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Medicine (Abingdon, England : UK ed.)最新文献

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Self-assessment/CPD answers 自我评价/ CPD答案
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-02-01 DOI: 10.1016/j.mpmed.2024.11.012
{"title":"Self-assessment/CPD answers","authors":"","doi":"10.1016/j.mpmed.2024.11.012","DOIUrl":"10.1016/j.mpmed.2024.11.012","url":null,"abstract":"","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 2","pages":"Pages 109-112"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150688","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}
引用次数: 0
Emergencies in diabetes – diabetic ketoacidosis and hyperosmolar hyperglycaemic state 糖尿病急症-糖尿病酮症酸中毒和高渗性高血糖状态
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-02-01 DOI: 10.1016/j.mpmed.2024.11.003
Mayank Patel
{"title":"Emergencies in diabetes – diabetic ketoacidosis and hyperosmolar hyperglycaemic state","authors":"Mayank Patel","doi":"10.1016/j.mpmed.2024.11.003","DOIUrl":"10.1016/j.mpmed.2024.11.003","url":null,"abstract":"<div><div>Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) are life-threatening emergencies in diabetes mellitus. Prompt clinical suspicion and confirmation of these diagnoses is vitally important. Protocol-based treatment, involving intravenous fluids and electrolyte replacement in both cases, with intravenous insulin used in DKA (but not always in HHS) and close monitoring, can then be started to reduce associated morbidity and mortality. Every effort should be made to identify the cause so that future preventive measures can be taken. Review by a diabetes team can ensure that diabetes treatment regimens are appropriate, educational updates are provided and patient follow-up is arranged to reduce the risk of recurrence.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 2","pages":"Pages 92-95"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150687","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}
引用次数: 0
Management of physical symptoms in the absence of organic disease 无器质性疾病时躯体症状的处理
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-02-01 DOI: 10.1016/j.mpmed.2024.11.010
Anne-Mary O Abe
{"title":"Management of physical symptoms in the absence of organic disease","authors":"Anne-Mary O Abe","doi":"10.1016/j.mpmed.2024.11.010","DOIUrl":"10.1016/j.mpmed.2024.11.010","url":null,"abstract":"<div><div>Physical symptoms that occur in the absence of disease are common in medical clinics. These can cause significant functional limitations and disability for patients. Patients often utilize healthcare resources to a disproportionate level and present in distress. This article will summarize some of the progress made in recent decades in nomenclature, classification understanding these conditions and improving management of these patients.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 2","pages":"Pages 67-71"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150684","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}
引用次数: 0
Breathlessness and cough in the acute setting 急性呼吸困难和咳嗽
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-02-01 DOI: 10.1016/j.mpmed.2024.11.009
Ben G Marshall
{"title":"Breathlessness and cough in the acute setting","authors":"Ben G Marshall","doi":"10.1016/j.mpmed.2024.11.009","DOIUrl":"10.1016/j.mpmed.2024.11.009","url":null,"abstract":"<div><div>The symptom of breathlessness is well recognized as part of the presentation of a wide range of medical conditions. It can be a manifestation of a life-threatening emergency. In acute medical settings, the priority is to quickly recognize patients who are critically unwell and require emergency treatment. For them, rapid initial assessment and immediate treatment are essential. Once symptoms have stabilized, or in less acute settings, a more thorough assessment is required. Cough is a common respiratory symptom, often part of a symptom complex and frequently troublesome for patients. It is important to recognize concerning associated features to prompt further investigation. In late 2019, severe acute respiratory syndrome coronavirus 2 infection emerged from a zoonotic source, resulting in many cases of infection, hospitalization and death, and has since spread in a pandemic across every continent. Even 5 years later, it remains a concern. A substantial percentage of patients with coronavirus disease (COVID-19) develop an acute respiratory illness requiring hospital care. Cough and acute breathlessness are two of the most prevalent symptoms in this infection; all such patients presenting to acute settings should currently be assumed to have COVID-19 and immediately tested with a viral swab from the upper airway to guide management.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 2","pages":"Pages 77-81"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150683","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}
引用次数: 0
The management of acute pain – an update 急性疼痛的处理——最新进展
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-02-01 DOI: 10.1016/j.mpmed.2024.11.007
James Smith, Lenny Ng
{"title":"The management of acute pain – an update","authors":"James Smith,&nbsp;Lenny Ng","doi":"10.1016/j.mpmed.2024.11.007","DOIUrl":"10.1016/j.mpmed.2024.11.007","url":null,"abstract":"<div><div>Although the prevalence and severity of pain are similar in medical and surgical wards, managing acute pain effectively in non-surgical patients has proved problematic. This article outlines recent updates in the general principles of acute pain assessment and management in medical patients. The challenges of managing patients with acute neuropathic pain, patients with drug dependency issues and elderly patients are specifically addressed.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 2","pages":"Pages 102-108"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150689","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}
引用次数: 0
Self-assessment/CPD answers 自我评价/ CPD答案
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-01-01 DOI: 10.1016/j.mpmed.2024.10.012
{"title":"Self-assessment/CPD answers","authors":"","doi":"10.1016/j.mpmed.2024.10.012","DOIUrl":"10.1016/j.mpmed.2024.10.012","url":null,"abstract":"","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 1","pages":"Pages 48-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134707","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}
引用次数: 0
