540 results match your criteria Acute medicine[Journal]


Medicine vs Motherhood.

Authors:
Caroline Lebus

Acute Med 2018;17(3):169

Acute medicine consultant, Addenbrooke's Hospital Hills Road, Cambridge, CB2 0QQ.

I'm sitting at my desk, trying to concentrate. On anything. It's impossible. Read More

View Article

Download full-text PDF

Source
December 2018
5 Reads

Curriculum mapping for Focused Acute Medicine Ultrasound (FAMUS).

Acute Med 2018;17(3):168

Consultant in Acute Internal and Intensive Care Medicine, Royal Berkshire hospital.

Point of care ultrasound (POCUS) in the hands of the non-radiologist has seen a steady growth in popularity amongst emergency, intensive care and acute medical physicians. Increased accessibility to portable, purpose-built ultrasound machines has meant that clinicians often have access to a safe and non-invasive tool to enhance their management of the unwell. Read More

View Article

Download full-text PDF

Source
December 2018
3 Reads

Focused Acute Medicine Ultrasound (FAMUS).

Acute Med 2018;17(3):164-167

Consultant in Acute Internal and Intensive Care Medicine, Royal Berkshire hospital.

Point of care ultrasound (POCUS) has seen steady growth in its use and applications in aiding clinicians in the management of acutely unwell patients. Focused Acute Medicine Ultrasound (FAMUS) is the standard created specifically for Acute Medicine physicians and is endorsed by the Society for Acute Medicine and recognised by the Acute Internal Medicine (AIM) training committee as a specialist skill. In this document we present a curriculum mapping exercise which utilises a 'knowledge, skills and behaviours' framework and incorporates the GMC's 'Good Medical Practice' (GMP) domains. Read More

View Article

Download full-text PDF

Source
December 2018
14 Reads

A case of Osmotic demyelination syndrome despite normal rate of Sodium correction with good recovery.

Authors:
S Mongolu

Acute Med 2018;17(3):160-163

Consultant Physician & Endocrinologist Michael White Centre for Diabetes, Endocrinology and Metabolic Bone Diseases, Brocklehurst Building, Hull Royal Infirmary, Anlaby Road, HU3 2RW.

The Osmotic demyelination syndrome (ODS) primarily occurs with rapid correction of severe hyponatraemia that has been present for more than two or three days. Some patients are, however at risk and can develop ODS at higher sodium concentration and lower rates of correction. A case of Osmotic demyelination Syndrome which developed despite an 'optimal' rate of correction of serum Sodium with good clinical outcome is described. Read More

View Article

Download full-text PDF

Source
December 2018
3 Reads

Sub-acute herpes simplex virus myelitis in a patient with esophageal cancer on chemo-radiation with 5-fluorouracil: a case report.

Acute Med 2018;17(3):156-159

Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.

No reported cases to date describe herpes simplex virus (HSV) myelitis in association with cancer and chemo-radiation. We report a case of sub-acute HSV myelitis in a 54-year-old man receiving chemo-radiation with 5-flourouracil for esophageal cancer who presented to the emergency department with increasing numbness in both lower limbs that gradually spread to waist level. Magnetic resonance imaging with gadobutrol contrast 1 week later showed transverse myelitis involving the dorsal columns. Read More

View Article

Download full-text PDF

Source
December 2018
3 Reads

An unusual case of dysphagia.

Acute Med 2018;17(3):154-155

Consultant Physician, Forth Valley Royal Hospital Larbert Scotland.

A 51-year-old lady, with a background of an arachnoid cyst and ventriculo-peritoneal shunt in situ, presented to the Acute Medical Unit with a 2-day history of neck pain. She awoke from sleep with the pain and it persisted since. She had not been involved in any trauma, had no previous history of neck or back pain and her pain was not controlled with simple analgesia. Read More

View Article

Download full-text PDF

Source
December 2018
5 Reads

What is the evidence base for ambulatory care for acute medical illness?

Acute Med 2018;17(3):148-153

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Acute ambulatory care is a critical component of the emergency care pathway with national policy support and a dedicated NHS Improvement network. The evidence base for treating acute medical illness outside hospital is a diverse mix of randomised and observational studies with varying inclusion criteria, prognostic stratification, interventions and healthcare setting which limits synthesis of all available evidence and translation to the UK context. There is little consensus on the level of risk for home-based treatment for acute medical illness. Read More

View Article

Download full-text PDF

Source
December 2018
2 Reads

Chronic deep vein thrombosis.

