8,481 results match your criteria British Journal Of Hospital Medicine[Journal]


Severe electrolyte disturbance in anorexia nervosa with gastrointestinal complications: reading both the clinical evidence and the patient.

Br J Hosp Med (Lond) 2020 May 23;81(5):1-3. Epub 2020 May 23.

Institute of Psychiatry, Psychology and Neuroscience, South London & Maudsley NHS Foundation Trust and King's College London, London, UK.

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http://dx.doi.org/10.12968/hmed.2019.0122DOI Listing

Polypharmacy: the whys, the so whats and the what nexts.

Br J Hosp Med (Lond) 2020 May 11;81(5):1-7. Epub 2020 May 11.

Department of Clinical Pharmacology, University College London Hospital Foundation Trust, London, UK.

There is an increasing awareness that polypharmacy - the use of multiple medicines by one individual - may bring harm as well as benefit. This has been termed 'problematic polypharmacy' and is associated with increased risk of admission to hospital, decreased quality of life and psychological harm. This article addresses the factors that may be contributing to the global rise of polypharmacy (the whys), the problems it can cause (the so whats), and some opportunities and strategies for improving and avoiding problematic polypharmacy in the future (the what nexts). Read More

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http://dx.doi.org/10.12968/hmed.2019.0383DOI Listing

Elephantiasis nostras verrucosa: a severe complication of lymphoedema.

Br J Hosp Med (Lond) 2020 May 23;81(5). Epub 2020 May 23.

Department of Dermatology, Imperial College Healthcare NHS Trust, London.

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http://dx.doi.org/10.12968/hmed.2019.0398DOI Listing

Acute compartment syndrome in the limb.

Br J Hosp Med (Lond) 2020 May 18;81(5):1-6. Epub 2020 May 18.

Department of Trauma and Orthopaedics, Hillingdon Hospital, London, UK.

Compartment syndrome of the limb is a true orthopaedic emergency that warrants prompt evaluation and treatment. Acute compartment syndrome of the limb is not uncommon and has the potential to cause devastating morbidity and mortality. Failure to provide urgent surgical intervention once established can lead to irreversible tissue damage within hours of onset. Read More

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http://dx.doi.org/10.12968/hmed.2020.0005DOI Listing

COVID-19 pneumonia misdiagnosed as pulmonary contusion in a child.

Br J Hosp Med (Lond) 2020 May 18;81(5). Epub 2020 May 18.

Faculty of Medicine, Department of Radiology, Giresun University, Giresun, Turkey.

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http://dx.doi.org/10.12968/hmed.2020.0224DOI Listing

Common neoplastic causes of paediatric and adolescent back pain.

Br J Hosp Med (Lond) 2020 May 4;81(5):1-6. Epub 2020 May 4.

Department of Spinal Surgery, Great Ormond Street Hospital, London, UK.

Neoplasm of the spinal column in children is rare, but can involve either benign or malignant tumours. Early detection of malignant tumours is key to successful clinical outcome and long-term prognosis. In such cases, back pain is a common presenting symptom, but often has a non-neoplastic cause. Read More

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http://dx.doi.org/10.12968/hmed.2020.0026DOI Listing

Aggressive mucous membrane pemphigoid: a cross-specialty dilemma.

Br J Hosp Med (Lond) 2020 May 4;81(5):1-3. Epub 2020 May 4.

Victoria Eye Unit, Wye Valley NHS Trust, Hereford, UK.

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http://dx.doi.org/10.12968/hmed.2019.0327DOI Listing

An overview of study designs.

Br J Hosp Med (Lond) 2020 May 4;81(5):1-6. Epub 2020 May 4.

Division of Surgery and Interventional Sciences, University College London, London, UK.

The numbers of clinical trials have increased exponentially over the last decade, amplifying the pressure to select an appropriate study design to obtain reliable and valid evidence. The ability to find, critically appraise and use evidence to develop new interventions is fundamental to evidence-based medicine. Different study designs have their own advantages and disadvantages, and provide different evidentiary value. Read More

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http://dx.doi.org/10.12968/hmed.2020.0127DOI Listing

State of the art urology 100 years ago.

