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Background Peripheral artery disease (PAD), the pathophysiologic narrowing of arterial blood vessels of the lower leg due to atherosclerosis, is a highly prevalent disease, with sharp increases in prevalence with age. Primary care is ideally located to identify and manage PAD. Objectives This study aims to identify the educational experiences, opinions, and confidence of primary care clinicians (PCCs) regarding PAD. Method This mixed-method study was conducted within primary care in England. An online survey was completed with follow-on semistructured interviews, between January and September 2021, with PCCs, namely GPs, practice nurses, and allied professionals (survey n = 874, interviews n = 50). Results PCCs report variation in PAD education received, where the content could not often be recalled. Patient-focussed experiential and self-directed learning, formed the largest method to gain PAD education. All PCCs recognized that they have an important role in recognizing PAD yet confidence in recognizing and diagnosing PAD was lacking. PCCs acknowledged that late or missed PAD diagnosis resulted in significant patient morbidity and mortality. Yet many did not recognize PAD as a common disease. Conclusion As "specialist–generalists" with finite resources, education provided to primary care needs to be applicable for the multimorbid patient presentations often seen, utilizing resources available in primary care, with consideration to the time constraints endured. [ABSTRACT FROM AUTHOR]

The risks of venous thromboembolism (VTE) following total hip and knee arthroplasty have been widely published. Our aim was to investigate the recorded incidence of VTE events at the time of elective and trauma hand surgery. The UK National Hospital Episode Statistics (HES) data linking VTE events with hand surgery for the financial years 2010–2012 were analysed. The local VTE rates following hand surgical procedures were also analysed. Finally, a cost assessment of VTE thromboprophylaxis was performed according to the British Society for Surgery of the Hand (BSSH) guidelines. 334,211 hand surgical procedures were performed throughout England of which there were 13 DVT and 27 PE events. These events were seen in patients with pre-existing comorbidities. The annual incidence of VTE is 0.006% at most in hand surgical patients in England. The cost of implementing mechanical VTE thromboprophylaxis to all patients having hand surgery would amount to £6,336,641 over 2 years. The cost of treatment for all VTE events would amount to £20,418. VTE prophylaxis is probably not necessary in patients undergoing isolated elective or trauma hand surgical procedures. [ABSTRACT FROM AUTHOR]

Intravenous drug abuse is a common social and medical problem. Incidence is estimated at 9⋅9 per 100 000 for England. In the ultrasound department, a common referral is for 'IVDA QDVT' (intravenous drug abuser, query deep vein thrombosis). Deep vein thrombosis (DVT) is a common complication of intravenous injection of drugs via the groin, but ultrasonically can present with a variety of different acute and chronic features, including complications. The groin should also be examined for other vascular and non-vascular complications. Non-vascular complications include cellulitis, sinus track formation, abscess and lymphadenitis. Vascular complications include arterial occlusion, arteriovenous fistula, pseudo-aneurysm, acute and chronic DVT, venous stenosis and complex collateral formation. The sonographer should also be aware of distant complications including endocarditis, septic pulmonary emboli and retroperitoneal extension of groin abscess. This is an increasing diagnostic problem. The sonographer should be aware of the range of pathologies both locally and systemically and be prepared to examine the veins, arteries and soft tissues, extending the examination above the groin and using imaging modalities if findings are atypical. If necessary, the radiologist should be involved at an early stage. [ABSTRACT FROM AUTHOR]