Primary biliary cholangitis: symptoms, diagnosis and management

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Haemochromatosis: what is it and could you have it?

Genetic haemochromatosis is the most common inherited genetic disorder among Northern Europeans, thought to affect 1:200 people in the UK. despite this, most people have never heard of the condition. Gerri Mortimore, lecturer in Post-registration \health Care at the \University of Derby, looks at the health implications of this disorder.N/

Genetic haemochromatosis: diagnosing and treating hereditary iron overload.

Genetic haemochromatosis (GH) is the most common inherited genetic disorder in caucasians, affecting approximately 1 in every 200–250 people. It leads to an increased absorption and deposition of iron, and if it is untreated it can cause systemic iron overload in some patients. This iron overload can cause inflammation and tissue damage to multiple organs, with the potential to lead to heart disease, diabetes and cirrhosis of the liver. Despite being a common condition, it is thought to be under diagnosed. However, it is known that some patients with a diagnosis of GH will present with cirrhosis at a young age, while others are virtually asymptomatic. Symptoms can be generalised, and diagnosis is made on blood tests. Treatment for GH requires the removal of blood, known as venesection. Approximately 400–500mls are removed at a time, and this procedure can be undertaken weekly until ferritin levels are brought down to 50 µg/l or below.N/

Alcohol: is it all that bad?

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Christmas health warnings go down like a sack of coal.

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Primary sclerosing cholangitis: a pre-malignant condition

Primary sclerosing cholangitis (PSC) is a chronic, progressive, cholestatic liver disease with no known cure. It is a serious condition, and diagnosis comes with an increased risk of developing cancer of the gallbladder, bile ducts or liver. Symptoms can include fatigue and jaundice, although the disease can be initially asymptomatic. Patients are at risk of deficiencies in fat-soluble vitamins. PSC is also associated with ulcerative colitis, and patients with a dual diagnosis will have an increased risk of developing bowel cancer. In addition, patients can develop fatal complications from colitis or liver failure. As such, primary sclerosing cholangitis can be characterised as a pre-malignant condition. In view of this, it is essential that patients undergo regular surveillance to observe and rapidly treat any developing complications.N/

Constipation in older people: a clinical review for advanced nurse practitioners

Advanced Nurse Practitioners (ANP) are autonomous practitioners who are required to manage clinical care in partnership with patients, families, and carers. This requires using evidence to undertake complex decision-making (Health Education England, 2017). This clinical review will examine the issue of constipation, with particular emphasis on the older patient group. The aetiology and epidemiology of constipation will be examined, the pathophysiological manifestation considered and the diagnosis and management within this population analysed. In doing so the evidence base will be critiqued to ensure autonomous, safe management of this condition

Genetic haemochromatosis.

Genetic Haemochromatosis (GH) is the most common inherited disorder in Caucasians affecting 1:200 in the UK. GH causes the body to absorb too much iron from the diet which over times can lead to systemic iron overload. Treatment involves weekly removal of blood termed venesection. There is little research that examines patients thoughts and feelings of being diagnosed with this life long disease which requires life long treatment in the form of venesections. Exploring the patients symptoms prior to and after venesection has not been fully studiedN/

An exploration into the curricular development of a master's programme designed to support advanced nurse practitioner education

With such fluidity within the NHS, the need to provide provision for health care to the general population is a challenge for government, professionals and the structures that support that development. This has necessitated a need to consider the current workforce and how it can be expanded and adapted to meet these expectations without compromise to patient safety and satisfaction. As nursing is one of the largest professions within the NHS this has meant that advanced nurse practice has grown to meet that demand, but without a consistent and clear framework for the underpinning educational development. Whilst this is certainly under current review and there is much local and national activity to address this issue, debate continues as to what educational provision should be in place. - The development of competencies by professional and governmental bodies is offering a national perspective on the skills and knowledge required by advanced practitioners. However, these competencies are left to be interpreted at a local level whilst trying to map to the proposed national view. The development of an educational programme is influenced by these external forces, with the additional need to accommodate the students’ professional standards of practice and acquisition of characteristics conducive with academic study at master’s level. - Agreeing what an educational curricular should entail in light of the fore mentioned complexities may prove problematic and result in a plethora of titles with differing underpinning knowledge and skills and as such a worrying lack of consistency. - Aim - To develop a programme which meets the academic requirement offering a systematic understanding of knowledge and critical awareness within the field of advanced practice. - Objectives - Establish the knowledge and skills required to support advanced practice - To constructively align the students’ acquisition of knowledge and skill development within the curricular design - To support the development of a practitioner who can demonstrate safe, autonomous practice and problem solving skills in complex and unpredictable situations.N/

Primary Biliary Cholangitis: an update on treatment.

Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is a chronic but progressive disease that, over many years, causes damage to bile ducts, leading to cholestasis and, in some patients, cirrhosis. The rate at which PBC progresses varies from person to person, but significant damage takes decades to occur. It predominately affects women aged 40–60 years with a female to male ratio of 9:1, but can affect anyone from the age of 20. There is no cure for PBC other than liver transplant, but medications can be given to slow down disease progression and for the treatment of symptoms. Health professionals should monitor for complications, including the development of osteoporosis, vitamin deficiencies and liver cirrhosis, which caries the associated complications of portal hypertension, varices and ascitesN/