{"title":"Stabler's sign: a rare association with portal hypertension.","authors":"Yoen Young Chuah, Yeong Yeh Lee","doi":"10.12968/hmed.2022.0231","DOIUrl":"https://doi.org/10.12968/hmed.2022.0231","url":null,"abstract":"","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Minimising complications and improving the success of peripheral regional blockade.","authors":"Dominic Wu, Amarjeet Patil","doi":"10.12968/hmed.2022.0304","DOIUrl":"https://doi.org/10.12968/hmed.2022.0304","url":null,"abstract":"<p><p>Peripheral regional blockade is a type of regional anaesthesia involving depositing local anaesthetics around a specific nerve or bundle of nerves that help transmit nociceptive signals to higher centres, such as the thalamus and somatosensory cortex. It is not only a widely used technique that provides surgical anaesthesia, but also acts as an essential part of the armamentarium against postoperative pain and pain following major skeletal trauma. This article discusses the structure and function of peripheral nerves, the classification and pathophysiology of peripheral nerve injury and, finally, how practising anaesthetists are committed to maximising success and minimising harm when performing peripheral nerve blockade in the operating theatre.</p>","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-10"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40662434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Complex regional pain syndrome of the foot and ankle following knee arthroscopy.","authors":"T Evans, A Steuer, R Dega, A Gobindpuri","doi":"10.12968/hmed.2022.0260","DOIUrl":"https://doi.org/10.12968/hmed.2022.0260","url":null,"abstract":"","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The rise of the clinical teaching fellow: a personal view of the postgraduate experience.","authors":"Kwaku Baryeh","doi":"10.12968/hmed.2022.0339","DOIUrl":"https://doi.org/10.12968/hmed.2022.0339","url":null,"abstract":"<p><p>Clinical teaching fellowships are becoming increasingly popular, with the numbers of posts ever-expanding. This increase has accelerated as education and training start to recover from the effects of the COVID-19 pandemic. However, the nature of these roles, the entry requirements and the potential benefits are often poorly defined. This article outlines the author's experience of working as a clinical teaching fellow for a year and provides tips on what to look out for when considering these roles, as well as how to get the most out of them.</p>","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pramin Raut, Neil Jones, Marjan Raad, Will Kieffer
{"title":"Common peripheral nerve entrapments in the upper limb.","authors":"Pramin Raut, Neil Jones, Marjan Raad, Will Kieffer","doi":"10.12968/hmed.2022.0111","DOIUrl":"https://doi.org/10.12968/hmed.2022.0111","url":null,"abstract":"<p><p>Entrapment of peripheral nerves can occur as they travel through restrictive spaces. This nerve compression can result in a constellation of signs and symptoms, which are often called syndromes. Patients initially report pain, paraesthesia and numbness, followed by weakness and clumsiness and, ultimately, muscle wasting. The specific region of paraesthesia and pain and the specific muscle weakness is determined by the peripheral nerve involved and the location of the entrapment. Diagnosis is mainly based on history and examination. Further investigations are available for atypical presentations. Each syndrome has its own set of risk factors, but repetitive action and muscle overuse are commonly associated with most syndromes. The treatment is activity modification followed by steroid injection and finally surgical decompression for ongoing persistent symptoms or severe initial presentation. This article outlines the history, examination, possible investigations and management for common peripheral nerve entrapments of the median, ulnar and radial nerves.</p>","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-11"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Telangiectatic pulmonary arteriovenous malformation presenting as a suspected malignant part-solid nodule.","authors":"Furkan Ufuk, Sercan Vurgun, Kadir H Alver","doi":"10.12968/hmed.2022.0206","DOIUrl":"https://doi.org/10.12968/hmed.2022.0206","url":null,"abstract":"","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40662435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Hudson-Phillips, Gemma Graham, Kofi Cox, Wail Al Sarakbi
{"title":"Fibroadenoma: a guide for junior clinicians.","authors":"Sarah Hudson-Phillips, Gemma Graham, Kofi Cox, Wail Al Sarakbi","doi":"10.12968/hmed.2022.0070","DOIUrl":"https://doi.org/10.12968/hmed.2022.0070","url":null,"abstract":"<p><p>Fibroadenoma is the most common cause of benign breast lumps and is typically seen in women under the age of 40 years. Fibroadenomas are classified as simple, complex, giant, myxoid or juvenile. They present as smooth, rubbery, mobile masses on palpation. Ultrasonographic and mammographic features typical of fibroadenomas include solid, round, well-circumscribed masses, with or without lobulated features. They are predominantly treated conservatively although clinical pathways recommend referral for triple assessment. Surgical intervention is indicated by the presence of one or more of the following features: the presence of symptoms, a diameter greater than 2 cm, rapid growth rate, complex features, disease recurrence or patient anxiety.</p>","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-9"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of penetrating chest trauma in the context of major trauma networks.","authors":"Benjamin Stretch, Amy Kyle, Mihir Patel","doi":"10.12968/hmed.2022.0002","DOIUrl":"https://doi.org/10.12968/hmed.2022.0002","url":null,"abstract":"<p><p>Major trauma networks reduce mortality in critically injured patients. Trauma patients should be appropriately triaged straight from the scene of injury, avoiding secondary transfer from a trauma unit. Selection criteria in regionally agreed triage tools are designed to identify which patients should be taken directly to the major trauma centre. Patients with life-threatening injuries still arrive at 'trauma units' in circumstances such as self-presentation, under triage, physiological instability or long journey time to the major trauma centre. This article presents a theoretical case of a haemodynamically unstable patient with penetrating injuries, and discusses the management of chest trauma, including diagnosis of life-threatening injuries, resuscitation strategies and definitive surgical management. Secondary transfer to the major trauma centre should be considered after instituting the minimal life-saving interventions. What constitutes a life-saving intervention requires an individual dynamic risk assessment and an understanding of major trauma networks.</p>","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative care of the breastfeeding patient.","authors":"Kirsty Matthews, Justice Reilly","doi":"10.12968/hmed.2022.0357","DOIUrl":"https://doi.org/10.12968/hmed.2022.0357","url":null,"abstract":"<p><p>Clinicians and institutions must recognise the unique set of considerations required by breastfeeding patients, a small but vulnerable cohort of patients. Modification of existing perioperative pathways, diligent prescribing and multidisciplinary involvement can facilitate safe and patient-centred perioperative care.</p>","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bernard Borg, Norbert Borg, David Pisani, Kevin J Schembri, Caroline J Magri
{"title":"Monophasic synovial sarcoma: a rare cause of a primary cardiac malignancy.","authors":"Bernard Borg, Norbert Borg, David Pisani, Kevin J Schembri, Caroline J Magri","doi":"10.12968/hmed.2022.0240","DOIUrl":"https://doi.org/10.12968/hmed.2022.0240","url":null,"abstract":"","PeriodicalId":520576,"journal":{"name":"British journal of hospital medicine (London, England : 2005)","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}