Brit J Hosp Med
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There is an increasing awareness that polypharmacy - the use of multiple medicines by one individual - may bring harm as well as benefit. This has been termed 'problematic polypharmacy' and is associated with increased risk of admission to hospital, decreased quality of life and psychological harm. This article addresses the factors that may be contributing to the global rise of polypharmacy (the whys), the problems it can cause (the so whats), and some opportunities and strategies for improving and avoiding problematic polypharmacy in the future (the what nexts).
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While use of mechanical circulatory support is increasing, knowledge of its fundamental role and limitations remains poorly understood by many medical professionals. This article summarises the main types of mechanical circulatory support and how they work, particularly focusing on the key information medical professionals should know should they encounter them in hospital. ⋯ Extracorporeal membrane oxygenation can provide both respiratory and circulatory support to patients. Ventricular assist devices can provide support for not only patients with acute cardiogenic shock, but also for ambulant patients in the community setting.