Clinical medicine (London, England)
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Letter Case Reports
Analysis of 24 cases of polycystic ovary syndrome after failed controlled ovarian hyperstimulation.
Some fertility patients with polycystic ovary syndrome (PCOS) undergoing controlled ovarian hyperstimulation (COH) experience ceased follicular growth during COH and fail to superovulate. In this article, 24 such PCOS patients resumed COH 15-20 days after previous COH treatment was stopped while patients were under ovarian downregulation. ⋯ The remaining seven cases saw ceased follicular growth at 13 mm. This provides a rescue protocol for failed COH patients with PCOS.
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Powerful new genomic technologies are transforming healthcare. The faster, cheaper generation of genomic data is driving the integration of genomics into all healthcare specialties. ⋯ However, despite these exciting advances, few clinicians are aware of or prepared for this genomics-based future. Through five patient-focused scenarios with accompanying interviews, this article showcases new genomic technologies while highlighting the inherent challenges associated with complex genomic data.
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Sleep problems are relatively common in patients with advanced disease, and are associated with significant morbidity in these groups of patients. The focus of this article is sleep problems in patients with advanced cancer, and specifically insomnia, 'vivid' dreams and nightmares. However, other sleep problems are also relatively common in this group of patients, including sleep-related breathing disorders and circadian rhythm sleep-wake disorders. Healthcare professionals should screen all patients with advanced diseases for sleep problems and, equally, initiate appropriate (evidence-based) interventions when they are discovered.
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It is estimated that 12,300 people slept rough in 2018, a 98% increase since 2010. Similar trends can be seen in the number of people living in tents or sleeping on overnight public transport. ⋯ Following the introduction of the Homeless Reduction Act 2017, hospitals must now take a more personalised approach to their homeless patients, ensuring that ongoing care is accessible after discharge. Here, we demonstrate that employment of a dedicated homeless housing officer within a district general hospital can radically improve both staff attitudes towards this patient group as well as individual patient outcomes.
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The use of multiple medications is common in palliative care, putting patients at risk of adverse events and a high tablet burden. Deprescribing is the process of reviewing and stopping potentially inappropriate medications in order to improve quality of life. ⋯ There is evidence for the safety of stopping certain medications, particularly those aimed at primary prevention. A systematic process of reviewing individual medications and their appropriateness is recommended.