Goodfellow Gems



The Goodfellow Foundation's support for the Goodfellow Unit stems from a relationship formed between the Goodfellow family and the University of Auckland in 1978. More

Goodfellow Gems are chosen by the Goodfellow Unit director Dr Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice. The Goodfellow Unit owns the copyright of the Gems.

The Latest GEMS

10 helpful ideas when working with transgender or gender non-conforming patients

Topical corticosteroids may be a safe alternative to treat phimosis in boys

Spironolactone; effective but regular serum potassium checks recommended forever

Beta-blockers no longer first line for simple hypertension

Stillborn children: photographs may help the healing

Gems are chosen by the Goodfellow director DrBruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice. ©The Goodfellow Unit

2017 Gems

10 helpful ideas when working with transgender or gender non-conforming patients

Topical corticosteroids may be a safe alternative to treat phimosis in boys

Spironolactone; effective but regular serum potassium checks recommended forever

Beta-blockers no longer first line for simple hypertension

Stillborn children: photographs may help the healing

Bronchiolitis- No medication in primary care; just monitor and refer when necessary

Early gluten exposure probably not associated with an increase in coeliac disease

Asthma: LABAs, house dust, breathing exercise and pets

Association between gout and high intakes of fructose – consider reducing it

Antibiotics – shorter courses (5 days) are better (pneumonia and cellulitis)

Antibiotics not effective for cough and coloured sputum (acute bronchitis)

Topical steroids first for scalp psoriasis

2016 Gems

Freezing is better than acid for common warts, but the same for plantar warts

Depression and isotretinoin - another reason for low dose

Drugs for male and female pattern baldness. Small benefit from finasteride and minoxidil

Stop using topical antibiotics

One third of non-coeliac patients with gluten sensitivity can detect gluten

Great patient decision aid for primary prevention of CVD

CPAP for OSA improves quality of life but does not reduce CVD events

Monogenic diabetes- common and needs oral not SC medication

Two new diagnoses? Neurological itch on the arm and back

>Hypertension SBP ≥ 180 DBP ≥ 110 (& asymptomatic) urgency not so urgent

>LAMA/LABA better and safer than ICS/LABA for COPD

>Sodium and potassium issues with blood pressure medication

>No good evidence for cheap, expensive or no dressing for surgical operations

>New advice for infant feeding to manage food allergies

>Docusate probably no better than placebo for constipation

>LABAs may cause muscle spasms. Consider stopping before adding quinine

>Judicious antidepressant use in pregnancy

>Is this red eye a bacterial conjunctivitis? – a user’s guide to correct treatment

>Acne: low dose isotretinoin 10 mg daily is effective with fewer side effects

>Head lice. Dimeticone (or dimethicone) appears superior to traditional treatments (like permethrin or malathion)

>Does testosterone supplementation help older men - no and maybe

>Managing alcohol withdrawal syndrome. Diazepam/ oxazepam OK but other classes should be avoided

>Nasal saline irrigation works for allergic and chronic rhinosinusitis but not the common cold

>Melatonin an option for insomnia in children with ADHD and autism

>BP target 120 more benefit than 140 in high risk cvd patients - but some issues

>Small benefits at higher doses with SSRIs but not TCAs. Both have more adverse effects at higher doses.

>Tiotropium has a small benefit for those with moderate-severe asthma

2014 and 2015 Gems

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WONCA Publications

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WONCA position statements

WONCA statements on a variety of issues

PEARLS

510 Limited evidence for benefits of dietary fibre in cardiovascular disease 509 Motor control exercise similar to other forms of exercise for chronic non-specific low-back pain 508 Little evidence for water precautions in preventing infections in children with grommets 507 Limited evidence for benefits of tricyclics for nocturnal enuresis 506 Over-the-counter analgesics effective for acute postoperative pain

WHO Disease Outbreak News

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WHO Emergencies and Disasters

Challenges and hope in delivering health in South Sudan Stop the violence. Protect health care WHO deplores bombing of MSF clinic in Kunduz