Clin Med
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Multicenter Study Comparative Study
British HIV Association national audit on the management of patients co-infected with tuberculosis and HIV.
This audit aims to compare UK management of tuberculosis (TB)/HIV co-infection with recommended practice and to describe local care arrangements. Services providing HIV care were invited to complete a survey of care arrangements and to review case notes of HIV positive patients aged over 16 who started therapy for active TB between October 2007 and April 2008. Corresponding TB services, if separate, were invited to complete a similar survey. ⋯ Culture confirmation of pulmonary TB met the CMO's 65% target. A high number of patients were diagnosed with HIV during investigation of TB. Contrary to current guidelines, many services do not routinely test TB patients for HIV.
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Neurological conditions comprise a significant proportion of patient admissions to hospital but, in the majority of cases, are admitted under the care of non-neurological physicians. As a consequence, neurological ward consultations are commonly requested by the admitting medical teams to review diagnoses and management plans. The outcomes of neurological ward consultations were examined and the time required for the referral process recorded by performing a detailed prospective three-month audit of inpatient referrals to the neurology service. ⋯ The consultation process was time consuming, however, both in respect of the initial review, but also with follow-up visits. This audit highlights the importance of neurological input in the diagnosis and management of hospital inpatients. The time taken for this process should be resourced appropriately.
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Biography Historical Article
Isolation in time: a cause of suffering in the elderly. Lessons from Krapp's last tape.
This column explores the links and synergies between medicine and literature. What roles can literature play in reflecting and influencing good practice, and what sorts of images of doctoring are to be found in drama, poetry, fiction, biography, electronic fora and film? The editors would be pleased to receive short papers, ranging from 500–1,000 words, on relevant topics. Those interested in contributing should email brian.hurwitz@kcl.ac.uk or neil.vickers@kcl.ac.uk