Postgraduate medical journal
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Case Reports
Neurosarcoidosis: unusual presentations and considerations for diagnosis and management.
Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%-15% of cases. Any part of the nervous system can be affected by sarcoidosis. ⋯ We include pertinent details about their presentations, imaging findings, pathology, management and clinical course.
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Multicenter Study
Grit and burnout in UK doctors: a cross-sectional study across specialties and stages of training.
Grit is characterised by the ability to persevere during difficulties and maintain a sustained effort over an extended period of time. Throughout their careers, doctors will experience many periods of stress and difficulty. This may result in burnout, defined by the presence of exhaustion and disengagement from work. This study aims to characterise the relationship between grit and burnout in doctors and to establish whether there are differences between specialties and levels of training. ⋯ An understanding of an individual's level of grit may be used to identify doctors at a greater risk of burnout. As a high level of grit is associated with less burnout, interventions to improve grit through resilience training should be examined. Further research is needed to understand how grit levels change during a doctor's career and why GPs experience higher levels of burnout.
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Observational Study
Interhospital transfer neurological deterioration in patients with spontaneous intracerebral haemorrhage: incidence and risk factors.
To explore the incidence and risk factors for interhospital transfer neurological deterioration (IHTND) in patients with spontaneous intracerebral haemorrhage (SICH). ⋯ About one-sixth of referred not comatose patients with SICH developed IHTND. Some risk factors were identified for the first time. Modifying procedures for proper transfer of patients at high-risk for IHTND might help in safely transferring patients with SICH.
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Evidence from randomised controlled trials shows that low-molecular-weight heparin is effective in reducing the risk of venous thromboembolism (VTE) in the clinical setting of temporary lower limb immobilisation. Despite this, international guidelines are non-committal in advocating the use of anticoagulation in this clinical scenario. We determined the risk of VTE associated with lower limb immobilisation and the proportion of VTE events associated with lower limb immobilisation by undertaking a secondary analysis of two case-control studies that had used a similar methodology. ⋯ Lower limb immobilisation is associated with a markedly increased risk of VTE and represents the most common potentially preventable cause in the 18-65-year age group, being present in one in seven cases treated for VTE. Consideration should be given to pharmacological prophylaxis in patients with lower limb immobilisation to reduce the substantial burden of preventable VTE.