Brit J Hosp Med
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The global epidemic of HIV/AIDs has seen many advances in the development of effective treatments, including antiretroviral therapy that provides increasing sustained viral suppression, robust immune reconstitution and fewer side effects than before. Early HIV treatment regimens were notoriously complex, comprising up to 22 pills that needed to be taken at different times of the day. ⋯ Novel drugs are constantly being developed to provide better tolerated medications with robust, sustained viral suppression and immune reconstitution; these include long-acting injectables and implants, and preventative treatments for pre-exposure prophylaxis. This article provides an overview of emerging therapeutics for the treatment and prevention of HIV infection.
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A considerable portion of the world's population practices fasting, for religious purposes like Ramadan or to adopt a healthier lifestyle such as intermittent fasting. During this period, individuals undergo metabolic changes that alter their internal environment. ⋯ However, remodelling of the gastric environment and increases in concentrations of H. pylori were recorded. There is no relationship between fasting and the risk of developing H. pylori-induced peptic ulcers, suggesting that individuals with uncomplicated ulcers are not at risk of developing further ulcers and can participate in fasts provided they take the recommended measures.
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Cardiogenic shock remains a time-critical, complex syndrome that continues to present challenges to clinicians and healthcare systems. Despite advances in the fields of cardiovascular and critical care medicine, mortality remains high. This article summarises the recent shock to survival document, which outlined the current and ideal future state of cardiogenic shock care nationally to improve patient outcomes. ⋯ Improved provision of focused cardiac ultrasound is essential to confirm a cardiac cause. Early identification of the patient with cardiogenic shock should be supported by access to defined pathways of care, including specialist shock centres and multiprofessional teams with domain expertise and the capability to manage the myriad of causative aetiologies. Given the absence of high-quality data to inform practice nationally, robust datasets are an unmet need to inform best practice, guide design of clinical services and pathways and drive innovation through research and clinical trials.