The Practitioner
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Neuropathic pain is defined as 'pain arising as a direct consequence of a lesion or disease of the somatosensory system'. It may reflect a widespread neuropathic process (e.g. diabetic neuropathy) or a more focal disorder (e.g. post-herpetic neuralgia). The practical importance of recognising neuropathic pain (as distinct from nociceptive pain) lies in the difference in effective treatments. ⋯ A specialist opinion should be sought where the diagnosis is uncertain, or the patient's condition is rapidly deteriorating or uncontrolled. This may be a specialist in a particular condition, to address issues of primary diagnosis, or a specialist in pain medicine to advise on, or provide, further treatment. Patients who are struggling with their pain are best served by specialist centres that can endeavour to explain the condition and encourage self-management.
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Ten per cent of girls and 3% of boys will have had a UTI by 16 years of age. The majority are acute, isolated illnesses that resolve quickly, with no long-term implications for the patient. However, UTIs may be associated with underlying congenital abnormalities, and recurrent infections can lead to renal scarring. ⋯ However, they should all be evaluated to help determine which require renal imaging as well as identifying triggers for recurrence. GPs are central to the identification of children at risk of renal pathology. All children who are diagnosed and treated for a UTI must be assessed for risk of renal abnormalities and/or recurrence.
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Biography Historical Article Classical Article
On inhalation in diseases of the throat. 1868.