Authors:
Harold Ellis

Br J Hosp Med (Lond) 2020 May 18;81(5):1-2. Epub 2020 May 18.

School of Medical Education, King's College London, London, UK.

One hundred years ago, on 27 May 1920, the inaugural meeting of the Section of Urology was held at the Royal Society of Medicine in London. The lecture, by Sir Peter Freyer KCB, paints a vivid picture of the state of art of urological surgery a century ago. Read More

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http://dx.doi.org/10.12968/hmed.2020.0109DOI Listing

Management of endocrine conditions at the end of life.

Br J Hosp Med (Lond) 2020 May 23;81(5):1-9. Epub 2020 May 23.

Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

An important facet to end-of-life care is deprescribing. This can be challenging when reviewing life-sustaining endocrine medications but, unlike for diabetes, there is no national guidance to support patients and clinicians faced with care planning. This article reviews the limited current evidence to highlight areas for further discussion and research with the aim of moving towards consensus opinion. Read More

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http://dx.doi.org/10.12968/hmed.2020.0096DOI Listing

Time for a culture change: understanding and reducing risk, morbidity and mortality from COVID-19 in those of black and minority ethnicity.

Br J Hosp Med (Lond) 2020 May 22;81(5):1-4. Epub 2020 May 22.

Vice Chancellors Office, University of Bolton, Bolton, UK.

Following a number of epidemics in the 21st century, including Ebola and Middle East respiratory syndrome, the SARS-COV-2 virus, causing COVID-19 disease, was declared a pandemic health emergency of international concern in January 2020. Read More

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http://dx.doi.org/10.12968/hmed.2020.0241DOI Listing

Troponin in critical care patients and outcomes.

Br J Hosp Med (Lond) 2020 May 23;81(5):1-8. Epub 2020 May 23.

Department of Anaesthesia and Critical Care, University of Edinburgh, Edinburgh, UK.

Myocardial infarction is common in the critically unwell population with pre-existing cardiovascular disease and is associated with a greater overall mortality. This article explores guidelines for diagnosing myocardial infarction, and research into the use of troponin as both a diagnostic and prognostic tool. Currently, the majority of patients in the intensive care unit with acute myocardial infarction go unrecognised. Read More

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http://dx.doi.org/10.12968/hmed.2020.0164DOI Listing

A matter of time: duration and choice of venous thromboprophylaxis in patients diagnosed with COVID-19.

Br J Hosp Med (Lond) 2020 May 18;81(5):1-2. Epub 2020 May 18.

Department of General Medicine, Barnet Hospital, Royal Free London NHS Foundation Trust, London, UK.

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http://dx.doi.org/10.12968/hmed.2020.0210DOI Listing

Perforation of terminal ileum by a toothpick.

Br J Hosp Med (Lond) 2020 May 11;81(5):1-2. Epub 2020 May 11.

Department of Pediatric Surgery, Alanya Education and Research Hospital, Alanya Alaaddin Keykubat University, Alanya, Turkey.

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http://dx.doi.org/10.12968/hmed.2020.0078DOI Listing

Radiographic development and resolution of lung abscess.

Br J Hosp Med (Lond) 2020 May 11;81(5):1-2. Epub 2020 May 11.

Department of Geriatric Medicine, Darent Valley Hospital, Dartford, UK.

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http://dx.doi.org/10.12968/hmed.2020.0077DOI Listing

Management of community-acquired pneumonia: essential tips for the physician on call.

Br J Hosp Med (Lond) 2020 May 23;81(5):1-9. Epub 2020 May 23.

UCL Respiratory, Department of Medicine, University College London, Rayne Institute, London, UK.

