Brit J Hosp Med
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Xanthogranulomatous pyelonephritis is a rare and chronic form of pyelonephritis. Patients can present with an array of signs and symptoms including flank pain, fever and weight loss. The insidious nature of its clinical presentation means that it can mimic a neoplastic process. ⋯ Management requires a multidisciplinary approach. Definitive resolution can only be achieved through nephrectomy. This article provides an overview and guide to diagnosis, investigation and management.
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With the exit of the UK from the European Union and the European Union Regulation 201/745 coming into effect on 26 May 2021, the regulatory landscape for medical devices is undergoing a substantial change, the implications of which will be felt by those procuring and using medical devices in clinical settings. This article outlines the changes that clinicians, as users of medical devices, should be aware of in the immediate future.
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Research carried out in 2016 by the authors investigated the challenges that doctors in training experience around leadership and followership in the NHS. The study explored contemporary healthcare leadership culture and the role of followership from the perspective of early career doctors. It found that the leadership and followership challenges for these doctors in training were associated with issues of social and professional identity, communication, the medical hierarchy, and relationships with senior colleagues (support and trust). ⋯ The study raised implications for medical education and training and suggested that followership should be included as part of formal training in communication and team working skills. The importance of both leadership and followership in the delivery of safe and effective patient care has been brought sharply into focus by the COVID-19 pandemic. This article revisits these challenges in light of the pandemic and its impact on the experiences of doctors in training.
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Patient education is an important part of obtaining informed consent, but can also be used to educate patients about how to prepare for surgery and help them take responsibility for improving their own health to reduce their risk of perioperative complications.