Watch the May clinical update from Jo Scott-Jones joined by Dave Maplesden, Pinnacle GP liaison in this 39 minute video. (Written version below.)
Clinical snippets are now available as a podcast too! Search on your favourite podcast platform for The New Zealand General Practice Podcast to listen, or click here to listen on Anchor.
A recent POEM of the Week podcast discusses the small risk of gastric cancer with long-term use of PPIs. Numbers needed to harm were 2000 users after 5 years and 1200 users over 10 years to get gastric cancer. The risk was higher in patients on higher doses. The advice was to try short periods and lower doses of PPI.
A BPAC article notes additional adverse effects associated with long-term use of PPIs including:
The BPAC article poses some questions to consider:
The RNZCGP has published advice on managing patients who refuse to wear a mask, initially in October 2021 with a more recent update.
This practice respects that some people are not able to routinely wear a mask and they have an exemption for this. However, both our practice staff and other patients are in a particularly vulnerable situation with unmasked patients entering the building.
For those who have an exemption, it would be appreciated if you would consider wearing a mask for the short duration that you are here.
If you are unable to wear a mask, we will insist that you remain separated from other patients by at least two metres.
Delayed diagnosis of scabies, particularly in aged care facilities, is a reasonably common source of complaint to HDC
When suturing a wound on the back of the hand and other areas in the elderly where the skin is like tissue paper first stick a piece of narrow Micropore tape or a wide steristrip along the wound edge and suture through it to close the wound. The tape can be removed at the time of suture removal or left in place to separate over a longer period. The technique is described in more detail with references and accompanying video on the laceration.com website.
In the latest NZF update, serotonin syndrome has been added as a precaution to phentermine (Duromine) prescribing information when phentermine is prescribed with other serotonergic drugs.
A non-exhaustive list of serotonergic agents is available in a 2015 Prescriber update article with phentermine having been added since that time.
An older BPAC article reviewed several cases of serotonin syndrome notified to CARM with clinical details:
There is evolving evidence regarding diagnosis and management of this condition summarised in a recent NZ Doctor article. A similar guidance article from the UK reiterates some of the principles of management
It’s great to finish 2020 on a high thanks to the hard work of our B4 School Check nurses. Your efforts have helped ensure children are receiving their B4SCs on time and this couldn't happen without you all, it’s a real team effort.
Read moreSt John asks healthcare professionals requiring an ambulance for your patient to call 0800 262 665. For emergencies outside your facility/medical centre it is still appropriate to call 111.
Read moreThis service is designed to ensure low acuity presentations to Taranaki Base Hospital are actively redirected back to primary care.
View detailsThe Foundation programme represents a collection of legislative, regulatory and clinical requirements for all general practices in Aotearoa New Zealand.