Brit J Hosp Med
-
In 2021 the National Institute for Health and Care Excellence updated its guidance for diagnosing and managing atrial fibrillation. This editorial summarises the key changes made in these guidelines and discusses their implementation in UK clinical practice.
-
Stroke is the UK's leading cause of disability. Stroke rehabilitation can maximise recovery and improve quality of life. This article discusses some post-stroke impairments, including hemiplegia, dysphagia, communication impairments and neglect, and how rehabilitation can address these. Developing techniques of adaptation or compensation is vital, since the extent of stroke recovery is dependent on successful neuroplasticity, with healthy neurons adapting to compensate for damaged ones.
-
Staphylococcus aureus bacteraemia is common, and associated with significant morbidity and mortality as a result of its high relapse rate and the risk of complicated infection. A positive blood culture for S. aureus should prompt a thorough patient assessment to identify a potential focus of infection, and the risk factors for the development or presence of complicated infection. ⋯ This article gives a systematic approach to the patient with S. aureus bacteraemia, including points to look for on history and examination, the markers of complicated infection, and when to request transoesophageal echocardiography and further imaging. Treatment principles outlined include the rationale for choice of antibiotic treatment and need to involve infection specialists.
-
Thrombolysis can be used to break down a pulmonary embolism more rapidly than standard anticoagulation. Its use has been confined to patients with massive pulmonary embolism and haemodynamic collapse, with disagreement over its role in submassive pulmonary embolism because of the risk of catastrophic bleeding.