Anaesthetic preoperative assessment, optimization and multidisciplinary prehabilitation 麻醉术前评估、优化及多学科康复
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-01-01 DOI: 10.1016/j.mpmed.2024.10.002
Sally Hargreaves, Claire Scarffe
{"title":"Anaesthetic preoperative assessment, optimization and multidisciplinary prehabilitation","authors":"Sally Hargreaves,&nbsp;Claire Scarffe","doi":"10.1016/j.mpmed.2024.10.002","DOIUrl":"10.1016/j.mpmed.2024.10.002","url":null,"abstract":"<div><div>People decide to have surgery because it is life saving or life enhancing. Most of the 10 million procedures that take place in the UK each year have an uncomplicated course, but an increasing number of individuals are at risk of poor outcomes because of co-morbid conditions and poor functional capacity. At age 65 years, 50% of the UK population have ≥2 long-term conditions. Complications that prolong length of stay occur after approximately 15% of inpatient operations, and a similar proportion of patients express regret that they have undergone surgery. Many of the risks of surgery can be mitigated by preoperative assessment and optimization. Prehabilitation plays a crucial role in preparing patients for major surgery.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 1","pages":"Pages 5-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134710","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}
引用次数: 0
Perioperative pulmonary complications 围手术期肺部并发症
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-01-01 DOI: 10.1016/j.mpmed.2024.10.009
Greg Warren
{"title":"Perioperative pulmonary complications","authors":"Greg Warren","doi":"10.1016/j.mpmed.2024.10.009","DOIUrl":"10.1016/j.mpmed.2024.10.009","url":null,"abstract":"<div><div>Pulmonary complications are prevalent and significantly affect both patients and health services. Rates of postoperative pulmonary complications (PPCs) will probably rise in a surgical population consisting of increasingly frail older patients with co-morbid conditions. In an attempt to reduce variability in the literature a standardized and robust definition of PPCs has been offered, with accompanying diagnostic criteria. Changes in pulmonary physiology perioperatively render patients susceptible to developing areas where ventilation is not matched to perfusion, leading to hypoxaemia and further complications. Risk factors can be classified into patient factors, procedural factors and physiological factors. Prevention strategies focus on optimizing modifiable risk factors and employing anaesthetic and surgical techniques that confer the least impact on respiratory function. Postoperative management includes optimal multimodal analgesia to facilitate breathing exercises and mobilization. Non-invasive ventilation strategies and high-flow nasal oxygen can reduce reintubation rates in individuals with postoperative hypoxia.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 1","pages":"Pages 15-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134709","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}
引用次数: 0
Perioperative models of care 围手术期护理模式
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-01-01 DOI: 10.1016/j.mpmed.2024.10.011
Mark Johnston
{"title":"Perioperative models of care","authors":"Mark Johnston","doi":"10.1016/j.mpmed.2024.10.011","DOIUrl":"10.1016/j.mpmed.2024.10.011","url":null,"abstract":"<div><div>Surgical care has a long and storied history, evolving from a necessity born of trauma to a speciality marked by precision and finesse. Over time, the principles and practices have continuously improved, driven by scientific advancements aimed at enhancing patient outcomes. There is no single agreed-upon model of care; instead, various approaches are employed. Patients often spend a considerable time awaiting treatment, making the effective use of the preoperative phase crucial for adequate preparation. The care of surgical patients requires substantial resources and coordination, with the patient staying at the heart of decision-making and treatment. Surgical care encompasses three distinct phases: preoperative, intraoperative and postoperative. To enhance care, multiple approaches can be used: traditional methods, using skilled clinicians for highly specialized guidance; protocol-based care, standardizing treatment through evidence-based protocols and care bundles; holistic patient focus, prioritizing the patient's needs and guiding what matters most to them; multidisciplinary approaches, encouraging collaboration among numerous team members; and patient empowerment, supporting education and self-directed prehabilitation. Combining these elements ensures comprehensive and patient-centred surgical care.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 1","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134711","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}
引用次数: 0
Think metabolic 认为代谢
Medicine (Abingdon, England : UK ed.) Pub Date : 2025-01-01 DOI: 10.1016/j.mpmed.2024.10.007
Yael Finezilber, Robin Lachmann
{"title":"Think metabolic","authors":"Yael Finezilber,&nbsp;Robin Lachmann","doi":"10.1016/j.mpmed.2024.10.007","DOIUrl":"10.1016/j.mpmed.2024.10.007","url":null,"abstract":"<div><div>Inherited metabolic diseases (IMDs) are a diverse group of genetic disorders that disrupt normal metabolism. While metabolic pathways can seem complex, their fundamental principles are simple. Disruption of a pathway, most often from deficiencies in enzymes or transport proteins, leads to the accumulation of molecules before the block, and deficiency of molecules after the block, both of which can produce disease. Traditionally, these conditions were thought of as diseases of childhood. However, a growing proportion of patients are now surviving into adulthood because of improved medical care, and we are increasingly recognizing attenuated forms of disease that only present in later life. Adults with many common presentations can have an underlying IMD, many of which are treatable. Therefore, it is important to think of these conditions. We describe a number of situations where an IMD should be part of the differential diagnosis and local metabolic consultation might be useful.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 1","pages":"Pages 44-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134705","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}
引用次数: 0
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