Brit J Hosp Med
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The enhanced recovery programme in colorectal surgery is an exciting and innovative new approach for pre- and postoperative management of surgical patients. It challenges some of the non-evidence-based practices and myths which have been entrenched in the minds of clinicians for decades.
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In 1977 powers to charge those not 'ordinarily resident' in the UK for NHS care were first introduced, and rules governing eligibility for free NHS care have become increasingly complex since. In this issue (p. 156), Dubrey et al present an interpretation of the current regulations and express concern that the treatment of ineligible patients presents a threat to the UK health system. Here we suggest the opposite: increasing attempts to restrict the access of vulnerable humans to health care present a threat both to individual and public health. We challenge all clinicians to provide immediately necessary care and to protect public health.
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Acute tendon injuries to the hand are common. In the UK, there are approximately 12000 inpatient admissions annually for injuries to the tendons and muscles of the hand and wrist (Dew, 2009). ⋯ Diagnosis of tendon injuries in the hand relies on careful clinical assessment, particularly if flexor and extensor tendon injuries are not to be missed. This article describes the tendon structure, explains the causes of tendon injury and discusses their assessment and management for a foundation level doctor who will face these injuries regularly whether in primary care or the emergency department.
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Regional anaesthesia encompasses central neuraxial and peripheral nerve blockade. These techniques all consist of introducing local anaesthetic to regions around nerves for the purposes of surgical anaesthesia and/or analgesia.