GPnotebook Podcast

Dry skin conditions are one of the commonest skin problems that present to primary care physicians, but their psychological impact and psychiatric comorbidities are often underestimated. In this podcast episode, Dr Roger Henderson looks at dry skin, its impact on mental well-being and how it should be assessed and treated. He also gives useful consultation hints and tips about both the dermatologi...

In 2019, vaccine hesitancy was listed as one the top ten threats to global health by the World Health Organization. In this episode, Dr Hannah Rosa explores vaccine hesitancy further, thinking about how we can make a difference in primary care. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-55-addressing-vacc...

Back in 2009, the conclusion of the first Lancet Climate Change Commission was that “Climate change is the biggest global health threat of the 21st Century.” In response to this, in October 2020, the NHS became the world’s first health service to commit to reaching carbon net zero, and in July 2022 it published its plan for delivery. So, what does all this mean for general practice? In this podcas...

In this episode, Dr Roger Henderson discusses the common problem of insomnia. He looks at what it is, how it is assessed, what causes it and ways of treating it. He also discusses simple tips patients can do at home that can cure one in three cases of insomnia without the need for any medication and mentions some famous people who suffered from insomnia along the way! Access episode show notes con...

Menopause and hormone replacement therapy (HRT) can be a source of anxiety for both patients and clinicians. Menopause is frequently in the media and is at the forefront of many consultations. It’s on our minds and on our patients’ too. In the first in a series of episodes on menopause, Dr James Waldron explores its background, its coverage in the media, the changing attitudes towards it, the impa...

Using electronic cigarettes (e-cigarettes), or ‘vaping’, has become the most popular form of nicotine replacement therapy in the UK. In this podcast episode, Dr Roger Henderson looks at why this is, the benefits to smokers, and whether we should be recommending such products to our patients who smoke. He also talks about current concerns over their increasing popularity in adolescents and what the...

In this podcast, Dr Kate Chesterman discusses post-sepsis syndrome. She talks about the long-term implications for physical and mental health following sepsis and highlights the considerations for primary care clinicians in managing this cohort of individuals. She also discusses the role of the wider multidisciplinary team, including input from voluntary organisations. Access episode show notes co...

Heat-related illnesses are increasing as a result of climate change. In this episode, Dr Roger Henderson looks at various aspects of heat exhaustion and heatstroke, including why they are different conditions and how to recognise them. He also talks about how they are treated and when hospital admission should be considered. Access episode show notes containing key references and take-home points...

In this episode, Dr Roger Henderson discusses the treatment pathway for people suffering from hay fever. This comprises options ranging from simple measures for allergen avoidance to the treatments to consider for specific symptoms and when to refer for specialist advice and consideration of immunotherapy. Access episode show notes containing key references and take-home points at: https://gpnoteb...

In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Glos CCG) and Dr Rob Hampton (Portfolio GP, Leicestershire) discuss the prescribing of medicines associated with dependence and approaches to their withdrawal. Is there a link between deprivation and long-term use of pain medications? What is the role of...

In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Rob Hampton (Portfolio GP, Leicestershire) and Dr Yassir Javaid (Cardiovascular and Diabetes Lead, Northamptonshire CCG) discuss the \"neglected chronic condition\" that is heart valve disease and the new NICE guideline covering its investigation and management in adults. Why can we expect an increase in cases over the...

In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Steve Holmes (GP, Shepton Mallet and Clinical Respiratory Lead, NHS England South West and NHS Somerset) and Dr Sarah Davies (GPwSI in Diabetes, Cardiff) discuss non-alcoholic fatty liver disease (NAFLD) in the context of diabetes. How is NAFLD best detected, diagnosed and managed in high-risk populations? How can prima...

In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Yassir Javaid (Cardiovascular and Diabetes Lead, Northamptonshire CCG) and Dr Patrick Holmes (GP, Darlington) examine the latest developments in renal medicine, with a focus on assessing and managing chronic kidney disease (CKD). What role do sodium–glucose cotransporter 2 inhibitors have in the management of the condit...