Acute Med 2018;17(3):144-147

Consultant Haematologist, Department of Haematology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust.

Deep vein thrombosis (DVT) is an important cause of short-term mortality and long-term morbidity. Although acute DVT is often well managed, there is uncertainty in the management of chronic DVT which is increasingly being noted among patients presenting with similar symptoms to their initial DVT. The presence of a residual venous clot can be a problem for both physicians and patients fearing the risk of emboli to the same extent as the acute DVT. Read More

View Article

Download full-text PDF

Source
December 2018
3 Reads

Examining trainee awareness of dermatoses and dermatological assessments during acute admissions (A quality improvement project).

Authors:
P Patel N King

Acute Med 2018;17(3):137-143

East Surrey Hospital, Canada Avenue, Redhill.

Studies demonstrate 67% of elderly patients can have dermatoses, which could result in functional and psychological consequences. Elderly presentations are further complicated by comorbidities and polypharmacy. This combined with limited dermatology training at undergraduate and postgraduate levels creates diagnostic challenges. Read More

View Article

Download full-text PDF

Source
December 2018
2 Reads

Mortality outcomes and emergency department wait times - the paradox in the capacity limited sytem.

Acute Med 2018;17(3):130-136

Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.

Background: There is concern that undue ED wait times may result in adverse outcomes.

Methods: We studied 30-day in-hospital mortality (2002-2017) for all medical admissions (106,586 episodes; 54,928 patients) focusing on clinical risk profile.

Results: Comparing 2002-09 vs. Read More

View Article

Download full-text PDF

Source
December 2018
7 Reads

Screening instruments for identification of vulnerable older adults at the emergency department: a critical appraisal.

Acute Med 2018;17(3):124-129

Department of Internal Medicine and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands.

Background: Early detection of vulnerable older adults at the emergency department (ED) and implementation of targeted interventions to prevent functional decline may lead to better patient outcomes.

Objective: To assess the level of agreement between four frequently used screening instruments: ISAR-HP, VMS, InterRAI ED Screener and APOP.

Methods: Observational prospective cohort study in patients ≥ 70 years attending Dutch ED. Read More

View Article

Download full-text PDF

Source
December 2018
3 Reads

Times are A-Changin': self-poisoning and ICU admissions in the northern part of the Netherlands.

Acute Med 2018;17(3):121-123

Emergency Department, University Medical Center Groningen (UMCG), The Netherlands.

Introduction: We noticed that fewer patients with self-poisoning were transferred from the ED to the Intensive Care Unit (ICU) than previously. To objectify this, we evaluated ED and ICU admissions in two time periods.

Methods: The number of admissions was collected during 1994-1998 and 2010-2014. Read More

View Article

Download full-text PDF

Source
December 2018
2 Reads

Are we able to predict who needs a bed the most?

Acute Med 2018;17(3):120

Department of Internal Medicine, Amsterdam University Medical Centers.

In recent years we indeed have witnessed an increasing demand on healthcare services coupled with spiraling healthcare costs forcing us towards identifying factors and interventions leading to greater healthcare efficiency. Read More

View Article

Download full-text PDF

Source
December 2018
2 Reads

Editorial - Acute Medicine is invested in patient care, and therefore multiple departments.

Acute Med 2018;17(3):119

Associate Editor, Consultant in Acute Medicine, University College London Hospitals.

There is a myth that Acute Physicians only work in Acute Medical Units (AMUs). In fact, they tread a constant path between the AMU, the Emergency Department (ED), ambulatory care, Intensive Care Units (ITUs) and various specialty wards within the hospital. Just as our focus is not tied to a single organ or body system, is it not solely linked to a certain geographical place. Read More

View Article

Download full-text PDF

Source
December 2018
3 Reads

Letter to Editor - Shaping the future of Acute Medical training.

Authors:
Mark Lander

Acute Med 2018;17(2):113

BSc (Hons) MBBS MRCP (Acute Medicine), ST5 Acute Internal Medicine, London Deanery.

