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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Although seemingly benign, the presence of a patent foramen ovale (PFO) may play an important role in the pathophysiology of disease, specifically a paradoxical embolism leading to cryptogenic stroke. The European Society of Cardiology recently published guidelines detailing how PFOs are associated with paradoxical embolism and how they are diagnosed and managed. ⋯ It reviews the clinical trials comparing device closure with medical therapy and highlights the current NHS England commissioning process on PFO management. Finally, we give an overview of other conditions where PFO device closure may need to be considered.
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Cases of monkeypox, a double-stranded DNA virus that is closely related to smallpox, have recently increased in non-endemic countries, prompting fears of a new health emergency. Tens of thousands of cases have now been reported globally, with the majority of locations not having historically reported monkeypox. Here we review the epidemiology, transmission, diagnosis, management and prevention of monkeypox.