Volume 5, Number 2, March-April 2008
POPULAR
TOPICBACK TO BASICSChronic Kidney Disease
CHANGING BEHAVIOURNeurolinguistic Programming: Getting to the Heart of Communication
Christine McClean Imagine what it would be like if you could communicate effectively with every person you meet.
What would it be like to know that any messages you want to put across to your patients mean
the same to them when they hear them as they mean to you? A few basic pointers in
neurolinguistic programming (NLP) may help to improve how clearly you communicate with
others. In this article we will look at linguistics, or the use of language, as one part of NLP and a
key indicator of how people make sense of, and interpret, the world. POPULAR
TOPICDISEASE FOCUSThe Metabolic Syndrome: Pie in the Sky or Major New Disease?
Brian Karet The metabolic syndrome is a bit like smoothie makers. Everyone’s heard of them, many
people seem to have them, but no-one is quite sure what to do with them. So let’s have
a look at how the metabolic syndrome came to enter our vocabulary, what it really
means and whether it is something that could help us to look after our patients better
or just another cumbersome tool that produces a lot of heat but no light. EDITORIALEditorial
Jan Procter-King We hope this issue of BJPCN is like an Easter egg – bright and appealing
on the outside, with useful articles building a solid structure that you can
really get your teeth into and lots of extra chocolates inside to sustain you
over the next few weeks. EVIDENCE 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?
POPULAR
TOPICMONITORINGUsing Troponins to Assess Cardiac Damage: Getting to the Heart of the Matter
Maria Mew, Claire Priestley Troponins are now measured routinely in patients with acute chest pain in most hospitals
in the UK. Studies have confirmed that they represent a marker of risk for subsequent
cardiac events in most patients. In this article we explore what troponins are, why they
may increase in acute coronary syndromes, how they are measured and how likely they
are to be used in the future. QUALITY MATTERSOptimising Management of Supraventricular Arrhythmias
Jayne Mudd, Angela Hall, Clair Malone Caring for patients with arrhythmias has evolved over the past decade as a result of
technological innovation in both diagnosis and treatment. This article highlights some of
the most common arrhythmias and reviews the most appropriate strategies for their
medical management. The National Service Framework (NSF) for Coronary Heart
Disease (CHD) sets out three quality standards in the chapter on arrhythmias and sudden cardiac
death and we look at how to successfully implement these. THERAPEUTICS REVIEWProcoralan (Ivabradine): A New Treatment Option for Angina
Mike Kirby Angina is on the increase as people live longer. It is the most common symptom of
ischaemic heart disease and occurs when the arteries are no longer able to supply the
heart with enough blood to meet its demands. Treatment aims to restore the balance
between oxygen supply and demand, to relieve the pain as quickly as possible and prevent
further angina attacks, to treat the risk factors, limit the progression of coronary artery disease and
reduce the risk of a heart attack. Procoralan (ivabradine) works by specifically inhibiting the If or
‘funny’ channel in the sinoatrial node of the heart (also known as the cardiac pacemaker) to reduce
the resting heart rate, matching the efficacy of beta-blockers without their side-effects. KEEP AND COPYStarting an a Beta-Blocker for your Heart Problem
POPULAR
TOPICHANDS ONImpaired Fasting Glycaemia and Impaired Glucose Tolerance: Reducing Progression
Bev Cox The journey from normal glycaemic control to type 2 diabetes is a gradual one and,
importantly, gives us lots of opportunities to diagnose so-called ‘pre-diabetes’ and step in
to reduce the chances of a patient developing full-blown diabetes, or at least delay its
onset. In this article, we review the rationale for early intervention, help you make sense of
impaired fasting glycaemia and impaired glucose tolerance and illustrate what to look out for
with case studies of patients you are likely to see in your practice. POPULAR
TOPICPATIENT ADVICE“You Will Need to Stop Driving.” Chronic Disease, Driving and the Law
Mandy Walsh Telling a patient that they will have to stop driving can be difficult, so it is essential to be
sure of the facts on the law regulating driving and chronic disease. When asked what they
know about chronic disease and stopping driving, many people may know that epilepsy is
an issue, and may mention diabetes. But are driving restrictions for one year, or is it three years?
Do they affect only patients with diabetes on insulin, and are some regulations only for heavy
goods vehicle (HGV) drivers? In this article, we give you the information to answer these questions.
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