Brit J Hosp Med
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Post-thrombotic syndrome and chronic thromboembolic pulmonary hypertension are two distinct clinical syndromes associated with adverse patient outcomes following a venous thromboembolism. Clinical manifestations of post-thrombotic syndrome include persistent pain, swelling and ultimately venous ulceration following a deep venous thrombosis. ⋯ The treatment of post-thrombotic syndrome mainly involves lifestyle modifications alongside the use of elastic compression stockings while patients with chronic thromboembolic pulmonary hypertension should be offered targeted surgical and medical treatment options available at expert centres. Further research is warranted for both conditions to determine the role of direct oral anticoagulants when used with a preventive or therapeutic intent.
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Fracture-related infection is a serious complication which can occur following musculoskeletal injury and is associated with significant morbidity. These complications can be challenging to recognise, and experts have provided a clearer definition of fracture-related infection to help with the diagnosis and detection of these infections. ⋯ Treatment requires a multifaceted approach with multidisciplinary involvement, and generally a combination of surgical techniques and prolonged antibiotics, the timing and choice of which should be optimised. This article provides an evidence-based review of the British Orthopaedic Association Standards for Trauma for the diagnosis and management of fracture-related infections.
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The pandemic has accelerated the data-sharing conversation and patients are increasingly receptive to sharing data, but missteps in this area could undermine public trust. This article outlines public concerns, lessons learned from previous unsuccessful activities, and the potential for secure data environments, which will be vital for the UK to maximise benefits for patients and the NHS.
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Racial microaggressions are often subtle and frequent occurences in the lives of people from marginalised racial groups. There is a broad lack of acknowledgement that they exist and when perpetrators are confronted, victims are often met with defensiveness or dismissal. ⋯ There is no single way to address microaggressions, but the authors propose some ways to identify and tackle them in the medical setting and beyond. It is hoped that this will encourage allyship and empower those who are bystanders to become more actively involved.
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Perioperative neurocognitive disorders are a group of conditions characterised by changes in cognitive function, which affect older people after surgery and anaesthesia. Multicomponent interventions may reduce the impact of perioperative neurocognitive disorders on patients and healthcare systems.