Lochgoilheadmedicalcentre.org.uk

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Dr von Kaehne has taken over the running of the practice in November 2004.
The aim of the practice is to provide seamless medical care for the community.
In order to maintain the optimum health of individuals and of the community as a whole, the practice isengaged in active health promotion, particularly in areas identified as of particular concern to the populationof the West of Scotland and Lochgoilhead specifically (e.g. heart disease, diabetes or emphysema). To thisend you may find that at a normal consultation further checks are being made or you may be asked to attendthe surgery to organise further tests.
Dr von Kaehne has an interest in Medical Education. On occasion it may happen that medical studentsor other doctors are participating in the surgery. On other occasions you may be offered questionnaires orasked to allow videoing of the consultations. Your help and participation is highly appreciated.
Dr Peter von Kaehne MRCGP DCH qualified 1994 in Frankfurt/Main, Germany and ever since practisedin the United Kingdom, mostly in Scotland. He is a member of the Royal College of General Practionersand holds a Diploma in Child Health by the Royal College of Physicians and Surgeons (Glasgow). He isBASICS trained and is developing links with local the fire brigade and mountain rescue to assist medicallyat casualties on road and mountain. For many years he has worked as a General Practioner in a practice forrefugees in the north of Glasgow. He has developed a special interest in the medicolegal aspects of tortureand maltreatment. He is a recognised expert in this area and will from time to time attend at court hearingsand in other places to provide expert opinions. This will have little or no impact on the running of thepractice.
Mrs Patricia Olde-Olthof RGN RM BSc is triple duty nurse in our practice. Her roles inculde practicenursing and district nursing in the Lochgoil area. She is also a moving and handling trainer for the Argylland Clyde Primary Care Trust.
Mrs Evelyn Campbell RGN RM BSc is a triple duty nurse attached to our practice with duties of healthvisiting, midwifery and district nursing in Lochgoil and surrounding areas.
Mrs Ann Liddell is the practice manager. If you have any worries, suggestions or complaints to make aboutteh running of the practice please contact her.
Mrs Jean Murray is the practice receptionist and dispenser.
• Monday from 10 to 11:30am and 4 to 5 pm • Wednesday from 10 to 11:30 am and 4 to 5 pm • Friday from 10 to 11:30 and 4 to 5 pm Appointments are always required and can be obtained by contacting the practice reception. The surgeryitself is opened daily from 9 am until 17:30 pm with the exception of a lunch break between 13:00 and 14:00and of Tuesday and Thursday afternoons.
The practice as a rule does not provide a routine home visiting service. Home visits are only made if thereis a clinical need to see a patient in another setting than the practice and are on the sole discretion of theclinician. Requests for home visits should be made before 9:30 am. The doctor will then call back and decidewhere the patient will be seen. It is usually in the best interest of the patient to attend the surgery as thereare far better facilities available in the surgery than in houses to examine and treat.
In emergencies within the hours of 8 am to 6 pm on weekdays please contact the surgery. In the unlikelyevent that there is no response please try again after 5 or 10 minutes. Should there be still no response andthe emeregency can not wait please dial 999 and ask for an ambulance.
Outside surgery hours please contact NHS24 (0845 4242424). The surgery telephone will put you throughto NHS24 during the out-of-hours periods.
The practice runs a dispensary which is solely to provide prescription items to (fully or temporary) registeredpatients of the practice. The dispensary does not provide OTC items. Such items might be available at thepost office or in the local shop.
Due to the nature of a small practice and a small dispensary not all items will always be readily available instock. Repeat prescription items to be dispensed should therefore be requested well in advance, usually atleast 3 business days, before 11am.
Prescription items can be obtained during normal surgery opening times only.
Should you wish to obtain your prescription directly from a different pharmacists, please ask at the receptionto obtain your prescription note. This should normally be possible within the same day or the next at latest.
Repeat prescription requests can be made in person to the receptionist, by telephone during suregry hoursand by letter. Should you wish to receive your prescription note by post (not the dispensed items!) pleasesend us an SAE.
Please also note that the practice and dispensary does not provide prescriptions covering long-term ab-sences from the practice area or indeed the UK. The ordinary prescibing and dispensing length is 28-30days and exceptions will only be made on clinical grounds. Please be aware that obtaining or providinglonger prescriptions to cover foreign travel can also be considered NHS prescription fraud under the currentregulations.
The practice is fortunate enough to have access to quite excellent dental services including a dental hygienist.
Appointments can be made at the reception.
• The practice has a quarterly Diabetes clinic and a quarterly Respiratory clinic. Exact dates can be enquired. Appointments are on invitation only. Thjese clinics are intended to improve disease control,not to diagnose these illnesses.
• The practice has a weekly anticoagulant clinic. Patients are required to attend on Monday morning with teh practice nurse for blood taking and will be see on on Tuesday before noon by the GP. Pleasedo not forget to bring your yellow book.