Community-acquired pneumonia is a common clinical problem requiring admission to hospital, with a particularly high incidence in the elderly population and those with significant comorbidities. Diagnosis is made on the combination of a short history of respiratory symptoms and systemic ill-health with new examination and/or radiological features of consolidation. Multiple other infective and non-infective conditions can mimic community-acquired pneumonia, leading to misdiagnosis in 5-17% of cases. Read More

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http://dx.doi.org/10.12968/hmed.2020.0124DOI Listing

The impact of patients losing their sense of smell.

Authors:
Carl Philpott

Br J Hosp Med (Lond) 2020 May 4;81(5):1-3. Epub 2020 May 4.

Norwich Medical School, Norwich, UK; James Paget University Hospital, Great Yarmouth, UK.

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http://dx.doi.org/10.12968/hmed.2020.0090DOI Listing

Antiphospholipid syndrome and challenges with direct oral anticoagulants.

Br J Hosp Med (Lond) 2020 May 4;81(5):1-11. Epub 2020 May 4.

Haemophilia and Thrombosis Centre, St Thomas' Hospital, London, UK.

Direct oral anticoagulants have become the mainstay of the management of venous thromboembolism and atrial fibrillation, and long-term anticoagulation is indicated for those at high risk of further thrombotic events. This includes patients diagnosed with antiphospholipid syndrome, for whom the 'triple positive' laboratory combination of lupus anticoagulant, β2-glycoprotein-1 and anti-cardiolipin antibodies signify those at greatest risk. Data from meta-analysis and randomised control trials have raised the concern that direct oral anticoagulants may be less effective than vitamin K antagonists for the prevention of thrombosis in patients with thrombotic antiphospholipid syndrome, particularly those with the triple positive profile. Read More

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http://dx.doi.org/10.12968/hmed.2020.0080DOI Listing

Assessing wrist pain: a simple guide.

Br J Hosp Med (Lond) 2020 May 11;81(5):1-7. Epub 2020 May 11.

Department of Trauma and Orthopaedic Surgery, Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe General Hospital, Scunthorpe, UK.

Wrist pain is a common presenting symptom, affecting any age group. Assessment of wrist pain can be very challenging for junior clinicians and non-specialists, especially in patients with a chronic condition. This article looks at the bony and neurovascular anatomy of the wrist joint and describes a simple guide to clinical assessment of wrist pathology, highlighting the awareness of red flag signs, which would warrant an immediate referral for secondary care input. Read More

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http://dx.doi.org/10.12968/hmed.2019.0051DOI Listing

Antiemetics: types, actions and uses.

Br J Hosp Med (Lond) 2020 May 11;81(5):1-8. Epub 2020 May 11.

Department of Acute Medicine, University Hospital Southampton, Southampton, UK.

Nausea and vomiting are common symptoms in the hospital setting, with numerous causes. Common precipitants leading to or complicating inpatient hospital admissions include nausea and vomiting secondary to drugs, gastrointestinal disturbances, metabolic aberrancies, and vestibular pathologies. Appropriate selection and prescribing of antiemetic drugs is therefore important for healthcare professionals. Read More

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http://dx.doi.org/10.12968/hmed.2020.0050DOI Listing

The impact of the novel coronavirus on trauma and orthopaedics in the UK.

Br J Hosp Med (Lond) 2020 Apr 10;81(4):1-6. Epub 2020 Apr 10.

Department of Trauma and Orthopaedics, Chelsea and Westminster NHS Foundation Trust, London, UK.

At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. Read More

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http://dx.doi.org/10.12968/hmed.2020.0137DOI Listing
April 2020
0.366 Impact Factor

Root cause analysis in the NHS: time for change?

Br J Hosp Med (Lond) 2020 Apr 8;81(4):1-4. Epub 2020 Apr 8.

Business School, Middlesex University, London, UK Conflicts of interest.

Root cause analyses were intended to search for system vulnerabilities rather than individual errors, using a human factors engineering approach. In practice, root cause analyses done in the NHS may generally fail to identify components where there are organisational failures, as there may be an inherent desire to protect institutional reputation. A human factors approach to root cause analysis looks at system vulnerabilities, considering the entirety of the environment in which an individual works and taking into account factors such as the physical environment and individual mental characteristics. Read More

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http://dx.doi.org/10.12968/hmed.2019.0352DOI Listing

Shared decision making in perioperative medicine.

