Combined hormonal contraception
This is an update from the FSRH on the use of combined hormonal contraception (CHC). There are a couple of elements in here that are new. I shall list these, then give the check-list of what they thin...
Louise Hudman is a GP locum and regularly summarises clinical guidelines.
CPD | Post-traumatic stress disorder (PTSD)
This is an updated guideline from NICE on Post-Traumatic Stress Disorder PTSD. The last guideline came out in 2005. I don't think this really changes our management much (i.e. watch and wait for 1 mon...
Bronchial thermoplasty for severe asthma
This is a new guideline on bronchial thermoplasty from NICE on bronchial thermoplasty for severe asthma. NICE advise that it can be used.This procedure reduces the smooth muscle mass lining th...
CPD | Contraception in the over 40s
This was an updated guideline from the FSRH on contraception in the over 40s. It came out in Nov 17, but as it is so useful, I thought it worth doing a summary. There were a few things that were new f...
iFuse for chronic sacroiliac pain
This is a new guideline from NICE advising that iFUSE can be used for treating chronic sacroiliac pain. The guideline was released in Oct 18. It is worth being aware of as we may have patients affecte...
CPD | Chronic Heart Failure in adults
This is an updated guideline on heart failure from NICE published in September 2018. Most of this is what we are currently doing. They have pulled several different guidelines together to make this mo...
Management of pancreatitis
This is a new guideline from NICE on pancreatitis from Sep 2018. Most of it is aimed at secondary care, but there are a few things that are useful for us which I've outlined below. Advice to give pati...
Transurethral steam ablation for lower urinary tract symptoms in men
This is a new guideline from NICE recommending that transurethral water vapour ablation can be used for treating lower urinary tract symptoms (LUTS) in men. It was published in Aug 18. This procedure ...
Valproate – contraindicated in women of childbearing potential
You have probably heard about this on the news, or seen it in other forms, but in case you have missed it, I felt it important to do an update. This information came out in Apr 18 from MHRA. Valproate...
CPD | Management of dementia
This is a new guideline from NICE on the management of dementia. Most of this is not new, but there were a couple of things I wasn't fully aware of. I'll list the things that were new to me, then do a...
Prostate artery embolisation for benign prostatic hypertrophy BPH
This is guideline from NICE advises that prostate artery embolisation can be used as a treatment for lower urinary tract symptoms association with benign prostatic hypertrophy (BPH). This came out in ...
Podcast | A viper’s nest: when venom is a man’s best friend
Did you know that captopril was derived from the venom of the deadly Brazilian pit viper? Since it went on the market in 1981 captopril and its successor ACE inhibitors have probably saved many more l...
CPD | Bladder Pain Syndrome (Interstitial Cystitis)
This is a new guideline from RCOG on Bladder Pain Syndrome, which used to be called Interstitial Cystitis, among other things. As this is a new guideline and it is a common problem (affecting up to 6%...
Bisphosphonates, raloxifene and teriparatide for treating osteoporosis
This summary is based on 3 recent NICE guidelines:Bisphosphonates in people for primary or secondary prevention. Raloxifene for primary prevention. Basically it isn't advised. Raloxifene and teripar...
Hearing loss and ear wax
This is a new guideline from NICE on managing hearing loss and ear wax, published in June 2018. Exciting? Well, there are a couple of good bits in here, especially given how common a problem this is. ...
Stop smoking intervention
This is a new guideline from NICE on stop smoking interventions. If you do nothing else, I would strongly encourage you to do the National Centre for Smoking Cessation and Training NCSCT e-learning mo...
Heavy menstrual bleeding (menorrhagia)
NICE published an update to its guideline on heavy menstrual bleeding (menorrhagia) in March 2018. There are a couple of changes:Hysteroscopy is now the first line investigation for most women who n...
Nice Attention Deficit Hyperactivity Disorder ADHD guideline
This is a guideline from NICE on Attention Deficit Hyperactivity Disorder ADHD. It was written in 2008, then updated in March 2018. The changes are relatively subtle, so I shall outline the changes, t...
Kyleena – a new intrauterine system for contraception
This is a statement from Jan 18 from FSRH giving information about Kyleena, which is a new levonorgestrel (LNG) containing intrauterine system (IUS). What is Kyleena? An IUS. It contains levonorgestre...
Otitis Media – when to use antibiotics
This is a new guideline from NICE on when to use antibiotics for otitis media (March 2018). It doesn't change common practice, but I found some of the statistics really helpful for explaining why we p...
