InnovAiT: Education and inspiration for general practice

Testicular and scrotal pain are common presenting complaints in the GP surgery. Often, men present after acute onset of pain, but more commonly male patients attend after a gradual progression of more vague testicular symptoms or when discomfort begins to impact upon normal activities of daily living. Testicular symptoms can be a cause of great anxiety among patients, particularly as men (most notably younger men) are often embarrassed or reluctant to consult, which GPs need to be sensitive to. This article discusses some of the common and important testicular pathologies and emphasizes how a structured approach to the history and examination helps in making a clinical diagnosis.

Renal colic is a common condition, which will often be seen by GPs throughout their careers. Making up 1% of all emergency admissions to hospital, specialist review and care may be frequently required; however, the responsibilities of initial prompt diagnosis and treatment, followed by patient education and secondary prevention will often lie with the primary care physician. This article aims to provide an overview of renal tract calculi and provide trainees with a general understanding of its aetiology, presentation and acute and long-term treatment.

‘What about that article in the Guardian about the study on the PSA test? Can I please have the new urine test (PCA3) instead? Will I be OK if the test result is normal?’ are the kind of questions that I have been asked about the prostate cancer screening and the prostate-specific antigen (PSA) test. This article should help the reader to have an informed discussion with men requesting the PSA test.

Contraception can be a daunting topic for both patients and doctors. However, choosing effective contraception offers choice in determining family size and spacing. Worldwide effective contraception prevents an estimated 187 million unintended pregnancies and averts an estimated 2.7 million infant and 215 000 pregnancy-related deaths. Progestogen only pills (POPs) are one of the many choices available.

The global human immunodeficiency virus (HIV) epidemic continues, with 33.3 million people living with HIV and acquired immune deficiency syndrome (AIDS) worldwide (World Health Organization. Global summary of the HIV/AIDS epidemic (2009)). Twenty-two and a half million of those living with HIV/AIDS are in sub-Saharan Africa, where the average adult prevalence is 5%. There is no cure for HIV, but antiretroviral therapy is highly effective and has dramatically improved prognosis in developed countries where treatment is available. Prognosis is significantly improved if HIV is diagnosed early, and therefore, it is important to be aware of HIV as a GP.

The advent of antiretroviral therapy has radically changed the prognosis of human immunodeficiency virus (HIV) infection. HIV is now a treatable medical condition and is increasingly managed as a chronic disease. The majority of those living with the virus remain fit and well on treatment. However, those living with HIV are at risk of adverse effects due to antiretroviral treatment and increased risk of cardiovascular disease.

How do we encourage our patients to give up smoking, drink less alcohol and engage in healthy activities that would enhance and possibly lengthen their lives? Health promotion and explaining risk are part of the GP's everyday job but it is a skill that could be improved. One suggestion for improving health promotion by GPs is that a motivational interviewing (MI) approach could be used. This article aims to describe the MI method and its practical relevance to primary care practitioners in dealing with common patient concerns.

A70-year-old woman comes to see you in surgery because she has developed a red and sore eye. Which issues do you need to consider as part of a focused clinical assessment?