I read with interest the Viewpoint article by Dr Chadwick regarding the future of Acute Internal Medicine (AIM) training, particularly the development of Capabilities in Practice (CiPs( and their potential to promote a greater identity within the specialty training. Dr Chadwick highlights the struggle we face in asserting why our specialty is so vibrant and vital. In my experience, Acute Internal Medicine training suffers from an identity crisis whereby the specialty is seen as being permanently on call, with trainees working more shifts as the Duty Medical Registrar (DMR) than on other specialty training programs, without the variability of outpatient and skill-based training. Read More

View Article

Download full-text PDF

Source
January 2018
7 Reads

Letter to Editor - Is the AIM curriculum, for higher specialty training, fit for purpose? - response.

Authors:
Nicola Cooper

Acute Med 2018;17(2):112

MBChB FAcadMEd FRCPE FRACP, Consultant Physician & Hon Clinical Associate Professor Derby Teaching Hospitals NHS Foundation Trust.

I read the article, 'Is the AIM curriculum, for higher specialty training, fit for purpose' with interest. However, I disagree with the author on a number of points. First, a curriculum is 'everything that happens in relation to an educational programme', not a document setting out intentions and expectations. Read More

View Article

Download full-text PDF

Source
January 2018
3 Reads

Assessment of Fluid responsiveness in the Acute Medical Patient and the Role of Echocardiography.

Acute Med 2018 ;17(2):104-109

Consultant in Emergency Medicine, Whipps Cross University Hospital, Whipps Cross Rd, Leytonstone, London E11 1NR.

Both hyper and hypovolaemia have been associated with poor outcomes. Assessment of fluid responsiveness is challenging in the acute medical patient, due to time constraints, limited evidence and quite often the lack of accurate assessment tools on the Acute Medicine Unit (AMU). This article explains how focused echo assessment is quick and easy to use for this purpose on the acute medical take and highlights key principles to bear in mind when assessing for hypovolaemia and whether to administer fluid therapy. Read More

View Article

Download full-text PDF

Source
October 2018
3 Reads

Iliofemoral deep vein thrombosis and the problem of post-thrombotic syndrome.

Acute Med 2018 ;17(2):99-103

MD, MRCP, FRCPath, Consultant Haematologist, Department of Haematology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust.

Deep vein thrombosis (DVT) is an important cause of short-term mortality and long-term morbidity. Among the different presentations of DVT, thrombus in the iliofemoral veins may be considered the severest form. Although anticoagulation is the mainstay of the management of iliofemoral thrombosis, despite adequate anticoagulant treatment, complications including post-thrombotic syndrome is not uncommon. Read More

View Article

Download full-text PDF

Source
October 2018
3 Reads

Abnormal cardiac conduction in a septic patient: incidental finding or cause for concern?

Acute Med 2018 ;17(2):98

The James Cook University Hospital, Middlesbrough, United Kingdom, TS4 3BW.

A 64-year-old male presents to the emergency department in acute respiratory distress. He gives a limited history of progressive shortness of breath of one week's duration and several episodes of sudden unexplained syncope. There was no history of chest pain, palpitations or localising symptoms of infection. Read More

View Article

Download full-text PDF

Source
October 2018
5 Reads

Successful intravenous lipid emulsion therapy: Olanzapine intoxication.

Acute Med 2018 ;17(2):96-97

Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.

Olanzapine is an antipsychotic drug used in psychiatric diseases. At high doses it exhibits cardiovascular and neurological sideeffects in particular. Lipid emulsion therapy for the removal of medication from plasma in high-dose lipophilic drug use has recently become very widespread. Read More

View Article

Download full-text PDF

Source
October 2018
8 Reads

Routine HIV Screening in Cancer Patients in the Emergency Department.

Acute Med 2018 ;17(2):91-95

Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Treatment of human immunodeficiency virus(HIV) in cancer patients improves outcomes and reduces transmission of this oncogenic virus. HIV testing rates of cancer patients are similar to the general population (15-40%), despite the association with cancer. Our aim was to increase HIV screening in the Emergency Department(ED) of a comprehensive cancer center through a quality initiative. Read More

View Article

Download full-text PDF

Source
October 2018
3 Reads

Direct and delayed admissions to ICU in older medical patients.

Acute Med 2018 ;17(2):83-90

MD, PhD, internist, Department of Internal Medicine, division of General Medicine, section Acute Medicine, Maastricht University Medical Centre, Maastricht University, School of CAPHRI, Maastricht, the Netherlands.

