Postgraduate medical journal
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Intravesical bacille Calmette-Guérin (BCG) has been used by urologists for several years after its first reported use as a cancer therapy in the 1930s. Morales in 1976 described the usage of BCG as a once weekly intravesical instillation for six weeks; this is a treatment regimen that still exists today. ⋯ Unfortunately, the more widespread use of BCG is often limited due its high side effect profile. Present research is directed towards reducing its side effect profile, improving its efficacy, and understanding its exact mechanism of action, which is not fully understood.
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Most cardiac arrest teams are made up of junior doctors. The stressful effect of cardiopulmonary resuscitation (CPR) on doctors has not previously been established. A questionnaire was sent to all 52 junior doctors who participated in the cardiac arrest team at a district general hospital. ⋯ Most junior doctors feel stress from CPR. Adequate review by senior doctors with documentation of do not resuscitate orders where appropriate, after discussion with patients, might be beneficial. Adequate training, improving communication skills, and support for junior doctors in the cardiac arrest team need to be reviewed since improvement in these areas may reduce stress.
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Senior house officers (SHOs) (n=78) at the start of their accident and emergency (A&E) post were given an anonymous five case history questionnaire, containing one case of true anaphylaxis, and asked to complete the medication they would prescribe. In the case of anaphylaxis, 100% would administer adrenaline (epinephrine) but 55% would do so by the incorrect route. ⋯ This has implications for training as the survey took place before the start of the A&E posting. Anaphylaxis is over-diagnosed and poorly treated despite Resuscitation Council guidelines.