Brit J Hosp Med
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Frailty describes a state of health whereby people develop multiple or cumulative deficits in physiological systems over the life course, leading to vulnerability and being less able to respond to acute and/or physiological stressors, which at times may be relatively minor. Mental health should be an important consideration in the assessment and management of frailty in older people. This article provides an overview and clinical perspective on the evidence relating to frailty and mental health assessment and management.
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Maintaining emergency eye services is crucial during the COVID-19 pandemic. This article describes the introduction of a new restructured referral pathway to reduce the burden on healthcare providers and create a safe environment. ⋯ Using this telephone and digital imaging review triage system, the authors have demonstrated a significant reduction in the need for face-to-face reviews. The reduction in avoidable patient face-to-face reviews allows the system to move from saturated to sustainable while increasing accessibility to services for patients who may not be able to present for face-to-face review. This complete audit cycle successfully charts interventions that maximise accessibility, reduce unnecessary hospital visits and deliver safe and prompt management during the pandemic.
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Dizziness and balance disorders are very common problems. Having a structured approach, including adequate history taking and clinical examination, in a multidisciplinary environment allows for effective management of patients with these complex symptoms. ⋯ While surgical intervention has a small role in the management of balance disorders, vestibular rehabilitation remains the cornerstone of treatment, along with different supportive measures. This article outlines the approach used in the authors' centre to manage patients with dizziness and balance disorders.
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This editorial explores how technology has helped clinicians during the COVID-19 pandemic, from patient care to education, the changes that have been made and the numerous exciting possibilities of where technology can amalgamate with health care.
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In a change from recalling births, deaths or medical discoveries, this article looks at a paper published in The Lancet 100 years ago. Occupying a little more than a single column, its vivid description of an operation carried out successfully under primitive conditions will be of great interest.