Clin Med
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Complex regional pain syndrome (CRPS) is a debilitating, painful condition in a limb associated with sensory, motor, autonomic, skin and bone abnormalities. Pain is typically the leading symptom, but is often associated with limb dysfunction and psychological distress. ⋯ The purpose of this concise guideline is to draw attention to these guidelines. Information in this article has been extracted from the main document and adapted to inform the management of CRPS as it presents to physicians in the course of their daily practice.
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As society changes, doctors must adapt. Despite remarkable advances in medicine, the pace of change--greater now than ever--is challenging doctors to define their role and relevance. Is medicine really facing a crisis? Are claims for a malaise in medicine overstated? Regardless, the profession has been called upon to respond collectively to change. ⋯ Approaches will vary but one constant should be a steadfast adherence to the scientific basis of medicine as a way of thinking. Engagement with the medical humanities will also help doctors stay fresh and deepen their understanding of what it feels like to be ill. In so doing, clinicians will find inspiration in the ordinary.
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The impact of twice-daily consultant ward rounds on the length of stay in two general medical wards.
Excess average length of stay (ALoS) not only results in an increased cost to hospitals but also increases the risk of hospital-acquired infection and thromboembolism. Various factors suggested to affect ALoS have yet to demonstrate a significant impact in clinical practice. Increased consultant input has been identified as an important factor influencing ALoS. ⋯ The number of discharges (NoDs) significantly increased (p < 0.01), ALoS reduced (p < 0.01), whereas, readmission rate and mortality remained unchanged (p = NS) over 12 months following twice-daily WRs compared to two other wards with twice-weekly WRs. This innovative model resulted in almost doubling the NoDs and halving the ALoS. This study suggests that ALoS can be reduced and sustained with a cultural and behavioural shift in consultant working patterns, without affecting readmission rate or inpatient mortality.