Clin Med
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Endoscopic ultrasound (EUS) is an increasingly available diagnostic and therapeutic tool used within the U. K. it has wide applications both in the gastrointestinal tract and mediastinum with its current main uses being in the staging of luminal malignancies and assessment of pancreatic and subepithelial lesions. The emergence of linear EUS has opened up new therapeutic avenues with fine needle aspiration, trucut biopsies, coeliac plexus blocks and transmural pseudocyst drainage all now possible. Future developments include localised brachytherapy/chemotherapy and alcohol ablation of unresectable pancreatic malignancies and EUS-guided endoscopic surgery.
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Comparative Study
Omission after admission: failure in prescribed medications being given to inpatients.
Prescribing errors are a recognised problem on admission to acute medical wards which may be detrimental to patient care. The authors had anecdotal evidence that prescribed medicines do not always reach patients and the aim of this audit was to quantify this problem. Admission prescription charts on two separate occasions were studied in detail and all drugs prescribed but not given in the first 48 hours were recorded along with the reason given for omission. ⋯ This may lead to increased morbidity and length of stay. Strategies need to be put in place to reduce this problem. The current system that permits omission of medications with inadequate justification must be revised.
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The history of the control of infectious disease reflects the balance between our understanding of the nature of infection, the mechanisms of host resistance and the available technology to deliver an intervention. However, behind this 'biomedical' construct lies a deeper set of issues which embody serendipity, public understanding, and population-based intervention and its acceptability by the wider community, often complicated by the decisions and subsequent vacillations of policy makers.
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A look at 50 years of personal photography, from Brownie Box to Canon digital single-lens reflex cameras, recording life, people, microscope slides and orchids in their habitats and in the studio to digitising old paintings, photos and herbarium specimens. Notes on photographic techniques and the use of ring flash, with comments on long-term conservation of digital images.
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This is a report of a Royal College of Physicians-sponsored study visit to the U. K. The 'Taking knowledge overseas' scheme enables promising, talented and motivated physicians to have access to high-quality postgraduate educational experience early in their career which will stimulate learning and encourage them to share good practice and knowledge on their return home. By the end of 2008, 26 doctors from low-income countries had benefited from the programme.