Key health statistics from primary health care

Abstract

vitamin or .by intestinal malabsorption ; this leads to deficiency of 25-hydroxycholecalciferol availability for calcitriol synthesis -and, hence, to an inability to absorb sufficient calcium in the intestine. Renal failure, in which there is deficient loc-hydroxylation, also causes hypocalcaemia. A rare cause of low serum calcium is primary hypoparathyroidism, in which there is deficiency of PTH, thus leading to failure to permit entry of sufficient calcium from the bony skeleton to the blood. In acute pancreatitis there is liberation of free fatty acids (FFAs) into the circulation, formed as digestive products by the action of pancreatic enzymes on local tissues; these FFAs bind calcium, thus removing a significant portion of its functional ionic form. Transfusion of large amounts of citrated blood can also lead to removal of ionic calcium. Certain drugs, such as phenytoin and phenobarbitone, induce the microsomal hydroxylating enzymes in the liver, thereby producing changes in vitamin D metabolism -and hence leading to hypocalcaemia. In neonatal life hypocalcaemia is not infrequently encountered. Furthermore, it is necessary to remember that collection of blood erroneously into EDTA will chelate calciumthereby causing its removal from the blood. In addition, there are other less common causes of hypocalcaemia, including resistance to PTH, resistance to vitamin D, pseudohypoparathyroidism -and hypocalcaemia by way of a number of other mechanisms, too (Cundy and Reid, 1995; Marshall, 1995).References CUNDY T and REID I (1995). Calcium, phosphate and magnesium. In: Clinical Biocbemistry -metabolic and clinical aspects, 87-116 (W J . It receives anonymous data from 438 practices across the UK concerning doctor-diagnosed illnesses, issuing of prescriptions, and out-patient referrals for each person covered by the database. This provides a comprehensive picture of the way patients are managed in practices worldwide.The latest release contains data pertaining to the years 1994-1996, and was drawn from data concerning over two million patients from 288 practices across the UK. It includes information regarding the prevalences of major diseases such as coronary artery disease, stroke, hypertension, diabetes, asthma, and mental illness. Analysis of disease prevalences includes breakdowns by NHS regional office area and by ONS area type, which group areas with similar socio-economic and socio-demographic characteristics. Some of the main findings include:.