Brit J Hosp Med
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Cardiogenic shock remains a major problem affecting a large proportion of patients with acute coronary syndromes, with a persistent high mortality rate. Although mechanical reperfusion with percutaneous coronary intervention has improved outcomes following acute coronary syndromes, there is limited evidence supporting the other current treatments used to manage patients with cardiogenic shock (intra-aortic balloon pumps, percutaneous left ventricular assist devices and extracorporeal membrane oxygenation). This article looks at these options, assessing current evidence and recent advances. It also discusses areas that still require research to ensure there is improvement in these high-risk patients, such as coordinated regionalised approaches to cardiogenic shock management with multidisciplinary care provided in designated tertiary shock centres.
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The use of psychotropic medication in pregnant and breastfeeding women is an area of great challenge for both women with mental health problems and clinicians. There are many uncertainties regarding risks of untreated illness to mother, fetus or infant as well as concerns over potential risks to the fetus or infant associated with use of psychotropic medications during pregnancy or breastfeeding. The purpose of the British Association of Psychopharmacology guidelines is to provide advice regarding making decisions around treating mental illness in the perinatal period. This article provides a summary and explanation of the consensus guidance.