As the profile of Acute Medicine grows, the development of an academic limb to the specialty is a logical and necessary step. This edition of the journal features an article written by Professor Derek Bell, the first chair of Acute Medicine, who took up this appointment in Imperial College, London earlier this year. Subtitled ‘a […]
Acute medicine was recognised as a subspeciality of General (Internal) Medicine by the Specialist Training Authority in July 2003. In practice it had been growing as a clinical entity for over a decade and several reports have been published.1, 2, 3 The most recent Royal College of Physicians report on Acute medicine: making it work for patients4 states “Acute medicine in the UK requires the development of an academic and research base in order to support teaching and training at medical undergraduate and postgraduate level, to support basic and clinical research, to develop clinical standards, and to provide audit tools for the assessment of clinical performance.”
Acute Medicine and Academic Medicine – a unique opportunity to improve health care Read More
Acute Medicine remains high on the agenda at all levels of organisation and planning in Healthcare provision and training in the UK. In March 2006, an RCP report to the Health Committee Inquiry on Workforce Needs and Planning for the Health Service said, ”The specialty of acute medicine is a new initiative and is likely to deliver improvements in delivery of this critical and expanding area of care in the NHS. To drive development we believe the number of SpRs and consultants in the field need rapid expansion to gain critical mass to deliver acute medicine efficiently.”
The Society for Acute Medicine:Trainees’ News Read More
Critical care is now a well established specialty in the UK. The rapid development of acute medicine across the country has many similarities to the development of critical care in the 1960’s. How these two specialties interface will be an important issue in the way acute hospitals deliver care over the next few years. The Surviving Sepsis Campaign resuscitation care bundle is a useful tool to help develop this interface.
Surviving Sepsis and the acute medicine – critical care interface Read More
Abstract
Native renal artery stenosis resulting in hypertensive encephalopathy is exceptionally rare, with only 3 previous case reports in adults. We report such a case in a previously well 20 year old female.
An unusual cause of fitting in a 20 year old girl Read More
Introduction
Venlafaxine is a selective serotonin and noradrenaline re-uptake inhibitor (SNRI), used in the treatment of depressive illness and anxiety disorder. Overdose may result in cardiac and neurotoxicity, but there are very few case reports of fatal isolated Venlafaxine overdose.1 The following case highlights the potentially serious consequences of overdose of this drug.
Fatal Venlafaxine poisoning: Case Report Read More
Abstract
Travel-related infections are becoming more common as travel abroad becomes easier. Whilst most imported infections will have recognisable features some of the more obscure will be less familiar to the clinician. A detailed travel history including all stopovers is vital as is a thorough examination. Falciparum malaria is a medical emergency and prompt treatment is essential. Emerging infections such as SARS and avian influenza provide new challenges in diagnosis for the admitting team.
Fever in the returning traveller Read More
Abstract
Infective endocarditis (IE) is an infection, usually of bacterial aetiology, which can affect any part of the endovascular surface of the heart or large intrathoracic vessels but most commonly affects cardiac valves. Without treatment this condition is invariably fatal and even with treatment is associated with a high incidence of morbidity and mortality. This article looks at the difficulties in diagnosing IE and the investigations used to confirm the diagnosis. It also lists the major causes of IE and its management.
The management of acute endocarditis Read More
Abstract
Symptoms compatible with a transient ischaemic attack (TIA) are a common reason to seek medical attention. Most TIAs resolve within an hour and leave no residual symptoms or signs. This can make the diagnosis problematic, but perhaps more importantly, can lead both patient and doctor to underestimate the importance of the event, and the urgency with which it should be addressed. The risk of a subsequent stroke is high: around 8% after seven days and 17-18% after three months.1,2 This review aims to discuss some of the issues surrounding the investigation and management of TIAs, including the potential role of Acute Medicine in the provision of timely and appropriate management for these patients.
Management of transient ischaemic attacks Read More
Introduction
The term shock probably originates from an inappropriate English translation of the word choc, which was used by the French army surgeon Henri Francois Le Dran to describe the collapse of vital functions culminating in death that he observed in soldiers who had been struck by missiles. In the 1800’s John Collins Warren described shock as a ‘momentary pause in the act of death’, a description which remains accurate to this day if the diagnosis is missed or delayed. Shock can be considered as the final pathway through which a variety of pathological processes lead to cardiovascular failure and death. Given the enormous spectrum of disease that can lead to shock it is not surprising that it is an extremely common cause of admission to the intensive care unit.
Recognition and management of the patient with shock Read More