Ladies will be invited to have this procedure every three years or occasionally more often if clinically required.
Results will be provided in writing. All members of the clinical team are available to provide this screening,but routinely it is carried out by female members of staff.
Ladies will be invited to attend the mass Breast Screening Facility when it is in the area. Alternativearrangements can be made for those who have difficulties attending. If any lady is worried about a breastlump do not hesitate to contact a member of staff.
Treatment of casualties including suturing is provided as required. Where possible please telephone to let usknow what has happened and you will be advised what to do. You will be required to attend at the surgeryunless this is clinically not indicated.
Minor surgical procedures can be carried out at the surgery with patients consent. These are normallycarried out with normal surgery hours at a time convenient to both patient and doctor.
You will be advised as to the feasibility of the procedure being carried out locally.
These are carried out in noirmal surgery hours. Prior explanation will be given and your consent required.
Advice may be sought at an time. If travelling abroad please attend the doctor 2 months before your holidayto enable a full course of vaccination.
4. Confidentiality and Access to Medical Records Confidentiality and Access to Medical Records All content of medical consulations and of medical records is considered confidential. Indeed, the mere factof registration or your attendance at our practice can be considered confidential. All our staff are trainedand obliged to maintain your confidentiality at all times and in perpetuity.
Access to your own medical records can always be obtained by contacting our practice manager. Should youwish to obtain copies of the same a fee might be required.
There are some statutory requirements to share medical information e.g. with the benefits office or withsocial work in some situations, e.g. in the course of applications for incapacity benefit or an assessment forCommunity Care.
With growing computerisation of the NHS more and more sharing of clinical records becomes increasingly thenorm. This can take the wholly beneficial form of your doctor or your nurse being able to obtain laboratoryor investigation results over the (secured) internet. It can also be a way of making the job of out-of-hoursdoctors safer and easier by providing them with access to summaries of medical histories. At the sametime though there are valid concerns that such data sharing might not always be in the best interests ofindividuals or simply be against their wishes. Should you have any concerns in this matter please feel freeto discuss them with the practice staff.
Anyone else (e.g. insurance companies, employers etc) requesting access to your medical information wouldnormally require your fully informed consent. Sometimes some such agencies will request access to yourrecords in a fashion or for details which the doctor might not feel is in your best interest or without whatappears to be fully informed consent. Under such circumstances the doctor will discuss with you what andhow information should be shared.
If you are a temporary resident, the fact that you attended and the notes of your consultation will beforwarded to your normal doctor. This can take a few months though.
The practice makes mostly use of the NHS facilities of the Vale of Leven Hospital, the Dunoon GeneralHospital and the Royal Alexandra Hospital in Paisley, last one mostly for emergencies.
Most of our laboratory tests are done in the Vale of Leven Hospital.
There are also various other ressources of the Argyll and Clyde Primary Care Trust we make use of, partic-ularly dieticians, chiropodist (attends our practice), physiotherapists etc.
We will also refer to private physicians and facilities, mostly in Glasgow. Please bear in mind that in anyreferral by a doctor, particular to a private facility, a fair degree of responsibility remains with the referringdoctor regarding the suitability of such a referral. This might restrict from time to time where we will beable and happy to refer to.
Most of the NHS provision in General Practice is charge free. An execption are for example prescriptioncharges.
There are though charges for non NHS work, e.g. medicolegal reports, insurance medicals, travel advice etc.
. Some of these charges are set, others will be calculated on an hourly base. You will be advised in advance ifthere are any charges for the work requested. A list of common charges is available at the reception. Usuallythe person requesting a work is responsible for any relevant fees.
The practice is legally obliged to collect prescription fees. Staff can and should ask to see evidence ofentitlement if it is claimed that such fees are not payable. Please note that non-payment of prescription feesby not entitled patients is considered fraud and a criminal activity. There is a whole department in the NHSbuerocracy solely concerned with chasing such people. Fees can be payed in cash or in cheque.
The practice is always happy to hear suggestions which might improve on our services. Please feel free tocontact the staff with your ideas. The practice also operates a complaints procedure in line with that ofmost other NHS organisations. The procedure is available in print from the reception.
Common Colds are viral infections which affect most of us at some time every year\.{ } Unfortunately thereis little a doctor can do to help to speed up recovery. Antibiotics do not help wirth virus infections. Normallyour bodies are perfectly capable of dealing with such viruses and we will recover with the help of some rest,maybe some Paracetamol or other common cold remedies. If you are worried that your problem is somethingmore serious obviously please feel free to ask for advise or a consultation.
