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BPJ 19 February 2009

Best Practice Journal

Management of impetigo

Impetigo is a highly contagious, bacterial infection of the skin, most commonly seen in children. It is typically diagnosed clinically and the aim of treatment is to clear the eruption and prevent the spread of infection to others. Topical treatment is usually adequate although oral antibiotics can be used for extensive infection. View Article

Scabies - diagnosis and management

Scabies manifests as an itchy skin rash, as a result of an allergic reaction to the female scabies mite. Infection is easily spread from person to person with direct skin contact. Clinical diagnosis can be made if burrows are observed on the skin. Permethrin and malathion are effective treatments for the rash View Article

Management of fungal nail infections

Fungal nail infection (onychomycosis) accounts for around 50% of all nail disease. Laboratory diagnosis is recommended before considering oral or topical treatment. However, treatment may not always be necessary, especially for elderly people or for those who do not have troublesome symptoms. View Article

Transient ischaemic attack - a medical emergency

For one in four people, transient ischaemic attack (TIA) is a forerunner for stroke. If TIA is suspected, aspirin should be immediately commenced, followed by stroke risk assessment. Patients at high risk of stroke should be referred urgently for specialist assessment View Article

The role of antiplatelet agents

Antiplatelet drugs including aspirin, clopidogrel and dipyrimadole, reduce the incidence of cardiovascular events by about 20-25% in people with established cardiovascular disease or at high risk of cardiovascular disease. This article provides an overview of each drugs current place in therapy. View Article

Warfarin vs. aspirin for the prevention of atrial fibrillation related stroke

The decision whether to choose aspirin or warfarin for stroke prevention is often not clear cut. There is evidence that treatment with warfarin is more effective for stroke prevention than aspirin. However warfarin is underutilised, particularly in elderly people, despite the fact with effective communication and monitoring it can be used safely. View Article

Sexually transmitted infections in New Zealand

Chlamydia remains the most commonly diagnosed STI in New Zealand, according to the annual STI Surveillance Report. Although not yet as prevalent as chlamydia, cases of gonorrhoea are increasing at a greater rate. Genital warts are the most frequently reported viral STI and the number of cases of syphilis continues to increase. View Article

Why people smoke

There are many reasons why people begin smoking, continue to smoke and find it hard to quit. Clinicians who want to discourage people from smoking are more likely to be successful if they have some understanding and empathy of these reasons and barriers. View Article

Upfront: New hope for genetic disorders: pre-implantation genetic diagnosis

Pre-implantation genetic diagnosis (PGD) represents the latest technology in genetic testing. However it also opens up an ethical minefield between the balance of scientific advances and "playing God". The purpose of this article is to provide information about the issues, preparing GPs and primary care professionals for questions from patients. View Article

Removal of isotretinoin prescriber restrictions

From 1 March 2009 PHARMAC will widen access to vocationally registered general practitioners. More in BPJ20. View Article

Quiz feedback: Bones & Joints/CVD risk assessment

In BPJ 17 (October 2008) we covered several issues in relation to “bones and joints” including prevention of osteoporosis, symptomatic management of osteoarthritis and monitoring of disease modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis. We also covered the PHO performance indicator of “cardiovascular risk assessment”. View Article