Brit J Hosp Med
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Almost all cancer therapies lead to a wide array of side effects, owing to the disruption of normal physiological processes and alteration of immunological responses. Of these, mucositis is one of the most commonly encountered side effects, presenting in about 20-40% of all patients receiving chemotherapy and 80% of those being treated with radiotherapy for head and neck malignancies. ⋯ The key to management is a multidisciplinary approach, revolving around pain control, oral hygiene, nutritional support and management of superimposed infection. The scarcity of therapeutic options for prevention or treatment of mucositis has resulted in clinical difficulty in controlling it, which, in turn, seriously affects the patient's quality of life and cancer management, contributing to patient morbidity and mortality.
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This study aimed to explore definitions of diversity, and views and attitudes towards diversity in healthcare among future generations of surgical trainees. ⋯ Important components of diversity continue to be under-recognised. Surgery must maximise diversity to attract, support and motivate the next generation of surgeons, for the benefit of the health service and the populations it serves.
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Review
The perioperative management of transgender patients: a knowledge gap we can no longer ignore.
Recent years have seen an increase in the number of people openly identifying as transgender in the UK, with current estimates ranging between 200 000 and 600 000 individuals. There has also been an increase in the number of patients undergoing both medical and surgical gender-affirming treatment. ⋯ Despite the need for these considerations, the perioperative management of transgender patients is not covered in the Royal College of Anaesthetists' curriculum; to date, no national guidelines exist on the subject. This article discusses some of the key, specific perioperative considerations relevant to transgender patients, and highlights the need for national guidelines and improved education on the subject.
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The forearm is the most common site of fracture in children. At the time of initial assessment, a thorough examination and neurovascular assessment of the limb is necessary. X-rays allow evaluation of the fracture location and type, in addition to the degree of displacement. ⋯ Manipulation and casting should be followed by orthogonal radiographs and a repeated neurovascular assessment of the limb. Oral analgesia and safety netting information should be provided on discharge and the child should be reviewed in fracture clinic within a week of the injury. This article reviews the British Orthopaedic Association Standards for Trauma and Orthopaedics for the early management of paediatric forearm fractures that do not require operative management.