Clinical medicine (London, England)
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Epileptic seizures are a common cause for presentation to acute medical services. Whether presenting with an isolated, unprovoked seizure or with status epilepticus, a good understanding of seizures and their mimics ensures appropriate investigation and treatment. This article describes the practical aspects of the management of patients presenting with seizures to the emergency department or the acute medical unit.
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Headache is common. Up to 5% of attendances to emergency departments and acute medical units are due to headache. ⋯ The role of the attending physician is to take a comprehensive history to diagnose and treat benign headache syndromes while ruling out sinister aetiologies. This brief article summarises the approach to assessment of headache presenting in acute and emergency care.
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Inhaled corticosteroids represent the mainstay of pharmacological treatment for reversible airways disease, and traditionally have had widespread use in non-reversible chronic obstructive pulmonary disease (COPD). However, use in this group may expose patients to an increased risk of pneumonia, without significant benefit to symptoms or exacerbation frequency. Here we provide a guide to the use of inhaled therapy in COPD for the general physician.
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We have a medical workforce crisis where we have insufficient trainees, demonstrated by rota gaps, and in turn nearly half of advertised consultant physician posts cannot be appointed to. Most physicians retire around age 62, and already 5% of the total consultant workforce is those who have retired and returned. If those reaching retirement age chose not to retire but continue working less than full time this would, at least in part, benefit the workforce and utilise valuable skills and experience to the benefit of the individual, the wider medical community and therefore our patients.