“Covid-19: In the footsteps of Ernest Shackleton” is a brief communication, just published online in Thorax. It describes a cruise ship which set sail after the COVID pandemic was declared, en route for the Antarctic. All passengers had temperature checks on embarkation, but a week into the trip some passengers developed fevers and the […]
Guidelines for the diagnosis and management of asthma: a look at the key differences between BTS/SIGN and NICE
John White, James Paton, Robert Niven, Hilary Pinnock On behalf of the British Thoracic Society The British Thoracic Society first produced a guideline on asthma and its management in 1990. The first collaborative guideline with the Scottish Intercollegiate Guideline Network (SIGN) using evidence-based medicine methodology was published in 2003 (1). It has since become a […]
Nivolumab Data Presented
http://www.bbc.co.uk/news/health-32936877 More to follow, no doubt. And there might *just* be a bit of journalistic hyperbole in there, but might this be some hope for lung cancer patients? […]
I broke my stethoscope this week. I was listening to a chest, on a ward round, as you do, and the ear-pieces just went all wonky. The metal spring hidden in the rubber tubing had snapped. My stethoscope is like Trigger’s broom – I’ve had the same stethoscope since 4th year of medical school; I’ve […]
Are you asleep yet?
I don’t do a lot of sleep medicine. It’s never appealed to me. But I work in a relatively small department, so it’s inevitable that I will see people with sleep apnoea, and have to deal with it. In all senses. We have a relatively small population to serve – about 450,000 across the whole […]
How many decisions do you make in a day? How many could you? Or should you? Last weekend I moved house. A weekend full of decisions. Not massively meaningful decisions you might think, but you’ve probably not met my wife. What should we take first? Where should we put the sofas? Where should we put […]
Exercise, but exercise restraint?
I wrote last time about the ongoing problem of breathlessness in our patients, with no organic cause beyond obesity. My usual response is to encourage weight loss by increased exercise – seems to be a winner, as exercise not only leads to weight loss, but it’s really good for us, right? And those patients who […]
We manage our ward work differently these days. Different from when I was a lad. We do blocks of time on the ward, looking after all the patients in the ward for those two weeks. It makes for a high intensity fortnight, not least because we look after all the patients in the high dependency […]
I teach the first year medical students about breathlessness. I also teach the FY docs, ST docs, nurses, physios, and anyone who’ll listen, about breathlessness. I’m a stickler for minutiae, so I spend at least one slide, usually a couple, teaching, then reminding, that breathlessness is a symptom, not a sign. One cannot tell if […]
NEJM Images in Medicine This Week
A nice image in medicine in the NEJM this week – not something we see a lot, but my radiology colleagues are always telling us to look under the diaphragm, behind the heart, and behind the clavicles. Nice example of why they’re right. Sometimes. […]