Hospital medicine (London, England : 1998)
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Transferring the seriously ill and injured is becoming a more formalized procedure in the UK. Whether from an accident site to medical care or between hospitals, the public expects that organized services are in place for safe patient transfer. As this is a developing subspeciality it is necessary to review the developments that have occurred over the previous 5 years.
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The NHS has expressed concern about stress in its workforce and is taking steps to reduce it. This paper reviews the factors associated with stress and burnout throughout a medical career. Clear messages emerge for all doctors and their employers.
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The Cochrane analysis of the use of albumin in critical illness has highlighted the need for more well-conducted studies on colloid use in burns. The lack of objectivity in the press regarding this material has compromised our ability to deliver those studies. The analysis provides no evidence that albumin is unsafe for the initial resuscitation of uncomplicated burns, and the fall in its use is more likely to be cost-related.
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This is the second of two articles reviewing catatonia. In the first, catatonia was described as an under-recognized syndrome with a potentially fatal outcome. It was suggested that treatment with neuroleptics may exacerbate the syndrome. The differential diagnosis, management and prognosis of catatonia are reviewed below.
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Levomepromazine (previously known as methotrimeprazine) has a broad range of beneficial effects in the terminal phase of many illnesses, resulting from its combined antipsychotic, anxiolytic and sedative actions. Levomepromazine can safely be administered in a continuous subcutaneous infusion with most other commonly used drugs in palliative care.