Br J Hosp Med (Lond) 2020 Apr;81(4):1-2

Anaesthetic Department, Guy's and St Thomas' Hospital, London, UK.

Shared decision making is a collaborative process between clinicians and patients, which aims to select the most suitable management option based on both best available evidence and patient preferences. This article looks at the role of shared decision making in perioperative medicine. Read More

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http://dx.doi.org/10.12968/hmed.2019.0295DOI Listing

Is it time to stop using desflurane?

Br J Hosp Med (Lond) 2020 Apr 14;81(4):1-2. Epub 2020 Apr 14.

Department of Anaesthesia, Salford Royal Foundation Trust, Salford, UK.

Desflurane has a carbon equivalence 20 times greater than sevoflurane. This article discusses alternative anaesthetic techniques, including sevoflurane, xenon, total intravenous anaesthesia and regional techniques, and methods of reducing venting of gases, which might lower the environmental impact of anaesthesia. Read More

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http://dx.doi.org/10.12968/hmed.2019.0411DOI Listing

Metastatic spinal cord compression.

Br J Hosp Med (Lond) 2020 Apr;81(4):1-10

Department of Trauma and Orthopaedic Surgery, East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, UK.

Metastatic spinal cord compression is compression of the spinal cord or cauda equina as a result of metastatic deposits in the spinal column. It affects approximately 4000 cases per year in England and Wales. Prompt identification and treatment of metastatic spinal cord compression is necessary to prevent irreversible neurological injury, treat pain and maintain patients' mobility, function and independence. Read More

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http://dx.doi.org/10.12968/hmed.2019.0399DOI Listing

Computed tomography manifestations of COVID-19 pneumonia.

Authors:
Peng An Bo Liu

Br J Hosp Med (Lond) 2020 04 11;81(4):1-2. Epub 2020 Mar 11.

Department of Infectious Diseases, Xiangyang First People's Hospital Affiliated to Hubei Medical College, Xiangyang, Hubei, 441000, China.

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http://dx.doi.org/10.12968/hmed.2020.0104DOI Listing

Taxing the brain: a case of neuropsychiatric systemic lupus erythematosus.

Br J Hosp Med (Lond) 2020 Apr 14;81(4):1-4. Epub 2020 Apr 14.

Department of Rheumatology, Lister Hospital, East and North Hertfordshire NHS Trust, London, UK.

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http://dx.doi.org/10.12968/hmed.2020.0049DOI Listing

Radial head fractures.

Br J Hosp Med (Lond) 2020 Apr 14;81(4):1-6. Epub 2020 Apr 14.

Department of Trauma and Orthopaedics, Queen's Medical Centre, Nottingham, UK.

Radial head fractures are a common fracture involving the elbow joint. Patients typically present after a fall onto an outstretched hand with elbow pain and swelling. Without adequate treatment, this can lead to long-term complications, including loss of elbow motion and pain. Read More

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http://dx.doi.org/10.12968/hmed.2019.0404DOI Listing

The role of interventional radiology in elective orthopaedic practice.

Br J Hosp Med (Lond) 2020 Apr 9;81(4):1-10. Epub 2020 Apr 9.

Department of Radiology, Stoke Mandeville Hospital, Buckinghamshire NHS Foundation Trust, Aylesbury, UK.

Interventional radiology is a subspecialty of radiology that provides a range of minimally invasive diagnostic and therapeutic procedures. It continues to expand and evolve, and has had a marked impact on clinical care in many settings, in some cases averting the need for major surgery and hospital admission. While its role in the setting of trauma is relatively well established, with arterial embolisation a valuable option in the management of haemodynamically unstable patients, it is less prominent in the elective setting. Read More

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http://dx.doi.org/10.12968/hmed.2020.0015DOI Listing

Folded stomach mimicking pneumoperitoneum in an asthmatic child.

