Faecal immunochemical testing (FIT) has a high sensitivity for the detection of colorectal cancer (CRC). In a symptomatic population FIT may identify those patients who require colorectal investigation with the highest priority. FIT offers considerable advantages over the use of symptoms alone, as an objective measure of risk with a vastly superior positive predictive value for CRC, while conversely identifying a truly low risk cohort of patients. The aim of this guideline was to provide a clear strategy for the use of FIT in the diagnostic pathway of people with signs or symptoms of a suspected diagnosis of CRC. The guideline was jointly developed by the Association of Coloproctology of Great Britain and Ireland/British Society of Gastroenterology, specifically by a 21-member multidisciplinary guideline development group (GDG). A systematic review of 13 535 publications was undertaken to develop 23 evidence and expert opinion-based recommendations for the triage of people with symptoms of a suspected CRC diagnosis in primary care. In order to achieve consensus among a broad group of key stakeholders, we completed an extended Delphi of the GDG, and also 61 other individuals across the UK and Ireland, including by members of the public, charities and primary and secondary care. Seventeen research recommendations were also prioritised to inform clinical management.

This chapter explores the links between globalization and infectious diseases in relation to changes in four major spheres—economic, environmental, political and demographic, and technological. It highlights areas where the evidence suggests that processes of globalization have led to changes in the distribution, transmission rate, and, in some cases, management of infectious diseases.

The classification of disease burdens is an important topic that receives little attention or debate. One common classification scheme, the broad cause grouping, is based on etiology and health transition theory and is mainly concerned with distinguishing communicable from noncommunicable diseases. This may be of limited utility to policymakers and planners. We propose a broad care needs framework to complement the broad cause grouping. This alternative scheme may be of equal or greater value to planners. We apply these schemes to disability-adjusted life year estimates for 2000 and to mortality data from Tanzania. The results suggest that a broad care needs approach could shift the priorities of health planners and policymakers and deserves further evaluation.

Introduction: A contact with the venoms produced by a pelagic jellyfish type, known as Pelagia noctiluca, can induce both local and general symptoms. We report here a case of jellyfish envenomation with a mauvestinger in a diabetic patient who developed localized skin involvement, delayed systemic reaction and hyperglycemia. To our knowledge this is the first report of this kind in literature. Case Report: The patient, an adult male tourist with type I diabetes, was stung on the forehead by a mauve stinger jellyfish while swimming on the Maltese coast in summer 2012. Local symptoms were initially of an erythematous, edematous and a vesicular topical lesion in the forehead region, followed by massive eye swelling 72 hours after the incident. In addition, his normally well controlled diabetes was affected, with an unusual severe episode of hyperglycemia that did not respond readily to alterations in his insulin regime. Conclusion: Pelagia noctiluca is a jellyfish known for its strong cytotoxic properties. We hypothesize that the stress

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