Clinical medicine (London, England)
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One in five people in the UK are deaf, with hearing loss affecting more than 70% of people over the age of 70. Despite this being a higher prevalence than asthma, heart disease or diabetes, deaf people experience persistent health inequalities with poorer experiences and outcomes in disease prevention and management. Clear communication and patient engagement with health are key to better outcomes. ⋯ Foundation doctors have regular and prolonged contact with their patients, and often feel underprepared when interacting with patients with hearing loss. This article aims to highlight these communication barriers and suggest changes for improvement. Improvement will require adaptations from both individual and organisational perspectives, with patient care as a clear focus for change.
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The COVID-19 pandemic has strained healthcare systems and how best to address post-COVID health needs is uncertain. Here we describe the post-COVID symptoms of 675 patients followed up using a virtual review pathway, stratified by severity of acute COVID infection. ⋯ Many patients continue to have a significant burden of post-COVID symptoms irrespective of severity of initial pneumonia. How best to assess and manage long COVID will be of major importance over the next few years.
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A 54-year-old woman presented to the emergency department with fluctuating consciousness without localising signs and non-specific neurology. Urgent computed tomography (CT) was unremarkable and differentials of opioid overdose or post-ictal state were considered. Magnetic resonance imaging of the brain demonstrated an artery of Percheron (AOP) infarct; resulting from occlusion of an uncommon anatomical variant in the thalamic and midbrain circulation. This should be considered in patients presenting with fluctuating consciousness and normal CT.
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Case Reports
Lessons of the month 2: Ocular manifestations and complications of hepatitis C infection.
We present a case of a man with hepatitis C with acute visual loss in his left eye over a 3-day period. Initial evaluation suggested a possible idiopathic orbital inflammatory syndrome as underlying cause for his symptoms. ⋯ Re-evaluation confirmed a diagnosis of marginal zone B-cell lymphoma. This case illustrates the importance of considering the various ocular manifestations of hepatitis C.