Br J Hosp Med (Lond) 2020 Apr 21;81(4):1-2. Epub 2020 Apr 21.

Department of Paediatrics, Yeovil District Hospital, Yeovil, UK.

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http://dx.doi.org/10.12968/hmed.2020.0039DOI Listing

Sir James Young Simpson: pioneer of anaesthesia in childbirth.

Authors:
Ellis Harold

Br J Hosp Med (Lond) 2020 Apr;81(4):1-2

School of Medical Education, King's College London, London, UK.

This year is the 150th anniversary of James Young Simpson's death in 1870. As well as being responsible for the introduction of general anaesthesia into obstetric practice, he made other important contributions to obstetrics and also to surgery as well as in the control of hospital infection. Read More

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http://dx.doi.org/10.12968/hmed.2020.0108DOI Listing

Blunt major trauma: now two different diseases?

Authors:
Timothy Coats

Br J Hosp Med (Lond) 2020 Apr 21;81(4):1-3. Epub 2020 Apr 21.

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

Major trauma in the UK has changed and can now be thought of as two different diseases: the traditional type of high energy transfer major trauma occurring in younger patients, and low energy transfer major trauma (usually an older person falling on one level). The current NHS trauma system is not well set up to treat low energy transfer major trauma - adapting to the changing disease is the next big challenge. Read More

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http://dx.doi.org/10.12968/hmed.2019.0418DOI Listing

An introduction to mechanical circulatory support in cardiac intensive care.

Br J Hosp Med (Lond) 2020 Apr;81(4):1-9

Department of Intensive Care Medicine, The Royal London Hospital, Barts Health NHS Trust, London, UK.

While use of mechanical circulatory support is increasing, knowledge of its fundamental role and limitations remains poorly understood by many medical professionals. This article summarises the main types of mechanical circulatory support and how they work, particularly focusing on the key information medical professionals should know should they encounter them in hospital. Mechanical circulatory support can be an effective treatment modality in selected pathologies, including myocardial ischaemia, pulmonary congestion, massive pulmonary embolic disease, postcardiotomy cardiogenic shock with failure to wean off bypass, right ventricular failure, bridge to heart and lung transplant and, increasingly, extracorporeal cardiopulmonary resuscitation. Read More

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http://dx.doi.org/10.12968/hmed.2020.0073DOI Listing

Unusual presentations in patients with systemic lupus erythematosus: a result of disease activity or something else?

Authors:
Anisur Rahman

Br J Hosp Med (Lond) 2020 Apr 14;81(4):1-3. Epub 2020 Apr 14.

Department of Rheumatology, University College London, London, UK.

Systemic lupus erythematosus can affect any organ or tissue, but skin manifestations, joint pain and fatigue are the most common symptoms. Two case reports in this issue describe patients with systemic lupus erythematosus who suffered severe internal organ manifestations. Read More

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http://dx.doi.org/10.12968/hmed.2020.0120DOI Listing

Multifactorial aggressive and reversible cardiomyopathy in systemic lupus erythematosus.

Br J Hosp Med (Lond) 2020 Apr 14;81(4):1-4. Epub 2020 Apr 14.

Department of Cardiology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.

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http://dx.doi.org/10.12968/hmed.2020.0053DOI Listing

Muscle wasting in the critically ill patient: how to minimise subsequent disability.

Br J Hosp Med (Lond) 2020 Apr 14;81(4):1-9. Epub 2020 Apr 14.

William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.

Muscle wasting in critically ill patients is the most common complication associated with critical care. It has significant effects on physical and psychological health, mortality and quality of life. It is most severe in the first few days of illness and in the most critically unwell patients, with muscle loss estimated to occur at 2-3% per day. Read More

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http://dx.doi.org/10.12968/hmed.2020.0045DOI Listing

Imaging features of inflammatory myofibroblastic tumour in the urinary bladder.

Br J Hosp Med (Lond) 2020 Apr 21;81(4):1-2. Epub 2020 Apr 21.

