Clin Med
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Patients admitted to UK hospitals with community-acquired pneumonia (CAP) require a chest radiograph for diagnostic purposes and to look for complications. This study investigated the association between a chest radiograph performed early in the process of care and clinical outcomes. ⋯ Antibiotics were administered after the radiograph in 89.8% of patients with a time to first radiograph < 4 hours compared with 40.7% of patients with time to first radiograph of > or = 4 hours (odds ratio 12.8, p < 0.001). A chest radiograph performed within four hours of hospital admission for CAP is significantly associated with a shorter hospital LOS and with antibiotic use after chest radiography.
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Myotonic dystrophy (MD) is an autosomal dominant disorder which affects both smooth and skeletal muscles. The incidence is approximately 1 in 8,000 births. ⋯ Cardiac rhythm disturbances are a common cause of death in these patients. This lesson describes a case in which a previously undiagnosed case of MD presented with an episode of ventricular fibrillation.