Editorial : Learnings from all walks of medical practice
Saravanan, Ponnusamy
Saravanan, Ponnusamy
Affiliation
University of Warwick, Coventry; George Eliot Hospital NHS Trust, Nuneaton
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Publication date
2024-03
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Abstract
Delighted to write my first editorial for this month's Clin Med on a topic that is close to my heart. Despite the prominence of evidence-based medicine, practical wisdom often gets sidelined. In this issue, Melson et al1 highlight the importance of how ‘doing simple things right most of the time’ is what needed to reduce harm in frail older patients with diabetes admitted to hospitals. Deintensification of treatment is crucial for those with high risk of falls which could potentially reduce hospital occupancy of people with diabetes. Graham-Brown et al shed light on the current state of acute kidney injury (AKI) across 24 NHS trusts.2 Regrettably, this nationwide audit reaffirms the importance of effective communication in discharge summaries for reducing post-AKI mortality. Clinicians must remain vigilant, recognising that our duty of care extends beyond hospital walls, especially amid resource constraints that we all are facing currently.
Penicillin allergy poses life-threatening risks. Yet, many patients labelled as penicillin-allergic may not actually be allergic to it and can tolerate it well. Anton-Vasquez et al demonstrate how active review can facilitate appropriate antibiotic prescribing, a simple measure may help combating antimicrobial resistance.3 Following the ‘simple’ theme, Espejo and colleagues in a single centre study illustrate how assessing mobility and mental state using the AVPUC scale in the emergency department can predict ICU admission and 30-day mortality.4
Headache is very common clinical presentation in emergency departments. Bahra et al’s5 pilot study uses a novel five-questions screening tool for differentiating secondary headaches requiring further investigation. The current issue's CME topic neurology spans common conditions like epilepsy to rare ones such as Huntington's disease and presents the need for neuropalliative care.6, 7, 8, 9, 10 Acute physicians will find valuable insights on managing these conditions in acute settings. Additionally, the issue covers new national stroke guidelines, highlighting opportunities for enhancing care.11
Finally, cardiometabolic disorders claim numerous lives globally, underscoring the imperative for improved care and training, as emphasised in two short communications.12,13 With the rapid evolution of therapies for diabetes and dyslipidaemia, updating training curricula is vital for delivering high-quality personalised medicine.
Citation
Saravanan P. Editorial: Learnings from all walks of medical practice. Clin Med (Lond). 2024 Mar;24(2):100201. doi: 10.1016/j.clinme.2024.100201.
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Article
Description
© 2024 The Author(s). Published by Elsevier Ltd on behalf of Royal College of Physicians. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)