Brit J Hosp Med
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Despite initial reports, renal involvement, including acute kidney injury, has emerged as a serious complication of COVID-19 disease, particularly in critically ill patients. The reported prevalence varies considerably, which may reflect reporting practices, although differences in pre-existing comorbidities and socioeconomic factors, and differences between ethnic groups, almost certainly contribute. ⋯ Treatment is, in the main, supportive, with kidney replacement therapy required in nearly 25% of reported cases. Few data currently exist as to the long-term burden of COVID-19-associated acute kidney injury but evidence suggests that only approximately one-third of patients are discharged with recovered renal function.
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Melanoma is the most aggressive skin malignancy with an ever-increasing caseload, especially in the western world. Recently developed immunotherapeutic modalities have substantially improved the prognosis of advanced melanoma. The association between serum levels of vitamin D and prognosis of melanoma has been a focus of ongoing research, with some evidence of vitamin D's potential as an adjunctive modality to immunotherapy. The National Institute for Health and Care Excellence guidelines clearly recommend that assessment of vitamin D levels and relevant advice should be an inherent aspect of the management of patients with melanoma at the secondary care level. ⋯ The authors propose that the simple and reliable pathway used to achieve and sustain the results could be easily adopted to ensure universal adherence to these guidelines.
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Historical Article
Academic surgery in the UK and the Surgical Research Society 50 years ago.
Fifty years ago, in 1970, academic surgical units had finally been established throughout the universities in the UK. Such departments had been created in the Scottish university cities in the 19th century; some medical schools in London had resisted this custom, but by now these bastions of the old system had surrendered!