Department of Pathology, Chengdu Third People's Hospital, Chengdu, China.

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http://dx.doi.org/10.12968/hmed.2020.0058DOI Listing

Discontinuation of antiviral drugs may be the reason for recovered COVID-19 patients testing positive again.

Br J Hosp Med (Lond) 2020 Apr 21;81(4):1-2. Epub 2020 Apr 21.

Department of Respiratory Medicine, Lanzhou University Second Hospital, Lanzhou, China.

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http://dx.doi.org/10.12968/hmed.2020.0156DOI Listing

Non-visible haematuria: would discontinuing urgent investigation have a visible impact?

Br J Hosp Med (Lond) 2020 Apr 9;81(4):1-7. Epub 2020 Apr 9.

Department of Urology, Taunton and Somerset NHS Foundation Trust, Taunton, UK.

National guidance in the UK continues to recommend urgent referral of selected patients with non-visible haematuria for urological assessment. The positive predictive value of non-visible haematuria for urological cancer is low, so it is uncertain whether this is an effective and equitable use of healthcare resources. This article considers rationales for and against continuing this practice, and outlines alternative investigative strategies for patients presenting with non-visible haematuria based on current knowledge and modern technology. Read More

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http://dx.doi.org/10.12968/hmed.2020.0035DOI Listing

E-cigarette or vaping product use-associated lung injury.

Authors:
Philip W Ind

Br J Hosp Med (Lond) 2020 Apr 8;81(4):1-9. Epub 2020 Apr 8.

Department of Respiratory Medicine, Hammersmith Hospital, Imperial College Healthcare Trust, Imperial College London, London, UK.

E-cigarette or vaping product use-associated lung injury is a recently recognised, acute pulmonary syndrome which has been reported (particularly from June to October 2019) throughout the USA, but not in Europe (although one probable case, in the UK, has been reported; Medicines and Healthcare products Regulatory Agency, 2020). It presents acutely, most often in young men, as severe pulmonary consolidation, usually with respiratory failure. The mortality is around 2%. Read More

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http://dx.doi.org/10.12968/hmed.2019.0371DOI Listing

Attention deficit hyperactivity disorder in adults: what the non-specialist needs to know.

Br J Hosp Med (Lond) 2020 Mar 16;81(3):1-11. Epub 2020 Mar 16.

Rajagiri School of Behavioural Sciences and Research, Rajagiri College of Social Sciences (Autonomous), Kochi, India.

Attention deficit hyperactivity disorder is a persistent, pervasive neurodevelopmental disorder, characterised by the core features of hyperactivity, impulsivity and inattention. While previously thought to be a condition that only affects children, it is now well recognised that in a significant proportion of cases both symptoms and associated impairment will persist into adulthood. Nevertheless, many cases are missed or misdiagnosed because of the lack of awareness of attention deficit hyperactivity disorder as a potential diagnosis in adults, the number of symptoms that overlap with other psychiatric conditions, and the high rates of comorbidity. Read More

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http://dx.doi.org/10.12968/hmed.2019.0188DOI Listing

Suprapatellar complete plica and lipoma arborescens: an unusual association.

Br J Hosp Med (Lond) 2020 Mar 16;81(3). Epub 2020 Mar 16.

Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.

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http://dx.doi.org/10.12968/hmed.2019.0397DOI Listing

Severe widespread actinic damage and squamous cell carcinoma: could hydrochlorothiazide be implicated? A report of two cases.

Br J Hosp Med (Lond) 2020 Mar 23;81(3):1-3. Epub 2020 Mar 23.

Department of Dermatology, Queen Elizabeth University Hospital, Glasgow, UK.

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http://dx.doi.org/10.12968/hmed.2019.0242DOI Listing

Clinical experience with Surgimend in breast reconstruction: an overview.

Authors:
F Bassetto L Pandis

Br J Hosp Med (Lond) 2020 Mar 4;81(3):1-18. Epub 2020 Mar 4.