The aims of this retrospective cohort study were to retrieve characteristics and outcomes of older (65+) medical patients who are directly admitted to ICU from the ED and to compare these with those admitted to ICU from a ward. Of 1396 patients, 21 (1.5%) were directly admitted to ICU and 54 (3. Read More

View Article

Download full-text PDF

Source
October 2018
4 Reads

Changes in vital signs post discharge as a potential target for intervention to avoid readmission.

Acute Med 2018 ;17(2):77-82

Section Acute Medicine, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.

Readmissions are treated as adverse events in many healthcare systems. Causes can be physiological deterioration or breakdown of social support systems. We investigated data from a European multi-centre study of readmissions for changes in vital signs between index admission and readmission. Read More

View Article

Download full-text PDF

Source
October 2018
3 Reads

Effective acute care handover to GP: optimising the structure to improve discharge documentation.

Acute Med 2018 ;17(2):68-76

MBBS, MRCP, Consultant Physician, Acute Medical Unit, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA.

Time and resource constraints have often led to the use of assessment records as discharge communications from acute and emergency departments. However, whether this addresses the primary care needs has not been demonstrated. This study examined the optimal structure that can impart key discharge information effectively using feedback from general practitioners (GP). Read More

View Article

Download full-text PDF

Source
October 2018
3 Reads

Results on patient flow of implementing an Acute Medical Unit.

Acute Med 2018 ;17(2):62-67

VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.

Background: There is an increased influx of patients needing admission. Introducing an acute medical unit (AMU) may increase the admission capacity without increasing the total number of beds.

Methods: Data collected during the first four years after implementation of an AMU in an academic tertiary care center in Amsterdam were analyzed. Read More

View Article

Download full-text PDF

Source
October 2018
5 Reads

HIV testing in Acute Care.

Authors:
P J Newton

Acute Med 2018;17(2):61

Consultant in Infectious Diseases and General Internal Medicine, Manchester University Foundation Trust, Cobbett House, Manchester Royal Infirmary, Oxford Rd, Manchester M13 9WL, UK.

Readers may be aware of the need to improve uptake of HIV testing in health care-settings to reduce the number of individuals with undiagnosed infection who later present with advanced disease. Late presentation of HIV infection is associated with a poorer immune response to antiretroviral therapy, an increased morbidity and mortality with a resultant higher cost burden to health-care services. Individuals with undiagnosed HIV infection who inadvertently transmit their infection to others are thought to be responsible for more than half of new HIV infections in the USA. Read More

View Article

Download full-text PDF

Source
January 2018
4 Reads

Getting information across the acute medicine and primary care interface - steps in the right direction.

Authors:
D Lasserson

Acute Med 2018;17(2):60

Professor of Ambulatory Care, University of Birmingham, Birmingham, B15 2TT, UK.

In the acute care pathway, patients often need to move from home to hospital and for the majority, back again. This movement across care interfaces ensures that assessments and interventions are delivered to reduce risk of harm and enhance recovery. However, information needs to move across interfaces too, which enables the clinician taking over care to understand the problem, what has been done and what remains to be done. Read More

View Article

Download full-text PDF

Source
January 2018
3 Reads

Editorial - An increasing global footprint.

Acute Med 2018 ;17(2):59

Associate Editor, Consultant in Acute Medicine, University College London Hospitals.

As those working in Acute Medicine gather at SAMsterDAM2, the spring conference of the Society for Acute Medicine, the growth, reputation and global representation of the specialty continues to grow. Alongside, the traditional strongholds of the UK, Ireland, Netherlands, Denmark and Australia growth in Asia continues with an AMU now established in Pakistan among other countries. Read More

View Article

Download full-text PDF

Source
October 2018
3 Reads

Editorial - Delivering and transforming, but many questions and challenges remain.

Acute Med 2018 ;17(1):2-3

Associate Editor, Consultant in Acute Medicine, University College London Hospitals.

Acute Medicine remains a specialty in its infancy and, as such, faces many challenges associated with developing new ways of working. As the Society for Acute Medicine celebrates its 18th birthday the extraordinary role of Acute Medicine in both maintaining and indeed enhancing the care and welfare of patients is increasingly evident. However, scepticism still persists among some colleagues with regards to its effectiveness - a perception heightened by the difficult environment that currently pervades in acute and emergency care in the UK which mirrors the experience of many countries internationally. Read More

View Article

Download full-text PDF

Source
September 2018
4 Reads

A Catastrophic Consequence of Cramp.

