Clinical Practice Features
A case of hypervitaminosis D in an older patient
This case focuses on how a patient acquired a toxic and very high level of vitamin D while on a recommended daily maintenance dose. It emphasises the need for best practice to ensure patients’ safety in terms of monitoring of vitamin D levels in patients with renal failure to prevent vitamin D toxicity.
A case of asymptomatic hyperkalaemia
Falls: more than just mechanical
Serving an ageing population is one of the biggest challenges faced by the NHS. Falls are a common presentation in this cohort where the cause is often multi-factorial and reversible. We as clinicians need to dig deeper in our histories, observe more closely in our examinations and broaden our differentials to ensure we don’t slip up.
Early warning systems in the community: a cautious welcome
Early warning systems have become part of regular and mainstream clinical practice in secondary care. There have been recent moves to attempt to utilise early warning scoring systems in the community to identify patients at risk of deteriorating and prioritise those requiring clinical review. There are numerous challenges to this approach, and this has been regularly discussed in the community setting about how best to consider its introduction and implementation.
The ageing eye
Flu campaign and national updates
Since early January, influenza hospital admission levels have risen by up to 50%. This outbreak has resulted in national updates in influenza plans. Annual influenza vaccination is still the best available method of protection against influenza, and is the primary strategy for disease control and prevention.
Common skin problems in the elderly
Updated guidance on diagnosis and management of chronic asthma
Opiates and chronic pain management in the older patient
It has long been known that opiates are potentially addictive thereby limiting their medical use, making them susceptible to abuse and adding to the global drug problem. Physicians should avoid the use of opiates to treat conditions that are likely to be chronic, without a well-defined culprit, and without prior exploration with the patient of the potential implications.