Clinical medicine (London, England)
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Diplopia or double vision is the separation of images vertically, horizontally or obliquely and can be monocular or binocular in origin. Binocular diplopia is most commonly caused by ocular misalignment or strabismus that can be detected using simple clinical tests. All patients with diplopia of acute onset should be investigated urgently and those with a headache or pupillary involvement need to be referred for same-day urgent imaging. Diplopia secondary to microvascular causes on the other hand often spontaneously resolves within six months.
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A new UK medical postgraduate curriculum prompted the creation of a novel national medical postgraduate 'boot camp'. An enhanced simulation-based mastery learning (SBML) methodology was created to deliver procedural skills teaching within this national boot camp. This study aimed to explore the impact of SBML in a UK medical boot camp. ⋯ An enhanced SBML methodology in a boot camp model enabled streamlined, standardised procedural skill teaching to a national cohort of junior doctors. Training curricular competencies were achieved alongside increased skill confidence.
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Observational Study
Reduction of physical activity during the COVID-19 pandemic is related to increased neuropsychiatric symptoms in memory clinic patients.
The COVID-19 pandemic led to unprecedented restrictions on social contacts and mobility. Memory clinic patients were disproportionately affected when care was disrupted and routines were abruptly changed. This trial was designed as a pragmatic, prospective, observational study to evaluate the effects of lockdown on memory clinic patients. ⋯ Fears regarding the pandemic were common and mostly related to the patients' health. Lockdown restrictions reduced physical activity in memory clinic patients which was associated with increased neuropsychiatric symptoms. Future restrictions should aim to mitigate the impacts on this vulnerable population.
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Diabetic retinopathy is a microangiopathy resulting from the chronic effects of diabetes mellitus. Healthcare professionals often work in isolation to deliver highly specialised care efficiently and effectively for people living with diabetes. ⋯ In this article, we discuss the epidemiology and natural history of diabetic retinopathy and describe an approach to its assessment and diagnosis. We provide an overview of the principles of diabetic retinopathy management and outline possible future treatments for diabetic retinopathy.