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Clinical Knowledge Summaries - CKS (Remove filter)

All women aged 65 years and over, and all men aged 75 years and over.

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For people at high risk of fragility fracture For people whose fracture risk is above the recommended threshold, offer a dual-energy x-ray absorptiometry (DXA)...

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Clinical Knowledge Summaries - CKS (Remove filter)

01 August 2020

Vaccination with a quadrivalent meningococcal vaccine that protects against the A, C, W, and Y capsular types is recommended for the following groups of people...

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01 August 2020

Vaccination is indicated for people who are travelling to areas or countries where poliomyelitis is epidemic or endemic if:They have not been previously immunized.

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01 August 2020

Travellers to rabies-enzootic areas should be offered pre-exposure immunization against rabies, especially if they are: Staying for more than one month.

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01 August 2020

Tetanus can potentially be contracted worldwide.

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01 August 2020

Tick-borne encephalitis vaccination is advised for people travelling to, or going to reside in endemic areas.

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01 August 2020

Give a typhoid vaccination to travellers to countries where typhoid is endemic (for detailed information, see the NaTHNaC website), especially if they are:...

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01 August 2020

Yellow fever vaccination is only available from designated centres: For the location of vaccination centres, see the Yellow Fever Vaccination Programme section of...

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01 August 2020

All pilgrims should ensure that they are up-to-date with routine immunizations, including measles, mumps, and rubella (MMR) and polio.

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01 August 2020

Consider rapid vaccination courses, and/or vaccination up to the day of departure for people without sufficient time before travel to allow standard vaccination...

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01 October 2019

Determine what type of urinary incontinence the woman has.

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01 October 2019

Stress urinary incontinence .

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Clinical Knowledge Summaries - CKS (Remove filter)

01 October 2019

Consider and look for the presence of any causes or conditions that may exacerbate urinary incontinence or overactive bladder.

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01 August 2020

Symptoms suggestive of breast cancer Table 2. Symptoms suggestive of breast cancer. Symptom Possible cancer Referral recommendation Axillary lump...

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01 August 2020

The terms used in the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral are as follows:Immediate: an...

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01 August 2016

Consider a diagnosis of cyclical breast pain when a woman describes pain that: Usually starts during the luteal phase of the cycle (within 2 weeks before menses),...

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01 August 2016

Reassure the woman that there is no serious underlying pathology.

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01 December 2017

Give advice on sources of information and support, such as: The Public Health England (PHE) leaflet on NHS breast screening.

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Clinical Knowledge Summaries - CKS (Remove filter)

01 May 2017

Ask about: Breastfeeding history:  Previous breastfeeding experiences, problems, pain.

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01 May 2017

Engorgement Breast pain typically starts in the first few days after birth, is often bilateral and worse before a feed.

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01 May 2017

Physiological milk let-down pain There is often pain for the first few minutes of breastfeeding, which resolves with continuation of the feed.

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Clinical Knowledge Summaries - CKS (Remove filter)

01 May 2017

Insufficient access to the breast Suggested by short or infrequent feeds, and/or no night feeds.

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01 May 2017

Ineffective infant positioning and attachment The infant may not remove milk efficiently so suckles a lot, stimulating the breast to produce excessive milk.

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01 May 2017

For all women with breastfeeding problems: Ensure that a person with appropriate training and expertise (such as a health visitor or breastfeeding specialist) observes...

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01 May 2017

For prescribing information on paracetamol, see the CKS topic on Analgesia - mild-to-moderate pain .

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01 May 2017

Flucloxacillin is found in trace amounts in breast milk, but is appropriate to use in breastfeeding women.

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01 May 2017

Only small amounts of erythromycin are found in breast milk, and it is not known to be harmful when breastfeeding.

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01 October 2018

Take a history.

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01 October 2018

Palpate the abdomen (if appropriate)  to assess for tenderness or a mass (which may indicate malignancy).

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01 October 2018

Differential diagnoses of bacterial vaginosis (BV) include: Other infections, such as: Candidiasis  —  characterized by a white, odourless, curdy...

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01 October 2018

If the woman is asymptomatic, treatment is not usually required, unless she is undergoing termination of pregnancy.

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01 May 2019

Other causes of facial weakness and paralysis include: Stroke  — forehead spared, extremities often affected.

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01 May 2019

Reassure the person that the prognosis is good.

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01 May 2019

For more information on prescribing of oral corticosteroids, see the CKS topic on Corticosteroids - oral .

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01 October 2017

Ask about symptoms of vertigo.

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01 October 2017

For more information on other conditions causing vertigo symptoms, see the CKS topic on Vertigo .

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01 October 2017

Advise the person: Most people recover over several weeks, even without treatment, but symptoms can last much longer and may recur.

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01 January 2019

A ssess whether this is a suitable time to stop taking the drugs.

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01 October 2018

Encourage:Regular oral hygiene, including tongue cleaning and good care of dentures.

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01 October 2018

It can often be difficult to be certain that a person is dying, but it is essential to recognize the signs of dying in order to appropriately care for people at...

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01 October 2018

Any topical artificial saliva and saliva stimulant product available on prescription in the UK can be tried to treat the symptoms of dry mouth.Salinum® ...

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01 October 2018

Pilocarpine should be avoided in people who:Have asthma.

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01 October 2018

Topical nystatin or topical miconazole are recommended for first-line treatment of oral candida infection.

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01 October 2018

In immunocompetent people, oral fluconazole is recommended for second-line treatment if candidiasis persists.

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01 October 2018

Chlorhexidine is the most effective antiseptic gel/mouthwash for reducing plaque, gingivitis, and gingival bleeding [Grossman et al, 1989 ; Overholser et al, 1990...

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01 October 2018

As corticosteroid use for aphthous ulcers is short-term, potential problems often associated with corticosteroid use (for example osteoporosis) are not relevant.

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01 October 2018

Topical aciclovir and topical penciclovir are recommended in immunocompetent people who are in the early stages of an uncomplicated herpes simplex infection in the...

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01 October 2018

Common adverse effects  include a metallic taste and gastrointestinal irritation (in particular nausea and vomiting).

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01 May 2016

Suspect acute pancreatitis in any person who presents with acute upper or generalized abdominal pain,  particularly if they have a history or clinical features...

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