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BPJ 52 April 2013

Best Practice Journal

A “how-to guide” for a sexual health check-up

Good sexual health is about achieving both physical and psychological wellbeing, free from disease, coercion or abuse. Reaching and maintaining good sexual health requires a positive and respectful approach to sex and sexual relationships, as well as the ability to have pleasurable and safe sexual experiences. View Article

A quick guide to managing anal fissures

Anal fissures are small tears in the epithelium of the anus that can be intensely painful. Most anal fissures are caused due to straining during bowel movements, constipation or repeated diarrhoea. They are equally common in both sexes, and most frequently affect people aged 15 – 40 years. View Article

The pharmacological management of Endometriosis

Endometriosis is a gynaecological condition in which endometrial tissue is present outside the uterine cavity, causing cyclic symptoms and, often, reduced fertility. A “working diagnosis” can be made based on the patient’s symptoms and evaluation of risk-factors, although laparoscopy is required for a definitive diagnosis. Medical management involves the hormonal suppression of endometriotic lesions and, where possible, the surgical ablation and excision of ectopic endometrial tissue. View Article

Cold season in primary care

A newer article is available on this subject: Cold season: managing without antibiotics

Every year New Zealanders spend significant amounts of money on supplements, over-the-counter, complementary and alternative medicines for the common cold. For most people, symptoms of the common cold are mild and self-limiting, and the products used to treat it are often expensive, lacking evidence of effectiveness and in some cases, have potentially serious adverse effects. Patients should be given advice on prevention and management and where possible, given unbiased, evidence-based information on the benefits and adverse effects of over-the-counter and alternative products.

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Hazards to Health: e-notification to your Medical Officer of Health

A new electronic notification system has been designed for general practices to report incidents related to exposures to hazardous substances. The system has been developed by bestpractice Decision Support (BPAC Inc) and the Centre for Public Health Research, and is funded by the Ministry of Health. View Article

Statins and the risk of acute kidney injury

THERE HAVE BEEN RECENT REPORTS in the literature associating the use of statins with acute kidney injury (AKI). A study by Hippisley-Cox and Coupland of over 225 000 patients starting statin treatment for the first time in England and Wales found a dose-response association between statin treatment and acute kidney injury (AKI). View Article

Hypomagnesaemia with proton pump inhibitors

IN DECEMBER, 2012 MEDSAFE published a warning on the risk of hypomagnesaemia for people taking any proton pump inhibitor (PPI). This follows a previous Medsafe warning in 2010 about hypomagnesaemia associated with omeprazole, the most commonly prescribed PPI in New Zealand. View Article

H1N1 influenza vaccination and the risk of childhood narcolepsy

IN MARCH, 2012 A SIGNIFICANT INCREASE in the rate of childhood narcolepsy associated with the influenza vaccine Pandemrix (GlaxoSmithKline) was reported in Finland. This vaccine was administered to over 30 million people in Europe to provide protection during the 2009 H1N1 pandemic. View Article

Correspondence: Dabigatran; Escitalopram and QT interval

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