Clinical medicine (London, England)
-
Technology has revolutionised our society. From the creation of the internet to smartphones and applications (apps), technology has changed how we communicate with each other, undertake regular tasks in our lives and access information at our fingertips. ⋯ With the emergence of a range of widely used technological options that can improve quality of life and metabolic outcomes, general physicians need to be aware of their application in diabetes, as well as how to manage acute diabetes presentations in people using these devices. This article aims to improve the knowledge that general physicians may have with diabetes technologies and guide them on the acute management in people using these technologies.
-
Cholestatic liver diseases are a challenging spectrum of conditions arising from damage to bile ducts, leading to build-up of bile acids and inflammatory processes that cause injury to cholangiocytes and hepatocytes. Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the two most common cholestatic disorders. In this review we detail the latest guidelines for the diagnosis and management of patients with these two conditions.
-
Cirrhosis is associated with intestinal dysbiosis, with specific alterations in the gut microbiota linked to particular aetiologies and manifestations of the disease. We review the role of the gut microbiome and the importance of the intestinal barrier in cirrhosis, provide an overview of the terminology and techniques relevant to this emerging area, and discuss the latest developments in therapies targeting the gut-liver axis.
-
We determined the impact of a system-wide multicomponent intervention to improve recognition and documentation of cognitive frailty syndromes on hospital administrative coding for delirium. ⋯ A multicomponent intervention increased sensitivity of hospital administrative diagnostic coding for delirium almost six-fold without increasing the false positive diagnosis rate.
-
Despite a body of evidence demonstrating reduced incidence of post-lumbar puncture headache associated with pencil-point (vs bevelled-edge) needles, their use remains variable in the UK. ⋯ In the context of wider literature on the power of default options in driving behavioural choices, changing defaults may be an effective, inexpensive and acceptable intervention to improve lumbar puncture practice.