Brit J Hosp Med
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Metastatic spinal cord compression is compression of the spinal cord or cauda equina as a result of metastatic deposits in the spinal column. It affects approximately 4000 cases per year in England and Wales. ⋯ Survival of patients with common malignancies has improved significantly with the ongoing development of radiotherapy and chemotherapy, as well as improved surgical treatment of resectable primary tumours. This article outlines the clinical approach to presentation, pathophysiology, diagnosis and management.
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E-cigarette or vaping product use-associated lung injury is a recently recognised, acute pulmonary syndrome which has been reported (particularly from June to October 2019) throughout the USA, but not in Europe (although one probable case, in the UK, has been reported; Medicines and Healthcare products Regulatory Agency, 2020). It presents acutely, most often in young men, as severe pulmonary consolidation, usually with respiratory failure. ⋯ Vitamin E acetate, often present in tetrahydrocannabinol-containing vape products as a solvent, has been implicated, as it has been identified in the bronchoalveolar lavage fluid of patients with e-cigarette or vaping product use-associated lung injury. This article reviews the recent literature, including clinical features, presentation and investigations, and possible mechanisms, in the context of vaping practices in the USA and the UK.
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At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.
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Biography Historical Article
Sir James Young Simpson: pioneer of anaesthesia in childbirth.
This year is the 150th anniversary of James Young Simpson's death in 1870. As well as being responsible for the introduction of general anaesthesia into obstetric practice, he made other important contributions to obstetrics and also to surgery as well as in the control of hospital infection.
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Major trauma in the UK has changed and can now be thought of as two different diseases: the traditional type of high energy transfer major trauma occurring in younger patients, and low energy transfer major trauma (usually an older person falling on one level). The current NHS trauma system is not well set up to treat low energy transfer major trauma - adapting to the changing disease is the next big challenge.