Hepatic Encephalopathy in the Hospitalized Patient: A Review for Hospitalists.

Hepatic encephalopathy is a well-recognized complication of decompensated cirrhosis. It is a reversible state of neurocognitive decline, the etiology of which is multifactorial. Diagnosis is predominantly clinical and usually a diagnosis of exclusion.

Supply problems of unlicensed and off-label medicines after discharge.

A total of 709 unlicensed and off-label medicines were prescribed for 338 patients discharged from a paediatric hospital between 1 November 2003 and 31 January 2004. Thirty three per cent of patients had difficulty obtaining these medications in primary care which caused treatment disruption. The main problems were: (1) community pharmacies being unable to supply; and (2) GPs' refusal to prescribe.