Acute Med 2018 ;17(1):50-52

Department of Renal Medicine, Norfolk and Norwich University Hospital, Norwich, UK.

Quinine has long been used for the treatment of conditions such as malaria and leg cramps, and is also present at low levels in some beverages; however, it can cause serious side effects. We describe a patient who developed severe haemolysis, thrombocytopaenia, and acute kidney injury following the ingestion of a single dose of quinine. This case demonstrates the importance of awareness of such potentially life-threatening consequences of exposure to this agent. Read More

View Article

Download full-text PDF

Source
September 2018
5 Reads

A young breathless patient.

Acute Med 2018 ;17(1):49

FRCR MRCS MBChB BSc, Consultant Radiologist, Forth Valley Royal Hospital, Larbert, Scotland.

A 34-year-old gentleman, with a background of osteoarthritis, presented to the Acute Medical Unit with a short history of breathlessness. He had returned from holiday to the United States five days previously. Since return, he had complained of myalgia, sore throat, a non-productive cough, mild anorexia and fevers at home. Read More

View Article

Download full-text PDF

Source
September 2018
6 Reads

Managing thyrotoxicosis in the acute medical setting.

Authors:
C Napier

Acute Med 2018 ;17(1):44-48

MBBS MRCP (UK), Endocrine Unit, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP UK.

Thyrotoxicosis is common and can present in numerous ways with patients exhibiting a myriad of symptoms and signs. It affects around 1 in 2000 people annually in Europe1. The thyroid gland produces two thyroid hormones - thyroxine (T4) and triiodothyronine (T3). Read More

View Article

Download full-text PDF

Source
September 2018
4 Reads

Nephrotic syndrome in adults.

Acute Med 2018 ;17(1):36-43

MD FRCP, Renal Unit, Royal London Hospital, Barts Health NHS Trust London, UK.

Nephrotic syndrome is an important presentation of glomerular disease characterised by heavy proteinuria, hypoalbuminaemia and oedema. The differential diagnosis of the underlying condition is wide including primary renal disorders and secondary diseases such as malignancy, infection, diabetes and amyloid. Presentations to acute medicine may be with hypervolaemia, complications of the nephrotic state (such as venous thromboembolism), or complications of therapy (such as infection). Read More

View Article

Download full-text PDF

Source
September 2018
6 Reads

Acute kidney injury in kidney transplant patients.

Acute Med 2018 ;17(1):31-35

Consultant in Critical Care & Nephrology Guy's & St Thomas' Hospital London.

Managing kidney transplant patients in an acute medical unit can be challenging, as patients have a single functioning kidney, underlying chronic kidney disease, and are immunosuppressed. Transplant patients develop AKI for all usual reasons but the differential diagnosis is wider and includes specific problems, such as obstruction of a single functioning kidney, vascular thrombosis, rejection, drug toxicity and drug-induced thrombotic microangiopathy. Septic AKI is common but again, the differential diagnosis of sepsis is wider. Read More

View Article

Download full-text PDF

Source
September 2018
4 Reads

The predictive value of leucocyte progression for one-week mortality on acutely admitted medical patients to the emergency department.

Acute Med 2018 ;17(1):26-30

Department of Emergency Medicine, Odense University Hospital, Søndre Boulevard 29, DK-5000 Odense, Denmark.

Objective: To clarify if leucocyte count progression can predict one-week mortality in unselected medical patients admitted to the emergency department. Additionally, we investigated the importance of leucocyte count progression for admission to the intensive care unit and length of stay.

Method: This retrospective cohort study uses data collected in two phases from patients admitted through the emergency department at Hospital of South West Jutland. Read More

View Article

Download full-text PDF

Source
September 2018
4 Reads

Relationship of the clinical acuity & complexity to the outcome of an emergency medical admission.

Acute Med 2018 ;17(1):18-25

Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.

Background: An Illness Severity and Co-morbidity composite score can predict 30-day mortality outcome.

