InnovAiT: Education and inspiration for general practice

Learning disability is commonly encountered in General Practice affecting between 1 and 2% of the Western world. Patients with learning disabilities have two and a half times as many associated medical problems. It often leads to functional impairment and increased need for lifelong support involving medical services. The care of patients with learning disabilities requires a holistic approach with awareness of the services available and knowledge of the barriers to health care faced by this patient group. This article aims to outline the definitions of learning disabilities and screening and diagnosis of these conditions in primary care, causes, principles of management and the difficulties and barriers in care delivery for these patients.

Attention-deficit hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity and impulsivity leading to difficulties at home, education and daily activities. ADHD remains relatively young within paediatric psychiatry with its recognition and management developing over the last 20 years. A consensus towards diagnosis and management has come with recent NICE guidelines.

Autism and Asperger's syndrome are part of a range of conditions incorporated under the term autistic spectrum disorders (ASDs). This article will aim to define these conditions and explain the differences between them, clarify some of the myths about their aetiology and equip the reader with the specific knowledge to diagnose, refer and manage patients with ASDs as effectively as possible.

A hernia is defined as an abnormal protrusion of a viscus, or part of a viscus, through the wall of its containing cavity. A hernia can therefore occur at many anatomical locations. Abdominal wall hernias are a common problem and prevalence of this condition has been estimated as approximately 2% for all ages. This review will concentrate on abdominal wall hernias, their presentation, diagnosis and management.

The pancreas is a retroperitoneal organ with both endocrine and exocrine functions. It was first described by a Greek physician Herophilus between 335 and 280 BC and was given its name by Ruphos only a few hundred years later. In 1642, Wirsung discovered the pancreatic duct and within three decades Graff investigated its secretory properties. Paul Langerhans described ‘islets of Langerhans’ in 1869 and the first description of pancreatitis as a disease was by Fitz in 1889. Halstead performed the first operation on the pancreas in 1898.

With an increase in prevalence of alcohol abuse and obesity, cirrhosis is on the rise. To prevent progression to end-stage liver disease and liver failure, abnormalities must be picked up early. This article provides an overview of liver failure and how to approach investigation and management of patients at risk.

In the 21st century, health care clinicians, managers and patients expect to see the findings of research incorporated into clinical practice, taking into account the needs and wishes of individual patients.