Family practice
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Postherpetic neuralgia (PHN) is a frequent complication of herpes zoster (HZ). Treatment results of this severe and long-lasting pain syndrome are often disappointing. From the point of view of possible prevention and early treatment, it is important to identify HZ patients who have an increased risk of developing PHN. ⋯ The risk of developing PHN increases with age. Preventive strategies should focus on patients with herpes zoster aged >55 years and with ophthalmic localization.
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Within most western countries, suicide is the second leading cause of death amongst adolescents. ⋯ (i) Fifteen year olds more at risk from parasuicide can be found amongst frequent attenders at general practice. (ii) Consulting more than once for mental health concerns or URTI where there are no physical signs could be an indicator of suicide risk.
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Patients sometimes have differences of > or =20/10 mmHg in their blood pressure depending on which arm is measured. The prevalence and prognostic value of this finding in general practice are unknown. If these differences are due to peripheral vascular disease, these patients may be at increased risk of cardiovascular or cerebrovascular events. ⋯ During a single assessment of blood pressure, there will be a minority of patients with a difference of > or =20/10 mmHg between their right and left arms. Measurement of both arms is therefore necessary to diagnose and treat hypertension accurately. This study suggests an association between blood pressure difference and increased morbidity and mortality. Priority should be given to managing other risk factors aggressively in those patients with a reproducible blood pressure difference of > or =20/10 mmHg.