Methods: We computed a summary risk score (RS) for emergency medical admissions and used cluster analysis to define four subsets Results: Four cluster groups were defined. Cluster 1 - RS 7 points (IQR 5, 8) Cluster 2 - 9 (IQR 8, 11), Cluster 3 - 12 (IQR 11, 13) and Cluster 4 - 14 (IQR 13, 15). Read More

View Article

Download full-text PDF

Source
September 2018
5 Reads

Can an acute admission to hospital be an opportunity for healthcare professionals to provide physical activity advice? A qualitative study of patients' perspectives.

Acute Med 2018 ;17(1):10-17

Honorary Assistant Professor, University of Nottingham, Nottingham, NG7 2RD.

Physical inactivity causes morbidity, mortality and healthcare expenditure. A minority of people undertake sufficient physical activity to meet the DoH recommendations. NICE has determined that brief advice in primary care is costeffective in increasing physical activity levels but there is no current recommendation for secondary care. Read More

View Article

Download full-text PDF

Source
September 2018
4 Reads

Continuous Monitoring of Respiratory Rate on General Wards What might the implications be for Clinical Practice?

Authors:
C P Subbe B Duller

Acute Med 2018 ;17(1):5-9

Clinical Studies and Research Consultant, Penpet Production, Stuttgart, Germany.

A high respiratory rate is a significant predictor of deterioration. The accuracy of measurements has been questioned. We performed a prospective observational study of automated electronic respiratory rate measurements and compared measurements with electronic counts obtained in the 10 minutes prior to the manual measurement. Read More

View Article

Download full-text PDF

Source
September 2018
4 Reads

Is the Acute Internal Medicine (AIM) curriculum, for higher specialty training (HST), fit for purpose?

Authors:
Andrew Brereton

Acute Med 2017 ;16(4):206-210

Brighton and Sussex Medical School (BSMS) Teaching Fellow and ST6 Acute Internal Medicine Department of Medical Education, 344a Mayfield House, University of Brighton campus, Falmer, BN1 9PH.

This review will critically appraise the AIM curriculum from a trainee,s perspective. The author will focus on the curriculum,s aims and objectives, availability of learning opportunities, adopted assessment and evaluation strategies and finally make recommendations to aid curriculum development. Read More

View Article

Download full-text PDF

Source
January 2018
8 Reads

Trainee Update, Winter 2017.

Acute Med 2017 ;16(4):205

Trainee Representatives, Society for Acute Medicine.

The Specialist Advisory Committee (SAC) of June 2017 discussed the sign off of procedural competences relating to Sengstaken-Blakemore tube insertion and transvenous cardiac pacing and the application for chief registrar roles. Read More

View Article

Download full-text PDF

Source
January 2018
34 Reads

The current state of Acute Medicine training.

Authors:
Ben Chadwick

Acute Med 2017 ;16(4):204

Chair, Acute Medicine Speciality Advisory Committee Consultant in Acute Medicine University Hospital Southampton Foundation Trust Tremona Road, Southampton SO16 6YD.

Acute medicine training has come a long way in a relatively short period of time. Acute Medicine was recognised as a speciality by the Royal College of Physicians in 2003, initially as a subspeciality of General Internal Medicine. Acute Medicine was formally recognised as a speciality in its own right in 2009. Read More

View Article

Download full-text PDF

Source
January 2018
6 Reads

Dissecting the Diagnosis - An Unusual Case of Pericarditis.

Acute Med 2017 ;16(4):200-203

Acute Medicine Consultant, Huddersfield Royal Infirmary, Acre St, Lindley, Huddersfield. HD3 3EA.

Chest pain is an extremely common presenting complaint on the acute medical unit. It is important to distinguish between patients who have serious pathology and those without. Often, the focus is on ruling out an acute coronary syndrome and inadequate consideration is given to other possible causes. Read More

View Article

Download full-text PDF

Source
January 2018
9 Reads

Euglycaemic DKA secondary to Canaglifozin, an easily missed diagnosis.

Acute Med 2017 ;16(4):196-199

Consultant Physician (Diabetes and Endocrinology), Frimley Park Hospital, Frimley, GU16 7UJ UK.

Diabetic ketoacidosis (DKA) is a state of hyperglycaemia, ketosis and metabolic acidosis. This carries a significant morbidity and mortality particularly if left untreated or if the diagnosis is delayed. We present a case of euglycaemic DKA in a 48 year old female with non-insulin treated T2DM who had good glycaemic control. Read More

View Article

Download full-text PDF

Source
January 2018
24 Reads

Painful lymphadenopathy due to silicone breast implant rupture following extensive global air travel.

