Brit J Hosp Med
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Ageing impairs liver function and reduces the liver's regenerative capacity. With the predicted increase in the older population, the burden of liver disease will proportionally rise in this age group. ⋯ Therefore, clinicians need to consider individual patient risk factors during the assessment of abnormal liver function tests. This article discusses various liver function tests, their pathophysiology, and the approach to interpret and manage common abnormalities in liver function test results and liver disease in the older population.
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The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. ⋯ A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.
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The idea of patients drinking, eating and mobilising (DrEaMing) at 24 hours postoperatively is being used as a marker of functional recovery. This marker of recovery and quality is explored in this article.
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The trauma and orthopaedic surgery department needed to modify practices as a result of the COVID-19 pandemic. This study quantitatively assessed the effects of changes in resource allocation on the efficiency of trauma, specifically the number of operations performed per defined trauma session. ⋯ Measures introduced at the start of the pandemic are likely to continue for the foreseeable future. Increased allocation of resources would be needed to allow urgent trauma surgery to provide a timely and efficient service.
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Failure to recognise the deteriorating patient can cause severe harm and is related to preventable death. Human factors are often identified as contributing factors. Simulation-based education is used to develop clinicians' human factors skills. ⋯ The evidence demonstrating the impact of simulation-based education on patient outcomes was equivocal. The quality of the evidence was low grade regarding the efficacy of simulation-based education on human factors. Further research is required to confirm the efficacy of simulation-based education for human factors and patient outcomes.