No abstract

Current statistics put obesity rates in England at 25%, with a further 36% being classed as overweight; the associated prescription cost for medical management is £15 300 000. The sequelae of obesity include heart disease, diabetes, hypertension, stroke and mental health illness. Post-bariatric surgical patients face significant on-going morbidity related to excess tissue, mobility and general wellbeing. The national guidelines for reconstructive plastic surgery on post-bariatric patients attempt to ration funding for surgery while eliminating the postcode lottery effect. This article summarises key points in the management of the post-bariatric surgical patient and emphasises referral criteria for body contouring.

S arcoma describes a group of malignant, connective tissue tumours of mesenchymal origin; i.e. arising from fat, muscle, bone, blood vessels and nerves. They are rare and typically account for approximately 1.2% of all cancers in the UK. The incidence of sarcomas is highest in young and old people. Early diagnosis followed by prompt and appropriate treatment is vital to reduce the mortality from sarcomas. This article focuses on increasing primary care awareness of the key clinical features of sarcoma and providing an update on relevant guidelines. Management of sarcoma in tertiary centres is also discussed. The GP curriculum and sarcomas Clinical module 3 20: Care of people with musculoskeletal problems states that GPs should be able to:. Assess the importance of presenting features. Identify 'red flags' that relate to cancer. Understand the challenge of some musculoskeletal conditions that may be better and more confidently managed by other healthcare personnel and refer those conditions which may benefit from early referral. Describe the key national guidelines that influence healthcare provision for musculoskeletal conditions ! The Author(s) 2017. Reprints and permissions: sagepub.co.uk/journalsPermissions.nav