Clinical medicine (London, England)
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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.
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Case Reports
Lessons of the month 3: Mosaic Klinefelter syndrome unveiled by acute vertebral fracture in a middle-aged man.
Klinefelter syndrome (KS) is the most common sex chromosome disorder in males. It is the result of two or more X chromosomes in a phenotypic male. ⋯ A broad spectrum of phenotypes has been described and many cases remain undiagnosed throughout their lifespan. In this case report, we describe a case of mosaic KS unmasked by acute vertebral fracture.
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There are significant health inequalities between Deaf and hearing people, including barriers to accessing care and communication difficulties in consultations. Such problems have particularly affected Deaf people with acquired cognitive deficits, leading to late and missed diagnoses. ⋯ We found that Deaf patients who use British sign language had difficulty obtaining an accurate diagnosis before attending our specialist clinic, highlighting the importance of tailored services for Deaf people. Our results show that the clinic improved communication for patients and accessibility to specialist investigations, ensuring diagnostic accuracy and overall reducing health inequality for this population.
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This study's aim was to investigate an association between outcome from in-hospital cardiopulmonary resuscitation (CPR) and increasing burden of comorbidities and frailty. ⋯ Our findings suggest an association between increasing patient multimorbidity and frailty and poorer outcome post cardiac arrest.
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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.