Clin Med
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Endocrine disease is common in pregnancy. Most pre-existing endocrine conditions, if well controlled, have little impact on maternal or fetal morbidity. ⋯ The initial diagnosis of many conditions is hindered by the overlap of symptoms that occur in normal pregnancy and those that suggest specific endocrine pathologies, and also by the changes in reference ranges for common biochemical measurements that occur as a result of physiological changes in pregnancy. This article summarises the common endocrine disorders in pregnancy and describes how pregnancy can alter their investigation, treatment and ongoing management, as well as the potential effects on the fetus.
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Panton-Valentine leukocidin is a cytotoxin produced by Staphylococcus aureus. It was initially discovered by Van deVelde in 1894 due to its ability to lyse leukocytes. ⋯ Panton and Valentine described this strain of S. aureus as a non-life-threatening, soft-tissue infection that caused recurrent furunculosis and abscesses; however, it is currently implicated in more serious and invasive infections in children and young healthy adults. This paper presents a case of the most fatal of these infections: necrotising haemorrhagic pneumonia.
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The two-year Foundation Programme was introduced in the UK as a structured way to deal with the lack of training, support and difficulties with career progression associated with the old senior house office (SHO) grade. Although it provides a clear curriculum and structure for career progression, there is growing dissatisfaction among participants about the difference between the aspirations of the Foundation Programme and the realities of working as a foundation doctor. In particular, the erosion of the traditional team structure, difficulties with the system of assessment and a feeling that the career structure is now too rigid has led to a situation where doctors are being forced to choose their specialty training too early and often with little experience in the specialty. To what extent is the Foundation Programme fit for purpose? This will be considered together with suggestions for future reform.