Peristeen transanal irrigation system for managing bowel dysfunction
This is a new guideline from NICE on the use of the Peristeen transanal irrigation system for managing bowel dysfunction. Peristeen is otherwise known as Coloplast; patients use it every other day. It...
Pancreatic cancer in adults (when to offer surveillance)
This is a new guideline from NICE on pancreatic cancer. Most of this is aimed at specialists, but there was a useful bit on when to consider surveillance in people who are at higher risk. Hopefully mo...
Faltering growth in children
This is a recent guideline from NICE, which gives advice on managing faltering growth in children. A lot of this is common sense, but as it is a new guideline, I will summarise the bits relevant to us...
Sore throat – when to use antibiotics
This is a new guideline from NICE which advises on when to use antibiotics in patients with tonsillitis or sore throat. If you already use a scoring system to help you decide when to prescribe it does...
Diagnosing and managing cystic fibrosis
This is a new guideline from NICE on diagnosing and managing cystic fibrosis. Most of this guideline will be much more relevant to secondary care, so I'm just covering the list of possible presentatio...
Multiple Sclerosis – Cladribine tablets (Mavenclad)
This is a new guideline from NICE on a new treatment for MS. Obviously we won't be prescribing this, but I thought it worth mentioning as we may see patients starting to use it. It is an oral medicati...
Sinusitis treatment down to five days
This is a NICE guideline from a couple of months ago in the use of antibiotics in sinusitis. I must say that this has changed my practice significantly, so well worth a read, especially the background...
Latest endometriosis NG73 guidelines from NICE
![By richie graham (originally posted to Flickr as jensute) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons](https://www.nasgp.org.uk/wp-content/uploads/2017/11/Endometriosis.jpg)
This is a new guideline from NICE on managing endometriosis. I'll do a general summary of this as it is a new guideline. However I don't think it changes very much that we do. There is a good algorith...
Eating Disorders
This is a new guideline from NICE on managing eating disorders. It is really targeted around anorexia nervosa and bulimia. Much of this is not new, but as we don't see patients with these disorders to...
Post pregnancy contraception
This is a new guideline from the FSRH on contraception after pregnancy. There is nothing particularly new about specific methods, but there are a few new interesting points (including a reminder that ...
Nice | Who should we be testing for cirrhosis?
This is a new guideline from NICE on cirrhosis. The most important bit for us is knowing who should be tested as we may need to be referring these patients on. Higher risk patientsHepatitis B Hepati...
Nice | Non-alcoholic fatty liver disease NAFLD
This is a new guideline from NICE on non alcoholic fatty liver disease (NAFLD) in children, young people and adults. To be honest, I don't think this guideline is terribly helpful. I've done a brief s...
Evolocumab and Alirocumab for treating dyslipidaemia
There are two new guidelines from NICE on the use of Evolocumab and Alirocumab for treating primary hypercholesterolaemia (both familial and non-familial) and mixed dyslipidaemia. What are these drugs...
FSRH | UKMEC update (risks of various contraceptive use)
The UKMEC criteria from the FSRH have been updated. These criteria tell you what conditions or criteria may make the use of different contraceptives inappropriate. If you are not familiar with it, it ...
Greenlight XPS (laser treatment) for treating benign prostatic hyperplasia
This is a new guideline on using the Greenlight XPS system for treating BPH. This has been widely reported in the media. It is as effective as TURP in low-risk patients and has the big advantage of be...
Nice | Non-alcoholic fatty liver disease NAFLD
This is a new guideline from NICE on non alcoholic fatty liver disease (NAFLD) in children, young people and adults. To be honest, I don't think this guideline is terribly helpful. I've done a brief s...
Nice | Detection and management of sepsis
This is a new guideline from NICE on the detection and management of sepsis. None of this is likely to be new, but it is worth looking through. I think the main reason is, sadly, from a medico-legal p...
FSRH | COC – risks of different oestrogen and progesterone
This is a statement from the FSRH on a study recently published on risks with COC use. This study looks at how the different dose of oestrogen and how the different progesterone affect the risk of PE,...
GP-Update | Normal variants of lower limb conditions in children
How often have you encountered an anxious parent with their child with bow legs or in-toeing and wondered ‘is this normal or not?’. If you don’t feel 100% confident in knowing which child needs simple...
Type 2 diabetes – canagliflozin, dapaglifozin and empaglifozin as monotherapies
This is new guidance from NICE advising that canagliflozin, dapagliflozin and empagliflozin can all be used as monotherapies in treating Type 2 Diabetes. Previously they have only been advised as add-...