Guideline publishers

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 teriparatide for secondary prevention. The advice hasn't changed. Previous guidance was rather complicated in that different bisphosphonates could be used at different levels of risk. This has all…
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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. Some top tips that were new for me: Consider an urgent referral to ENT for someone of Chinese…
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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. I will not deal with weight loss in the first few days, as this is generally managed…
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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 doesn't change a lot. Take home points: use a scoring system (FeverPAIN or Centor) and prescribe penicillin 500mg QDS…
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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 presentations (as I'd forgotten quite a lot of these) and also some of the different mucolytic treatments (as I was not aware…
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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 information. Main learning points: 1st line antibiotic is now penicillin. Length of treatment is five days. Only consider antibiotics…
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