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Seven days in medicine: 6-12 April

General practitioners currently take around two thirds of the 372 million appointments made at general practice surgeries in England every year, but they and other experts, interviewed by the public services think tank Reform, said that around half of these appointments could be taken by nurses and other clinicians. The report added that the government’s target of recruiting an extra 5000 GPs should be abandoned and that bigger practices and new technology could deliver better access and avoid millions of unnecessary visits to emergency departments (see the full BMJ story at doi:10.1136/bmj.i2082).  
feeds.bmj.com
over 3 years ago
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6

Seven days in medicine: 6-12 April

General practitioners currently take around two thirds of the 372 million appointments made at general practice surgeries in England every year, but they and other experts, interviewed by the public services think tank Reform, said that around half of these appointments could be taken by nurses and other clinicians. The report added that the government’s target of recruiting an extra 5000 GPs should be abandoned and that bigger practices and new technology could deliver better access and avoid millions of unnecessary visits to emergency departments (see the full BMJ story at doi:10.1136/bmj.i2082).  
feeds.bmj.com
over 3 years ago
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1

Mild cough and decreased breath sounds in an 82 year old woman

An 82 year old woman presented to her general practitioner with a tickling cough and symptoms of an upper respiratory tract infection. Her blood gas saturations were normal and she was otherwise well. However, she had a history of tuberculosis and had undergone an unknown operation many years ago. The GP thought that she had decreased breath sounds at …  
feeds.bmj.com
over 3 years ago
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1

Mild cough and decreased breath sounds in an 82 year old woman

An 82 year old woman presented to her general practitioner with a tickling cough and symptoms of an upper respiratory tract infection. Her blood gas saturations were normal and she was otherwise well. However, she had a history of tuberculosis and had undergone an unknown operation many years ago. The GP thought that she had decreased breath sounds at …  
feeds.bmj.com
over 3 years ago
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0

Health anxiety: the silent, disabling epidemic

“We are glad to say, Mr Jones, that all your test results are normal and you have nothing to fear.” Mr Jones has received this message many times after being examined for many severe diseases such as cancer, multiple sclerosis, and heart disease, which over the years he has been convinced he must have. Yet, this is the core of his problem—despite how much he would like to, he cannot do what the doctor says: stop worrying. He used to attend his general practitioner frequently to be reassured that nothing was wrong with him, but the reassurance was only short lived and then the worrying started all over again. After many years of distress, Mr Jones is embarrassed that he cannot control his health worries and preoccupation and has lately avoided contact with his GP, knowing it does not help him very much.  
feeds.bmj.com
over 3 years ago
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0
0

Health anxiety: the silent, disabling epidemic

“We are glad to say, Mr Jones, that all your test results are normal and you have nothing to fear.” Mr Jones has received this message many times after being examined for many severe diseases such as cancer, multiple sclerosis, and heart disease, which over the years he has been convinced he must have. Yet, this is the core of his problem—despite how much he would like to, he cannot do what the doctor says: stop worrying. He used to attend his general practitioner frequently to be reassured that nothing was wrong with him, but the reassurance was only short lived and then the worrying started all over again. After many years of distress, Mr Jones is embarrassed that he cannot control his health worries and preoccupation and has lately avoided contact with his GP, knowing it does not help him very much.  
feeds.bmj.com
over 3 years ago
Preview
0
0

Health anxiety: the silent, disabling epidemic

“We are glad to say, Mr Jones, that all your test results are normal and you have nothing to fear.” Mr Jones has received this message many times after being examined for many severe diseases such as cancer, multiple sclerosis, and heart disease, which over the years he has been convinced he must have. Yet, this is the core of his problem—despite how much he would like to, he cannot do what the doctor says: stop worrying. He used to attend his general practitioner frequently to be reassured that nothing was wrong with him, but the reassurance was only short lived and then the worrying started all over again. After many years of distress, Mr Jones is embarrassed that he cannot control his health worries and preoccupation and has lately avoided contact with his GP, knowing it does not help him very much.  
feeds.bmj.com
over 3 years ago
Preview
0
0

