Clinical medicine (London, England)
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Sickle cell disease is characterised by recurrent painful crises often leading to hospitalisation. During the COVID-19 pandemic, it was important to try to reduce the need for hospital admission for these high-risk patients while at the same time ensuring that hospital avoidance did not put them at risk of deterioration from disease-related complications. ⋯ There were no cases of unsafe hospital avoidance or presentations to hospital that were inappropriately delayed. Frequent telephone communication with patients and provision of ambulatory care were, among others, two very important means of supporting our patient population.
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COVID-19 has proven to be a potent disruptor of postgraduate training, assessment and learning. In so doing, it has equally proved to be a potent catalyst and has driven innovation. Here we discuss the response of the Federation of the three UK Royal Colleges of Physicians to the challenges presented in these areas by the COVID-19 pandemic.
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Case Reports
An unusual case of persisting hypoxia in a patient with a thrombolysed pulmonary embolism.
Exertional breathlessness and hypoxia are common presenting complaints in acute medicine. We describe a case where the patient continued to have persistent hypoxia even after the primary cause (pulmonary embolism) was diagnosed and treated. The hypoxia persisted as an enigma, its cause remaining elusive till diagnosed. Standard first-line investigations would not have reached the underlying diagnosis in this case and, as such, it demonstrates the keen clinical sense and complex investigative strategy required to solve the puzzle.