Unusual presentation of rheumatic fever in a 3-year-old child in the UK.

In the developed world, acute rheumatic fever (ARF) is rare. When it does arise, symptoms commonly include fever, arthralgia and rash. We describe a presentation of a 3-year-old child with ARF in a UK District General Hospital.

What is the optimum method of weaning intra-aortic balloon pumps?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is weaning an intra-aortic balloon pump by volume superior to ratio reduction in terms of failure of weaning, inotropic support and haemodynamic parameters? A total of 667 papers were identified as a result of the search described below. Six papers were relevant to the question asked.

Non elective re-admissions to an acute hospital in people with diabetes: Causes and the potential for avoidance. The WICKED project.

Introduction: Managing people with diabetes is a health priority worldwide. Cost benefit attempts at avoiding non elective admissions (NEA) have had some success. To develop an NEA avoidance service, we audited multiple NEA in those with diabetes.

Lifetime costs and outcomes of repair of Tetralogy of Fallot compared to natural progression of the disease: Great Ormond Street Hospital cohort.

Background: Tetralogy of Fallot is a congenital heart disease that requires surgical repair without which survival through childhood is extremely rare. The aim of this paper is to use data from the mandatory follow-up of patients with Tetralogy of Fallot to model the health-related costs and outcomes over the first 55-years of life.

Method: A decision analytical model was developed to establish costs and outcomes for patients up to 55 years after diagnosis and first repair of Tetralogy of Fallot compared to natural progression.