Utility of biomarkers in the differential diagnosis of heart failure in older people: findings from the heart failure in care homes (HFinCH) diagnostic accuracy study.

Background: The performance of biomarkers for heart failure (HF) in older residents in long-term care is poorly understood and has not differentiated between left ventricular systolic dysfunction (LVSD) and HF with preserved ejection fraction (HFpEF).

Methods: This is the first diagnostic accuracy study in this population to assess the differential diagnostic performance and acceptability of a range of biomarkers against a clinical diagnosis using portable echocardiography. A total of 405 residents, aged 65-100 years (mean 84.

Heroin users' experiences of depression: a qualitative study.

Background: Heroin users represent a challenging group of patients for GPs, with a high morbidity including a high prevalence of depression. Compared to other groups, management of 'depression' in heroin users is likely to require different approaches. Aim.

The impact of nutritional status on the outcome of Indian patients undergoing neurosurgical shunt surgery.

Undernutrition is common in surgical patients, is frequently unrecognised and is strongly associated with adverse outcomes such as high rates of complications and mortality, worsening functional status and prolonged hospitalisation. Owing to the associated infection and symptoms such as repeated vomiting, a high prevalence of undernutrition is expected in hydrocephalus patients, which may contribute to their poor surgical outcomes. The aim of this study was to evaluate the influence of preoperative nutritional status on the outcome of Indian patients with hydrocephalus undergoing neurosurgical shunt surgery.

Coxiella burnetii infection of an aortic graft with multiple vertebral body erosion.

Q fever is caused by Coxiella burnetii and often has an insidious clinical presentation. We describe a rare case of Q fever infection of an aortic graft presenting with pyrexia and constant severe midlumbar pain due to erosion of multiple vertebral bodies. After successful treatment with graft resection and extra-anatomic vascular reconstruction, the patient continues on lifelong antibiotic therapy.