Clin Med
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Patients admitted to UK hospitals with community-acquired pneumonia (CAP) require a chest radiograph for diagnostic purposes and to look for complications. This study investigated the association between a chest radiograph performed early in the process of care and clinical outcomes. ⋯ Antibiotics were administered after the radiograph in 89.8% of patients with a time to first radiograph < 4 hours compared with 40.7% of patients with time to first radiograph of > or = 4 hours (odds ratio 12.8, p < 0.001). A chest radiograph performed within four hours of hospital admission for CAP is significantly associated with a shorter hospital LOS and with antibiotic use after chest radiography.
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We report a case of a 45-year-old man presenting with asomatognosia, or loss of body part ownership, when he experienced difficulty acknowledging that his arm was his own. His symptoms might easily have been considered to be of psychiatric origin. Instead they turned out to be due to highly focal stroke secondary to carotid dissection, an important and often missed cause of stroke in younger patients.
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The regular meetings of the chief medical officers (CMOs) from the European Union's (EU's) 27 Member States provide an important forum to address issues of common interest affecting Europe's populations. Yet there is no universally agreed role for a CMO. ⋯ Four broad categories of countries were identified: those whose CMO is the most senior doctor in the health ministry, in some cases with responsibility spanning all of government; where they are head of a division within the health ministry; head of a separate body such as a national board of health; and countries where no single individual can be identified. Although the diversity of health systems means that these roles cannot be harmonised, there is scope to explore what can be learnt from the different approaches.