Clin Med
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The earliest sign of DN is the development of microalbuminuria which is associated with a significant risk of both progressive renal failure and premature death from cardiovascular disease. Optimal glycaemic and BP control, including the use of RAAS blocking drugs, can prevent, slow and even reverse the processes causing DN.
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Alcohol misuse is a common reason for hospital admission. While there is considerable evidence from other areas that provision of specialised alcohol services can reduce alcohol intake, there is currently less evidence for medical departments in an acute hospital setting. ⋯ This service assessed 3632 patients over five years and has seen a reduction in hospital admissions, violent incidents against staff and primary care attendances. It is believed that this model of care is an effective means of intervening in people with alcohol-related problems.
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Lyme disease is rare in the U. K. but there is evidence of an increase in both prevalence of, and patient concern about, the infection. There are no published data characterising Lyme disease as it is seen in the U. ⋯ Screening enzyme immunoassay tests were negative in 39% and reference laboratory immunoblots were negative in 31% of patients, principally those with early infection. The majority of patients were cured with one course of antibiotic treatment, three patients had evidence of persistent infection after treatment and two required intravenous therapy. No cases of chronic Lyme disease were seen.