Brit J Hosp Med
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Biography Historical Article
James Syme: distinguished Edinburgh surgeon of the 19th century.
This year marks the 150th anniversary of the death of James Syme, one of the most distinguished members of the Edinburgh school of surgery in the 19th century.
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Review Case Reports
Novel treatments for progressive multifocal leukoencephalopathy.
Progressive multifocal leukoencephalopathy is a rare demyelinating disorder of the CNS, caused by John Cunningham virus, that occurs in those with impaired immune systems. Existing treatment options are ineffective or unproven. This article reviews research into novel therapies: immune checkpoint-blocking antibodies (nivolumab and pembrolizumab), allogenic BK virus-specific T cell treatment and filgrastim. Results for these therapies in small clinical trials are promising, but further research is required to assess efficacy fully.
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Review
Autoantibodies in the diagnostic work-up of neuropathy: clinically useful or purely academic?
The search for autoantibodies in patients with acute and chronic neuropathies has become widespread in neurological practice. These tests are more routinely available and therefore are more commonly requested in larger hospitals with neuroscience centres, although they are now also regularly requested from district general hospital settings, including by non-neurologists. However, the clinical value of these frequently expensive tests is often unclear and their impact on management not always obviously beneficial. This article reviews the main immunological tests used to search for specific autoantibodies in the setting of neuropathy and discusses their potential diagnostic importance, together with the eventual therapeutic implications of results obtained.
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COVID-19 has caused an unprecedented pandemic and medical emergency that has changed routine care pathways. This article discusses the extent of aerosolisation of severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, as a result of oesophagogastroduodenoscopy and colonoscopy. ⋯ As it is a highly infectious disease, clinicians treating patients with COVID-19 require effective personal protective equipment. The main routes of infection are direct contact and droplets in the air and on surfaces. Aerosolisation carries a substantial risk of infection, so any aerosol-producing procedure, such as endoscopy, should be performed wearing personal protective equipment and with extra caution to protect the endoscopist, staff and patients from cross-infection via the respiratory system.