Similar to common colds, most sore throats are the result of viruses and are beyond a doctor’s ability todo very much to improve the situation. Most of the time rest and Paracetamol is probably the best way ofaction.If you maintain though high temperatures, have white spots on the tonsils, have swollen lymph glandsor any other worrying syptoms please feel free to contact the surgery for advise or a consultation.
Tick bites are a common occurance in the summer months in Lochgoilhead. Ticks can occasionally spreadnasty and possibly serious illnesses, teh most iimportant locally of which is Lyme’s disease or Borelliosis.
Ticks - if not completely removed - can also cause significant local inflammation at the bite area, which cantake a long time to heal up.
Ther are various ways of removing ticks safely. In the doctor’s experience the easiest way is to grab theanimal carefully and without squeezing with pincers and remove it with a twisting movement. If you areworried or unable to remove a tick please contact the surgery.
If ticks are removed within 24 hours and before they are engorged the medical consensus is that the risk toobtain a serious infection is small. If the tick had been attached for longer or was engorged, a case can bemade for using a single dose of an antibiotic as prophylaxis. Please make an appointment to discuss thiswith the doctor.
If you develop any kind of rashes or fever after a tickbite it is imperative that you see your doctor. Yourdoctor might prescribe a longer course of antibiotics and/or organise some blood tests.
If you are pregnant or in any way immunocompromised it is important that you discuss tickbites with yourdotcor irrespective of the above advise.
Similar to ticks, midges are a common nuisance during the summer months. Little can be done to preventbites though there are a huge variety of common remedies, both to prevent bites and to sooth the misery ofbeing bitten too often.
If you do suffer under particularly strong reactions to the little beasties, antihistamines, like Chlorpheni-ramine or Loratadine, which are available over the counter can be useful and are in most cases safe. Beaware of the risk that antihistamines might influence your reactions and particularly your driving skills. Youmust avoid any alcohol when using such remedies.
Please contact the surgery if you are concerned about any reactions to midges or other insect bites.
The times when doctors prescribed liberally any amount of sleeping tablets are long gone. Occasionalsleeplessness as such is something we best deal with with the help of a good book, a cup of hot chocolateand a warm blanket on a comfy sofa. we will come to little or no harm from having occasionally poor orno sleep. Also for most of us, growing older means that we require less and less sleep. Many elderly peoplemanage just fine with only 5 or 6 hours of sleep every night, while younger people often require a lot more.
On the other side, sleeplessness can obviously be one of the more obvious signs of having e.g. a depressionor a number of other medical or psychological problems. Please contact the surgery if you are worried aboutyour inability to sleep sufficiently.
Healthy people of all ages will have a wide variety of bowel habits, all of which perfectly normal and healthy.
Anything between 2 or 3 times a week and 2 or 3 times a day is probably just fine. Stools can also be ofthe harder or softer variety, without this being anything unusual or worrying. If you maintain a healthy dietwith plenty of fruit, fibres and fluids, you should have no problem with maintaining health bowel habits.
Unless you are on any medications which cause constipation, there is normally no reason for any medicationagainst constipation.
It is important though to be aware of how your bowels function and to be alert of any changes. Particularlyif you have any sudden significant changes to your bowel habits you should consider contacting your surgeryfor an appointment. The appearance of blood, fresh or old is always a reason for serious concern.
Unless you are systemically unwell with temperature, hot and cold sweats or dizziness and weakness as aresult of a dental abscess - in which case hospital treatment might well be a necessity - there is little to begained from an appointment with a GP for a dental problem. GPs are not trained to provide help for dentalproblems. Antibiotics are not considered to be a good choice of treatment for dental abscesses in absenceof a more definitive treatment. We would therefore strongly encourage you to make preferentially use ofan appointgment with the on-call dentist in the case of serious dental problems. The Dunoon dentists haveundertaken to see in Lochgoilhead registered patients in case of dental emergencies.
The practice has and maintains a practice website. This website is usually much more uptodate thanthis leaflet as the leaflet is printed only once a year. All important general announcements and news areincorporated into the practice website. Please look at it at www.lochgoilheadmedicalcentre.org.uk

Source: http://www.lochgoilheadmedicalcentre.org.uk/files/PracticeLeaflet.pdf

Tesi 6 luglio

SECONDA UNIVERSITÁ DEGLI STUDI DI NAPOLI FACOLTÁ DI MEDICINA E CHIRURGIA DIPARTIMENTO DI PSICHIATRIA, NEUROPSICHIATRIA INFANTILE, AUDIOFONIATRIA E DERMATOVENEREOLOGIA Direttore: Prof. Mario Maj IL DISTURBO POST-TRAUMATICO DA STRESS: VALUTAZIONE DELL’EFFICACIA DELL’EYE MOVEMENT DESENSITIZATION AND REPROCESSING IL DISTURBO POST- TRAUMATICO DA STRESS

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