The British journal of general practice : the journal of the Royal College of General Practitioners
-
The ANA-associated diseases are rare autoimmune diseases (including Systemic lupus erythematosus [SLE], Sjögren's, Scleroderma, autoimmune hepatitis). Interpretation of ANA-tests is difficult, it is frequently positive in patients who do not appear to have an associated disease. In those who are ANA-positive we suspect there are features that can help distinguish those who will later develop disease. ⋯ Defining the test result is difficult. However, there is clear differentiation between the positive and negative/unknown cohorts. Positive-test status is associated with ANA-disease development and mortality. If ANA-positive, most of those who will develop disease are diagnosed soon after testing; male gender and advanced-age reduce the risk of ANA-diseases.
-
Postural hypotension (PH), the drop in blood pressure (BP) on standing, is associated with falls, all-cause mortality and cognitive decline. PH diagnostic criteria require lying-to-standing BP measurements. PH Prevalence in older adults is 20%, however, it is infrequently recorded in primary care records, suggesting PH testing and/or recording is under-utilised in this setting. ⋯ Interim findings suggest that most PH assessments in primary care do not meet current guideline criteria. Full findings from this survey are expected to inform and influence future national guidelines.
-
People with diabetes who do not attend their annual review appointments often have poorer glycaemic control and increased complication rates. A postal kit for self-collection of blood tests, urine samples, and anthropometric data may facilitate remote annual reviews and improve uptake. ⋯ Postal kits for annual reviews were well-received by people living with diabetes. Designed well, they have the potential to overcome far more than just the physical barriers to annual review attendance.
-
Benign paroxysmal positional vertigo (BPPV) is a prevalent and disabling pathology. Its diagnosis and treatment according to clinical practice guidelines is carried out through canalicular repositioning maneuvers, but these maneuvers are not performed routinely in primary care consultations. ⋯ The majority of diagnostic records related to vertigo/dizziness were non-specific (9 out of 10). The number of prescriptions for betahistine, and referrals, mainly to an otolaryngologist, are considerable and an avoidable expense. Better knowledge about vertigo/dizziness in care could improve the diagnostic and therapeutic accuracy of this pathology as well as the social and health costs it produces.
-
Transgender and gender diverse (TGD) individuals experience an incongruence between their assigned birth sex and gender identity. They may have a higher prevalence of health conditions associated with cancer risk than cisgender people. ⋯ Multiple cancer risk factors are more prevalent among TGD individuals compared with cisgender individuals. Future research should examine how minority stress contributes to the increased prevalence of cancer risk factors in this population.