Clinical medicine (London, England)
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Many secondary care departments receive external advice calls. However, systematic advice-call documentation is uncommon and evidence on call nature and burden infrequent. The Liverpool tropical and infectious disease unit (TIDU) provides specialist advice locally, regionally and nationally. We created and evaluated a recording system to document advice calls received by TIDU. ⋯ Implementing an advice-call recording system was feasible within TIDU. Call and follow-up burden was high with advice regarding fever in returned travellers predominating. Similar systems could improve clinical governance, patient care and service delivery in other secondary care departments.
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Patients with suspected lung cancer require computed tomography (CT), specialist interpretation of the CT and a consultation with a specialist. Significant time savings could be made with rapid access to these components in the front end of the lung cancer pathway. ⋯ Through simple reorganisation of workload, we have significantly reduced the pathway for patients with suspected lung cancer to meet a specialist with a reported CT, something we firmly believe is replicable across all hospitals.
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Case Reports
Images of the month: Demonstrative oral mucosal sarcoidosis in a patient with pulmonary disease.
Sarcoidosis is a multisystem granulomatous disease that preferentially affects the lungs and intrathoracic lymph nodes. Oral involvement is quite rare and usually appears in patients with known systemic sarcoidosis but it may also be the initial finding of a systemic disease. ⋯ Recognising oral sarcoidosis may be difficult but it is important not to miss an asymptomatic pulmonary sarcoidosis. Patients with oral lesions of sarcoidosis should be screened for systemic disease.