Clin Med
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Adolescence represents a critical period of development during which personal lifestyle choices and behaviour patterns establish, including the choice to be physically active. Physical inactivity, sedentary behaviour and low cardiorespiratory fitness are strong risk factors for the development of chronic diseases with resulting morbidity and mortality, as well as economic burden to wider society from health and social care provision, and reduced occupational productivity. ⋯ Every encounter represents an opportunity to ask about physical activity, provide advice, or signpost to appropriate pathways or opportunities. Key initial targets include getting everyone to reduce their sedentary behaviour and be more active, with even a little being more beneficial than none at all.
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The systemic autoinflammatory syndromes often present with recurrent fevers. They have proved exceptionally informative about the innate immune system. Although extremely rare, they are important to recognise, as many can now be completely controlled by long-term drug therapies. Diagnosis relies on clinical suspicion followed by genetic testing.
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The Royal College of Physicians' Acute care toolkit 10 has recommended the use of the AMB score as an aid to determining patients suitable for ambulatory care. As this score has only been previously validated in one centre, the present study calculated the score of 200 patients referred to the medical take to see if it successfully identified patients who had a length of stay of less than 12 hours. In our test centre, the score was found to have a reduced sensitivity compared with the original centre (88 vs 96%) and a positive predictive value of 39%. Therefore in our hospital this was not a useful scoring system, and other trusts need to be aware that the AMB score may not be as effective as the original study suggested.
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Letters not directly related to articles published in Clinical Medicine and presenting unpublished original data should be submitted for publication in this section. Clinical and scientific letters should not exceed 500 words and may include one table and up to five references.