Clin Med
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The doctor has a responsibility to develop and maintain an effective approach to ethical decision making and the skills to implement the correct moral action. At the heart of this process is the experience and knowledge of particular conditions and their outcomes, alongside excellence in communication skills and working with colleagues.
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Typhoid fever should be considered in the diagnosis of any patient with a fever from the Asian community even in the absence of a travel history to an endemic region. Blood cultures taken prior to antibiotics are the best way of making the diagnosis early and preventing the complications that arise from a prolonged bacteraemia.
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Morbidity and mortality for any physical illness treated in hospital and complicated by dementia is increased. Length of stay is also prolonged for any physical illness and dementia. ⋯ Enhanced communication with patients and carers, more attention to hydration and nutrition and improved environmental factors within the hospital would be a start. All NHS staff require an increased insight and training about the consequences of physical illness complicated with dementia.
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There have been huge advances in endocrine care as a consequence of improved biochemistry and diagnostic techniques as well as improved imaging. Specialist transethmoidal endoscopic surgery has improved results in pituitary tumour patients and minimally invasive parathyroid surgery has had the same consequence in patients with parathyroid disease. Multidisciplinary teams have improved outcomes in a number of areas and, as described above, endocrinologists are dealing with more in the way of endocrine disease to expand boundaries. Much work remains to be done particularly concerning the care of children and adults with late endocrine effects of cancer treatment and obesity.
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Over half a century ago, a Canadian judge defined a profession in a way that resonates still today, not only for lawyers and doctors, but for the current wide variety of professions and professionals. This article is a reflection on this definition. It briefly considers the historical context within which the knowledge base that characterises a profession evolved and what the various component parts of the judge's definition entail. A final consideration goes beyond the terms of the definition proposed--that of our ethical responsibility as professionals to stand up and be counted and, in the context of the disorder around us, to speak out.