background Out-of-hospital cardiac arrest survival rates in the UK are poor, and non-medically trained individuals have been identified to perform substandard cardiopulmonary resuscitation (CPR). Millions watch televised medical dramas and, for many, these comprise their only education on CPR. This study aims to investigate the quality of CPR portrayed on these programmes and whether this has an effect on public knowledge. Methods Prospective observational study of 30 consecutive episodes of three popular medical dramas. Public knowledge of CPR and viewing habits were assessed with a survey of non-medically trained personnel. results 90 episodes were reviewed with 39 resuscitation attempts shown. Chest compression rates varied from 60 to 204 compressions per minute with a median of 122 (95% CI 113 to 132).
1. Three cases of osteomyelitis of a metatarsal sesamoid bone are described. 2. The diagnosis should be considered in patients with acute pain under the first metatarsophalangeal joint, particularly if the temperature is elevated. 3. Failure ofdiagnosis may lead to persistent disability until sinus formation and sequestration dictate operative intervention. 4. Early antibiotic therapy may lead to resolution of the infection.
1. The management of gas gangrene by hyperbaric oxygen is described. 2. The mode of action, administration and risks of hyperbaric oxygen are discussed. 3. A series of seventeen cases, with one death, is recorded from a hospital unit with a small chamber, using two atmospheres in pure oxygen.
We are grateful to Dr Robert A. Goldstone of Paterson, New Jersey, for pointing out an error in the article by M. R. Colwill and R. H. Maudsley on "The Management of Gas Gangrene with Hyperbaric Oxygen Therapy" in this Journal of November 1968, 50-B, 732. On page 742, the second line should read "They recommend the use of/ow molecular weight dextran (dextran 40, Rheomacrodex) to prevent the sludging and thrombosis that also occur . . ." The correction is important because high molecular weight dextran (dextran 70, Macrodex) would not be expected to have the desired effect.
BackgroundThe Baveno VI consensus identifies patients with compensated advanced chronic liver disease (cACLD) who can safely avoid screening endoscopy. However, concordance in clinical practice with this guidance is unknown. We audited clinical practice and the provision of transient elastography (TE) aiming to identify potential cost savings and benefits.
Methods
Retrospective data collection from 12 sites across London over 6 months by reviewing oesophagogastroduodenoscopy (OGD) reports, platelet count and TE results as well as information on site-specific provision of TE.
ResultsThree-hundred and fifty-one screening procedures were identified; 177 (50.43%) had a TE test performed within the preceding 12 months; 142 (80.23%) patients with a recent TE test did not meet criteria for screening OGD. TE provision varied widely between sites.
ConclusionImproving concordance with the Baveno criteria through improved provision of TE would have benefits for patients, healthcare systems and the environment and would help to address the challenges of moving on from the COVID-19 pandemic.
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