Acute Med 2017 ;16(4):192-195

FRCP, DTM&H, PhD.

A 25-year-old Caucasian flight attendant with an extensive travel history presented with night sweats, fevers, weight loss and axillary and supraclavicular lymphadenopathy. Apart from surgical breast augmentation, she had no past medical or surgical history. She was anaemic, leucopenic and lymphopenic, and a broad infection screen was negative. Read More

View Article

Download full-text PDF

Source
January 2018
12 Reads

Medical High Dependency Unit series, Article 4: Tracheostomy management.

Acute Med 2017 ;16(4):185-191

Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF.

The number of patients with tracheostomies managed within high dependency units is increasing. National audits have suggested that the care of these patients could have been improved upon with a significant minority of cases resulting in death or serious adverse events. Because of this, it is crucial that staff working within medical high dependency units have a good understanding of the indications for and techniques of insertion of tracheostomies. Read More

View Article

Download full-text PDF

Source
January 2018
5 Reads

Using a Delphi study approach to develop competencies for Allied Health Professionals working in Acute Medicine.

Authors:
Thomas Edwards

Acute Med 2017 ;16(4):177-184

Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH.

A Delphi study approach was used to develop a national standard of competencies for Occupational Therapists and Physiotherapists working in acute medicine. Nineteen expert therapists participated in the Delphi study, which consisted of four rounds. A total of two hundred and seventy one competencies were developed and agreed for inclusion in a single document. Read More

View Article

Download full-text PDF

Source
January 2018
7 Reads

Acute Medical Ward for better care coordination of patients admitted with infection - evidence from a tertiary hospital in Singapore.

Acute Med 2017 ;16(4):170-176

Department of Internal Medicine, Singapore General Hospital, Academia level 4, 20 College Road Singapore, 169856.

Coordination and consolidation of care provided in acute care hospitals need reconfiguration and reorganization to meet the demand of large number of acute admissions. We report on the effectiveness of an Acute Medical Ward AMW (AMW) receiving cases that were suspected to have infection related diagnosis on admission by Emergency Department (ED), addressing this in a large tertiary hospital in South East Asia. Mean Length of Stay (LOS) was compared using Gamma Generalized Linear Models with Log-link while odds of readmissions and mortality were compared using logistic regression models. Read More

View Article

Download full-text PDF

Source
January 2018
12 Reads

Long-term health related quality of life in patients with sepsis after intensive care stay: A systematic review.

Acute Med 2017 ;16(4):164-169

VU University Medical Centre, Amsterdam, The Netherlands, Section Acute Internal Medicine.

Sepsis is a major health care issue and sepsis survivors are often confronted with long-term complications after admission to the intensive care unit (ICU) which may negatively influence their health related quality of life (HRQOL). This study aimed to systematically evaluate the outcome in terms of HRQOL in patients with sepsis after ICU discharge. A literature search was conducted in the bibliographic databases PubMed, EMBASE, and CINAHL, including reference lists of published guidelines, reviews and associated articles. Read More

View Article

Download full-text PDF

Source
January 2018
8 Reads

Characteristics and outcome of acute medical admissions with hyponatremia: even mild hyponatremia is associated with higher mortality.

Acute Med 2017 ;16(4):156-163

Department of Internal Medicine, Division of General Medicine, Section Acute Medicine & CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.

Hyponatremia is a common finding in hospitalized patients. In this retrospective cohort study we assessed the characteristics and outcome of acute medical admissions with hyponatremia. Compared to the normal sodium group, those with hyponatremia were significantly older and the Charlson Comorbidity Index (CCI) was higher. Read More

View Article

Download full-text PDF

Source
January 2018
6 Reads

Oxford specialist handbooks in neurology: Stroke Medicine.

Authors:
Jennie McNaught

Acute Med 2017 ;16(3):150

Specialty Doctor in Stroke Medicine and Elderly Care.

This is a pocket sized book (if your pockets are 20×18×2 cm big, that is) and it weighs less than two decent stethoscopes. Its small physical size belies the comprehensive coverage given to the subject. It is a really a compact textbook covering all aspects of stroke care. Read More

View Article

Download full-text PDF

Source
January 2018
30 Reads