Health anxiety: the silent, disabling epidemic

“We are glad to say, Mr Jones, that all your test results are normal and you have nothing to fear.” Mr Jones has received this message many times after being examined for many severe diseases such as cancer, multiple sclerosis, and heart disease, which over the years he has been convinced he must have. Yet, this is the core of his problem—despite how much he would like to, he cannot do what the doctor says: stop worrying. He used to attend his general practitioner frequently to be reassured that nothing was wrong with him, but the reassurance was only short lived and then the worrying started all over again. After many years of distress, Mr Jones is embarrassed that he cannot control his health worries and preoccupation and has lately avoided contact with his GP, knowing it does not help him very much.  
feeds.bmj.com
over 3 years ago
Preview
0
0

Health anxiety: the silent, disabling epidemic

“We are glad to say, Mr Jones, that all your test results are normal and you have nothing to fear.” Mr Jones has received this message many times after being examined for many severe diseases such as cancer, multiple sclerosis, and heart disease, which over the years he has been convinced he must have. Yet, this is the core of his problem—despite how much he would like to, he cannot do what the doctor says: stop worrying. He used to attend his general practitioner frequently to be reassured that nothing was wrong with him, but the reassurance was only short lived and then the worrying started all over again. After many years of distress, Mr Jones is embarrassed that he cannot control his health worries and preoccupation and has lately avoided contact with his GP, knowing it does not help him very much.  
feeds.bmj.com
over 3 years ago
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0
0

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 3 years ago
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0

Seven days in medicine: 4-10 May

Two UK general practitioners are on trial for manslaughter for not visiting or summoning an ambulance to a 12 year old boy, Ryan Morse, who died from Addison’s disease in 2012. Joanne Rudling and Lindsey Thomas could have saved Ryan’s life if they had acted in response to phone calls from his mother, Cardiff Crown Court was told at the trial opening. John Price QC, prosecution counsel, told the jury that the doctors could not have been expected to diagnose Addison’s disease but should have recognised that Ryan needed immediate medical treatment. The trial is expected to last four weeks. (See full BMJ story at doi:10.1136/bmj.i2603.)  
feeds.bmj.com
over 3 years ago
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0
0

Seven days in medicine: 4-10 May

Two UK general practitioners are on trial for manslaughter for not visiting or summoning an ambulance to a 12 year old boy, Ryan Morse, who died from Addison’s disease in 2012. Joanne Rudling and Lindsey Thomas could have saved Ryan’s life if they had acted in response to phone calls from his mother, Cardiff Crown Court was told at the trial opening. John Price QC, prosecution counsel, told the jury that the doctors could not have been expected to diagnose Addison’s disease but should have recognised that Ryan needed immediate medical treatment. The trial is expected to last four weeks. (See full BMJ story at doi:10.1136/bmj.i2603.)  
feeds.bmj.com
over 3 years ago
Preview
0
0

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 3 years ago
Preview
0
2

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 3 years ago
Preview
0
1

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 3 years ago
Preview
0
1

Seven days in medicine: 4-10 May

Two UK general practitioners are on trial for manslaughter for not visiting or summoning an ambulance to a 12 year old boy, Ryan Morse, who died from Addison’s disease in 2012. Joanne Rudling and Lindsey Thomas could have saved Ryan’s life if they had acted in response to phone calls from his mother, Cardiff Crown Court was told at the trial opening. John Price QC, prosecution counsel, told the jury that the doctors could not have been expected to diagnose Addison’s disease but should have recognised that Ryan needed immediate medical treatment. The trial is expected to last four weeks. (See full BMJ story at doi:10.1136/bmj.i2603.)  
feeds.bmj.com
over 3 years ago
Preview
0
2

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 3 years ago
Preview
0
1

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 3 years ago
Preview
0
1

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 3 years ago
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0
9

Chest and neck pain in a 22 year old woman

A 22 year old woman was referred to the emergency department by her general practitioner owing to severe chest pain that was now radiating to her neck. The pain has been worsening over the past 24 hours. It first started when she was eating fish at a seafood restaurant. What does the lateral soft …  
feeds.bmj.com
over 3 years ago