A risky business?

Since April 2009, the Quality and Outcomes Framework (QOF) has rewarded UK general practices for "cardiovascular risk assessment at the outset of diagnosis using an agreed risk assessment treatment tool" for all new patients diagnosed with hypertension. However, there are concerns that the current tool relies largely on data that may be inappropriate for the UK. In this month's editorial we discuss these concerns and an alternative risk assessment tool.
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Using NSAIDs in cardiovascular disease

The risk of unwanted cardiovascular effects associated with NSAIDs has been publicised in the UK in recent years by the Medicines and Healthcare products Regulatory Agency and the National Prescribing Centre. In this article we consider the evidence on cardiovascular risk in the context of other unwanted effects of NSAIDs, and offer practical advice on the use of NSAIDs in patients with cardiovascular disease.
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Podcast: In this issue - March 2010

A monthly audio round-up detailing the contents of the latest issue of DTB.
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Managing primary hyperparathyroidism in primary care

Patients with calcium concentrations above 3mmol/L typically start to develop symptoms of hypercalcaemia. Milder hypercalcaemia is often asymptomatic, and the problem is therefore usually discovered as an incidental finding on routine biochemical screening. Primary hyperparathyroidism is a common cause of hypercalcaemia. In this article we consider the recognition and further management of patients presenting with asymptomatic primary hyperparathyroidism in primary care.
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Body surface area for adjustment of drug dose

For many drugs, it is important to adjust the dose for individual patients. To estimate the dose, a patient's body weight or body surface area is often used. Body surface area is difficult to measure directly, but may be calculated using formulae involving the patient's weight and height. In this article we discuss body surface area and when it is used in practice, in particular, for calculating drug doses in children and for cancer chemotherapy.
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