Clinical medicine (London, England)
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People who inject drugs are disproportionately affected by acute/chronic bacterial and viral infections that are a cause of significant morbidity. Clinical presentations to the acute medical take vary from skin and soft tissue infections to complications of bacteraemias, and can be challenging with difficulties in adherence, pain management, early self-discharges and loss to follow-up. This review summarises the most recent UK epidemiology of injecting drug use and infection as well as clinical presentation and management.
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Acute stroke is the leading cause of disability in the UK and a leading cause of mortality worldwide. The majority of patients with ischaemic stroke present with minor deficits or transient ischaemic attack (TIA), and are often first seen by patient-facing clinicians. Urgent evaluation and treatment are important as many patients are at high risk of major vascular events and death within hours to days after the index event. ⋯ Each of these drugs has a unique mechanism and has been tested as a single agent or in combination. Aspirin, when given early is beneficial and short-term treatment with aspirin and clopidogrel has been shown to be more effective in high-risk TIA / minor stroke. This review concludes by highlighting gaps in evidence, including scope for future trials that could potentially change clinical practice.