In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Anthony Cunliffe (Macmillan National Clinical Adviser for Primary Care) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Glos CCG) discuss the exacerbation of health inequalities related to the COVID-19 pandemic, with a specific focus on cancer services. Which common avoidable cancers and their r...

In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Yassir Javaid (Cardiovascular and Diabetes Lead, Northamptonshire CCG) and Dr Steve Holmes (GP, Shepton Mallet and Clinical Respiratory Lead, NHS England South West and NHS Somerset) discuss the \"heart–lung connection\" – specifically, the overlap between chronic obstructive pulmonary disease (COPD) and heart failure....

n this episode, which has been recorded for Chronic Conditions Month 2022, Dr Sarah Davies (GPwSI in Diabetes, Cardiff) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) discuss the interplay between mental health and conditions such as diabetes, dementia and heart disease. What role do lifestyle factors such as diet and physical activity have in modulat...

In this episode, Dr Kate Chesterman discusses binge-eating disorder. She explores the defining characteristics of the condition and highlights the importance of referring to eating disorder services for treatment. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-40-identifying-and-supporting-people-with-binge-eating...

In this episode, Dr Kevin Fernando and Dr Jim McMorran discuss the ongoing NHS-Galleri trial. The study, which is being conducted among 140,000 asymptomatic patients in England, will assess whether the new Galleri blood test can assist in detecting cancer early when used alongside existing screening measures in the NHS. Kevin and Jim consider the sensitivity, specificity and positive predictive va...

In this episode, Dr Kate Chesterman discusses the finding of an undescended testicle at the 6-week baby check. She considers the possible diagnoses and associated risks. Kate also takes us through the primary care assessment and clarifies the important question of when to refer. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/urolo...

In this episode, Dr Kevin Fernando considers the case of Juliana, a 43-year-old journalist who requests a cholesterol check because her father experienced a heart attack in his early 50s. She has no past medical history of note. Her lipid profile returns as follows: total cholesterol (TC), 7.5 mmol/L; HDL-cholesterol, 1.4 mmol/L; triglycerides, 2.2 mmol/L; LDL-cholesterol, 2.9 mmol/L. What should...

In this episode, Dr Kate Chesterman discusses the role of the primary care practitioner in the long-term follow-up of people who have undergone bariatric surgery. She highlights the current variability in monitoring and makes listeners aware of where to access the current guidance on postoperative biochemical monitoring and micronutrient replacement. Access episode show notes containing key refere...

In this episode, Dr Kevin Fernando discusses diagnostic and management tips – as well as pitfalls to avoid – related to subclinical hyperthyroidism. Fatima is a 71-year-old woman who presents in primary care with non-specific malaise and a past medical history of atrial fibrillation, ischaemic heart disease and osteoporosis. On examination, there is no evidence of thyroid swelling. Her blood tests...

In this episode, Dr Kate Chesterman discusses the case of Lauren, a 32-year-old lady who is 30 weeks pregnant. Lauren presents with dysuria and increased frequency. Kate talks us through the current guidance on urinary symptoms in pregnancy and considers who to investigate, when to treat and what to treat with. She highlights physiological changes in pregnancy, important obstetric and non-obstetri...

In this episode, Kevin considers the diagnosis and management of superficial venous thrombosis. Lesley is a 64-year-old woman who presents to us with a sore, itchy right leg and no past medical history of note. On examination, she has a tender, hard, erythematous varicose vein extending from her thigh to ankle. What should we do next? Should we be worried about underlying deep vein thrombosis? Acc...

In this episode, Kate discusses gynaecomastia and its investigation and management in primary care. She talks us through an infographic produced by The Association of Breast Surgery called Guidance on Gynaecomastia and considers the following important questions: “who do I need to be worried about?”, “what investigations should I consider?” and “when should I make a referral?”. Access episode show...