Clinical medicine (London, England)
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Interpreting pleural fluid results correctly requires an awareness of the possible aetiologies of a pleural effusion and an understanding of the reliability of the outcome of each investigation. All results must be interpreted within each different clinical context and knowledge of the pitfalls for each test is necessary when the diagnosis is unclear. This review aims to discuss the common aetiologies of a pleural effusion and some of the pitfalls in interpretation that can occur when the diagnosis is unclear.
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Obesity is a major health and economic crisis facing the modern world. It is associated with excess mortality and morbidity and is directly linked to common conditions such as type 2 diabetes mellitus, coronary heart disease and sleep apnoea. The management of obesity and its associated complications has evolved in recent years, with a shift towards more definitive strategies such as bariatric surgery. This review encompasses the dietary, pharmacological and surgical strategies currently available for the management of obesity.
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Frailty is a common condition in later life in which minor stressors may result in major changes in health. While the biological mechanisms of frailty are increasingly understood, relationships with the wider determinants of health, health inequalities and the concept of resilience are less well-established and the role of the clinician in their modification is less well understood. ⋯ The wider determinants are closely linked to the concept of resilience, which is the process of effectively negotiating, adapting to or managing significant sources of stress or trauma. Better recognition of the relationship between frailty, the wider determinants, inequalities and resilience can enable a framework around which policy responses may be developed to build resilience in people living with frailty at an individual and community level as well as enabling clinicians to better identify how they may support their patients.