treatment

Acute abdominal pain: An unusual medical cause

Abstract

Lyme disease is an infectious illness that arises from the spirochete, Borrelia burgdorferi transmitted via a bite by Ixodid ticks. There were 768 cases in the United Kingdom (incidence 1.46/100,000) identified by the Health Protection Agency in 2006. Clinical manifestations of Lyme disease can be multi-systemic. It is important for the acute physician to be aware of this condition. Its relative infrequency and unusual presentation can result in delayed diagnosis with potential for suboptimal outcome. Here, we present a case of Lyme disease presenting with abdominal pain and intestinal dysmotility.

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Acute Asthma in Adults: Controversies and Best Practice

Abstract

Asthma in the emergency care setting is common and may be life-threatening. Last year the British Thoracic Society updated their guidelines for the management of asthma, however some treatments remain controversial and there is variation in adherence to these and other national and international guidelines.

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Psoas Abscess: Diagnosis and Treatment

Abstract

Psoas abscess is an uncommon presentation on the acute medical take. However recognition and appropriate treatment is essential. This review is designed to highlight the clinical features, microbiology, diagnostic tests and treatment for this condition. In order to illustrate some of the pitfalls and complexities in the management of psoas abscess we have included a case history of a patient who was recently treated in our department.

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Management of Tuberculosis for the Acute Physician

Abstract

Tuberculosis is increasing world-wide and also in England and Wales, where there are marked geographical and ethnic variations. Acute physicians should be aware of this, and also of the variable manifestations of this multisystem disease, as well as current epidemiology which informs clinical risk stratification. Treatment is highly evidence based, and bacteriological confirmation should be sought whenever possible, partly because of the current level of drug resistance.

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