Scot Med J
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Necrotising soft tissue infection (NSTI) is an extremely serious condition that relies on a high index of suspicion, prompt diagnosis and emergent radical surgical treatment. We explored the presentation, management and outcomes of NSTI within our department. We also assessed the potential benefit of using risk predictor scoring system. ⋯ Physicians and surgeons need to be suspicious of NSTI in severe cases of soft tissue infection to prevent delay in diagnosis and life-saving treatment. Scoring system can be used judiciously as adjunct to aid diagnosis.
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Cyclizine is commonly prescribed as an anti-emetic post-operatively. We report a case of a 51-year-old woman who developed addiction to intravenous cyclizine following regular administration at recommended doses. ⋯ We compare this case to cyclizine abuse reported amongst other populations. Prescribers should be aware of the potential of cyclizine as a drug of abuse.
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Takotsubo cardiomyopathy is the acquired, reversible syndrome characterised by apical ballooning and base hypercontractility and probably precipitated by emotional and physical stressors that cause a hyperadrenergic state. It presents as an acute coronary event without there being coronary disease. ⋯ To the author's knowledge, this is the first case of this syndrome occurring in such a prolonged septic process and where the primary focus was a surgical wound. This may indicate continued myocardial injury secondary to a sustained hyperadrenergic state as a possible mechanism for takotsubo cardiomyopathy, rather than a one-time catecholamine surge.
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Estimate costs for health and social care services in managing older people in the community who fall. ⋯ Transparent, robust cost information demonstrates the substantial burden of falls for health and social care services and should be a driver for implementing evidence-based interventions to reduce falls.
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Comparative Study
Peri-operative renal morbidity secondary to gentamicin and flucloxacillin chemoprophylaxis for hip and knee arthroplasty.
This retrospective cohort study uses serum creatinine levels to assess the effect of gentamicin and flucloxacillin on renal function in hip and knee arthroplasty patients. ⋯ Flucloxacillin and gentamicin significantly worsens renal function post-operatively compared with cefuroxime.