds in England in 2004. This was almost 5% more compared to the 1995 figures, and the estimated prevalence for 2010 is 20% if nothing is done, meaning that one million children will be obese. What can we do to reverse this growing epidemic of childhood obesity?

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 BJPCN – Evidence in Practice – will keep you on top of relevant research without having to spend hours in the library. 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.

HAVE YOU HEARD?Have you heard?

PREVENTION IN PRACTICEHeart disease in women: no longer a cinderella issue
Julie Crookdale

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TOPICQUALITY MATTERSOptimising the prevention and management of obesity: putting NICE guidance into practice
Mike Kirby

Obesity is a rapidly growing problem in the UK. Department of Health statistics show that the prevalence of obesity in children under 11 years of age rose from 9.9% in 1995 to 13.7% in 2003, and in adults obesity prevalence has trebled since the 1980s, with more than 50%, (almost 24 million adults), now being classed as overweight or obese. In the article, we review the latest guidance from the National Institute for Health and Clinical Excellence (NICE) on how to prevent and manage obesity in practice.

THERAPEUTICS REVIEWSitagliptin: the first in a new class of drugs for type 2 diabetes
Sandra Waddingham

Sitagliptin (trade name Januvia) is the first in a new class of drugs for diabetes – the dipeptidyl peptidase-4 (DPP-4) inhibitors. This new, oral hypoglycaemic agent has recently been approved for the treatment of type 2 diabetes. It is available on prescription and can be prescribed in primary care. Principal advantages include lack of weight gain and hypoglycaemia, which should make sitagliptin very popular with patients. This article looks at what a DPP-4 inhibitor is and how it works to lower blood glucose, as well as where this class of drug fits into current practice.

KEEP AND COPYYou and your treatment: starting on a glitazone

POPULAR
TOPICPATIENTS AS PARTNERSPhase II cardiac rehabilitation in primary care
Jeannie Hayhurst

Cardiac rehabilitation is an aspect of Coronary Heart Disease (CHD) management that many primary care health professionals admit to knowing relatively little about. In this article, we explore the central role of primary care in cardiac rehabilitation.