Iain Crossingham

Iain Crossingham

Affiliations: MRCP, FFICM Consultant Physician &Intensivist Medical Admissions Unit Royal Blackburn Hospital Haslingden Road Blackburn BB2 3HH UK

All Journals from Iain Crossingham

Exertional Syncope as a presenting feature in Guillain-Barré syndrome

Abstract

Guillain-Barré syndrome (GBS) is an acute demyelinating disorder of the peripheral nervous system that results in motor weakness, absent reflexes and autonomic nervous system dysfunction. Autonomic failure is reported in approximately 65 % of patientswith GBS and usually follows extensive motor involvement. In this case our patient presented with syncope and other signs of autonomic failure before the motor weakness developed. Few cases in the literature have reported features of autonomic failure before established weakness in GBS; to our knowledge, syncope has not been described previously as a presenting feature of GBS.

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Measuring Hospital Mortality

Abstract

The hospital standardised mortality ratio (HSMR) and the summary hospital mortality index (SHMI) are both in current use in the UK as measures of the performance of acute hospitals. Characteristics of both the acute hospital itself and of its local healthcare environment influence these indices. Whilst many hope that measures of mortality can be used as a surrogate for healthcare quality, this is an evolving area.

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