Clinical medicine (London, England)
-
The NHS in England has rapidly expanded staff testing for COVID-19 in order to allow healthcare workers who would otherwise be isolating with symptoms suspicious of COVID-19 to be cleared to work. However, the high false negative rate associated with current RT-PCR tests could put other staff, family members and patients at risk. We believe combining swab testing with real-time lung ultrasound (LUS) would improve the ability to rule-in COVID-19 infection in those requiring screening.
-
The objective was to study hospitalised COVID-19 patients' mortality and intensive care unit (ICU) admission with covariates of interest (age, gender, ethnicity, clinical presentation, comorbidities and admission laboratory findings). ⋯ COVID-19 has high mortality. BAME and male patients were associated with ICU admission. High CRP and low albumin (after correcting for age) were associated with mortality.
-
A 42-year-old man presented with fever, sore throat, rash and painful right knee swelling, preceded by self-medication with oral steroids. Blood and knee cultures yielded group A Streptococcus After 2 weeks of intravenous antibiotics and two arthroscopic knee debridements, he continued to experience spiking fevers, and electrocardiographic changes developed. We postulate that the patient suffered from the first presentation of acute rheumatic fever, following an invasive group A bacteraemic streptococcal infection. The possible role of cardiac magnetic resonance imaging in the diagnosis of rheumatic carditis is discussed.
-
Paroxysmal atrial fibrillation (PAF) is a frequent cause of recurrent stroke but can be difficult to detect because of its episodic and often asymptomatic nature. We sought to improve rate of PAF detection through a quality improvement project (QIP) to deliver early prolonged inpatient cardiac monitoring on the stroke unit (SU). ⋯ Although this study had a number of limitations, it did demonstrate that early and prolonged non-invasive IP cardiac monitoring could be delivered 'in-house' on the SU and improve AF detection rates.
-
This study investigated the clinical significance of 18F-fluorodeoxyglucose positron emission tomography / computed tomography (18F-FDG PET/CT) in identifying the causes of fever of unknown origin (FUO). ⋯ 18F-FDG PET/CT has great clinical importance in diagnosing and identifying causes of FUO and improves the accuracy of FUO diagnosis when combined with serum CRP levels.