Plastic Surgery Department, Padova University, Italy.

In the field of breast reconstruction, products and techniques are continuing to evolve to ensure good clinical and quality outcomes. This article reviews the published literature regarding the use of fetal bovine-derived acellular dermal matrix (SurgiMend, SurgiMend PRS and SurgiMend PRS meshed), focusing on safety, clinical outcomes and surgical techniques. Read More

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http://dx.doi.org/10.12968/hmed.2018.0428cDOI Listing

Lower extremity peripheral artery disease: a basic approach.

Br J Hosp Med (Lond) 2020 Mar 4;81(3):1-9. Epub 2020 Mar 4.

Section of Adult Cardiology, Chong Hua Heart Institute, Cebu City, Philippines.

Peripheral artery disease of the lower limbs is a chronically progressive disorder characterised by the presence of occlusive lesions in the medium and large arteries that result in symptoms secondary to insufficient blood flow to the lower extremities. It is both a manifestation of systemic atherosclerosis and a marker of increased cardiovascular morbidity and mortality. Because of its highly heterogenous clinical picture, a detailed history and physical assessment, a high degree of suspicion for peripheral artery disease and the use of the ankle-brachial pressure index is essential to identify patients with peripheral artery disease. Read More

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http://dx.doi.org/10.12968/hmed.2019.0263DOI Listing

Clinically available reinforcing materials for soft tissue reconstruction.

Br J Hosp Med (Lond) 2020 Mar 4;81(3):1-10. Epub 2020 Mar 4.

MD Anderson Cancer Center, University of Texas, Houston, Texas, USA.

Navigating the rapidly evolving field of materials for soft tissue reinforcement is challenging given the volume of clinically available options. Additionally, the current generally accepted classifications of these mesh materials confound the understanding of their utility by grouping disparate materials that have attributes overlapping category boundaries and that do not fully consider their clinically functionality. This review article highlights, from a materials science perspective, the most important attributes of these materials to improve the clinical decision-making process in the selection of the most appropriate features and design for the patient, surgery and clinical need. Read More

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http://dx.doi.org/10.12968/hmed.2018.0428bDOI Listing

The end of the rapid sequence induction?

Br J Hosp Med (Lond) 2020 Mar 4;81(3):1-2. Epub 2020 Mar 4.

Department of Anaesthetics and Critical Care, Peterborough City Hospital, Peterborough, UK.

The rapid sequence induction has been a cornerstone of anaesthetic teaching since it was first described in 1970. Although the technique is taught as a standard protocol there is considerable variation in its practice. So, can we reach consensus over what to include in 'the safe, textbook version' of a rapid sequence induction in modern anaesthesia? Read More

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http://dx.doi.org/10.12968/hmed.2019.0361DOI Listing

Direct to implant breast reconstruction with biological acellular dermal matrices.

Br J Hosp Med (Lond) 2020 Mar 4;81(3):1-7. Epub 2020 Mar 4.

Department of Breast Surgery, Royal Marsden NHS Foundation Trust, London, UK.

Breast cancer is the most commonly diagnosed female cancer in the UK, with one in eight women receiving a cancer diagnosis during their lifetime. Forty per cent of women diagnosed with breast cancer undergo mastectomy as their primary therapeutic procedure. While a full range of choices is offered, breast reconstruction using implants is the patient-preferred method of reconstruction following mastectomy. Read More

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http://dx.doi.org/10.12968/hmed.2018.0428aDOI Listing

Symptomatic scrotoliths in a child.

Br J Hosp Med (Lond) 2020 Mar 16;81(3):1-2. Epub 2020 Mar 16.

Department of Paediatric Pathology, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK.

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http://dx.doi.org/10.12968/hmed.2019.0394DOI Listing

Persistent distal femoral physis line in an adult.

Br J Hosp Med (Lond) 2020 Mar 11;81(3). Epub 2020 Mar 11.

Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.

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http://dx.doi.org/10.12968/hmed.2019.0350DOI Listing