Lupus psychosis: an unusual cause of acute confusion presenting to acute medicine.

A young lady was brought to the hospital by the police after they found her wandering in the streets far away from her home behaving oddly. At admission, she was confused and had various delusional thoughts accompanied by visual and auditory hallucinations. After she was identified and her old medical notes were retrieved, it was found that she had a diagnosis of systemic lupus erythematosus (SLE) previously for which she declined any treatment.

Weil's disease in a temperate climate: diagnostic uncertainty and the importance of prompt antibiotic treatment.

A man in his 50s presents with a short history of rigors, back pain and dark urine. This was associated with scleral icterus. He was initially treated as urosepsis due to perinephric fat stranding on his first CT but continued to deteriorate with worsening sepsis requiring intensive care admission.

Making research everybody's business-Innovation to introduce Foundation doctors to research.

In order to train a future workforce able to meet the needs of its patients it is vital to ensure that opportunities to engage in research are inbuilt to training programmes. This strategy meets national recommendations recently published by NIHR, RCP and GMC. A nationally funded expansion of 'standard' Foundation programmes offers a unique opportunity to develop innovative new posts which include exposure to clinical research.

Persistent renal replacement requirement following fulminant psittacosis infection in pregnancy.

is a zoonotic bacterial infection that most commonly causes mild flu-like symptoms in humans. However, in pregnancy, it can present as fulminant psittacosis associated with systemic illness, disseminated intravascular coagulation, renal and hepatic failure. We describe a case of a veterinary nurse in her 30s who presented at 32 weeks' gestation with rapidly progressive multiorgan failure, with positive, serology.

Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial.

Unlabelled: The National Optimal Lung Cancer Pathway recommends rapid progression from abnormal chest X-rays (CXRs) to CT. The impact of the more rapid reporting on the whole pathway is unknown. The aim of this study was to determine the impact of immediate reporting of CXRs requested by primary care by radiographers on the time to diagnosis of lung cancer.

Embolisation of iatrogenic lumbar artery bleed causing psoas haematoma following elective lumbar puncture.

The case of a female patient in her 50s presenting as a surgical emergency with abdominal pain and a positive Obraztsova's sign. Seven days prior to the presentation, a lumbar puncture (LP) had been performed to investigate severe headaches and exclude a subarachnoid haemorrhage. The patient was subsequently found to have an acute lumbar arterial bleed causing haemodynamic instability and a psoas haematoma.

Building the barricade-DIY slit lamp breath shield.

Ophthalmologists were concerned about the risk of SARS-COV-2 transmission via droplets given the close proximity to the patient during slit lamp examination. There is a need to design a simple, low-cost, waterproof breath shield to minimise risk of infection.Dimensions of the Haag-Streit slit lamp (model BM 900) were recorded to guide accurate design of the breath shield.

Sumatriptan dose increase-induced acute angle closure glaucoma in chronic migraine sufferer.

In this case study, we explore a case of bilateral acute angle closure (AAC) attack detected in a 52-year-old female patient with no other ophthalmic background or predisposition to angle closure, following an increase of her regular sumatriptan dose used for migraine relief. Even though the initial presentation was misinterpreted as migraine attack, it nevertheless alerted the treating physicians to immediate cessation of the drug, allowing for the pertinent ocular symptomatology to be unveiled. Drug-induced bilateral AAC is a rare occurrence and can lead to significant ocular morbidity if not detected and treated early.

Pfeifer-Weber-Christian disease and successful treatment with mycophenolate mofetil: a case report.

Inflammatory conditions manifest with a broad spectrum of signs and symptoms. Panniculitis is such a condition affecting the subcutaneous fat and presents as tender erythematous nodules. It is also associated with a systemic response and has been described in the literature as early as in 1892 by Pfeifer and in the 1920s by Weber and Christian.