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BACKGROUND Reports of non-invasive ventilation (NIV) use in clinical practice reveal higher mortality rates than in corresponding randomised clinical trials. AIM To explore factors related to chronic obstructive pulmonary disease (COPD) admissions and NIV use that may explain some of the previously reported high mortality rates. METHODS National UK(More)
UNLABELLED The purpose of this study was to determine if routine clinical assessment could reliably predict in-hospital death in patients admitted with acute exacerbation of COPD (AECOPD). METHODS In a case-crossover study the case records of AECOPD related deaths were reviewed. Clinical and laboratory variables including performance status (WHO-PS) and a(More)
Platypnoea orthodeoxia syndrome is a rare condition in which shortness of breath and hypoxaemia occur when upright and resolve when prone. The hypoxaemia results from increased right to left shunting of deoxygenated blood, when standing, through a patent foramen ovale (PFO), atrial septal defect (ASD) or other right to left shunt, in the absence of raised(More)
Over the past century, the UK has made significant progress in combating tuberculosis (TB) through improved health care and better preventative measures. However, it has now been identified as a new threat that needs concerted action. An important component in dealing with this threat is identifying and treating people with latent infection. This will(More)
A pleural effusion is the accumulation of fluid in the pleural space. It is a relatively common finding in clinical practice. The diagnostic approach to the patient presenting with a pleural effusion is aimed at defining the effusion as a transudate or an exudate. This review summarises the initial assessment and investigation of pleural effusions diagnosed(More)
A 62-year-old man presented with a 6-week history of shortness of breath, weight loss and painful swelling of the great toe. Examination elicited an ulcerated swelling of the right great toe, thought to be an ingrowing toenail. Chest 'crackles' and an enlarged supraclavicular lymph node were detected. Biopsies of the toe swelling and bronchi both showed(More)