British journal of hospital medicine
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Over the last 10 years, our understanding of bacterial meningitis has improved considerably and new methods of treatment and prevention have been introduced. This review summarizes these advances and discusses more recent developments which will affect the management of bacterial meningitis in the near future.
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This article reviews the management of acute and chronic pain in childhood. Many of the common problems are discussed and the range of therapeutic options are reviewed, including possible future advances. The management of pain in neonates is not discussed. The second article of this series will describe the use of sedative drugs in paediatric practice.
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Diabetic ketoacidosis remains a life-threatening condition. Management is usually straightforward, but there is still a significant mortality and morbidity, largely arising from the unpredictable complication of cerebral oedema. ⋯ Good supervision from senior members of staff is essential, and there should be early concern if progress is not as predicted. Rapid intervention with mannitol and hyperventilation is necessary if signs of cerebral oedema develop.
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The marked increase in the use of day surgery has major implications for the provision of surgical training. It is essential that day surgery units be used effectively for surgical training. We identify current constraints on such training and suggest methods for improvement.