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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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.
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The UK government recently decided to extend the interval between the first dose of the Pfizer BioNTech and AstraZeneca COVID-19 vaccines from 3 weeks to 12 weeks to maximise the number of people receiving the initial dose, despite the trials only providing vaccine efficacy data based on a schedule of 21 days between doses. This editorial discusses whether there is evidence to support this policy change.
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Thomas Willis is known for the discovery and description of the circle of Willis, but his contributions to the development of medicine were much broader, including the first use of the term 'neurology'.