We bring you the latest news from the healthcare about the health care in the United Kingdom.

zondag 4 november 2018

DTB: Spontaneous splenic rupture due to rivaroxaban

Spontaneous splenic rupture due to rivaroxaban

In conjunction with BMJ Case Reports, DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years.

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  • Restrictions on the carriage of medicines (including controlled drugs) vary from country to country.

  • The International Narcotics Control Board and the International Society of Travel Medicine publish details of national regulations on travelling with controlled drugs.

  • A Home Office personal import/export licence is required if a traveller is carrying a supply of controlled drugs (into or out of the UK) that will last more than 3 months or will be travelling with controlled drugs for 3 months or more.

  • Travellers must check the local rules that apply to the transport of medicines for each country they enter and leave.

  • Travellers must check whether airlines or airports have additional requirements for the transport of medicines.

    Introduction

    High-profile cases of British tourists arrested for carrying medicines across international borders have highlighted the risks associated with travelling without appropriate authorisation.

  • Restrictions on travelling with medicines

    Key learning points

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    Five-day nitrofurantoin is better than single-dose fosfomycin at resolving UTI symptoms

    Review of: Huttner A et al. Effect of 5-day nitrofurantoin vs single dose fosfomycin on clinical resolution of uncomplicated lower urinary tract infection in women. JAMA 2018;319(17):1781–9.

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    Exercise is an important intervention for treating intermittent claudication

    Review of: Lane R et al. Exercise for intermittent claudication. Cochrane Database of Syst Revs 2017;12:10.1002/14651858.CD000990.pub4.

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    Audit of COPD exacerbations in secondary care

    Review of: Review of: Stone RA et al. COPD: working together. National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme: clinical audit of COPD exacerbations admitted to acute hospitals in England and Wales. 2017. National Clinical Audit Report. London. RCP, April 2018.

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    Non-adherence to prescribing guidelines for reduced kidney function puts older people at risk

    Review of: Wood S et al. Application of prescribing recommendations in older people with reduced kidney function: a cross-sectional study in general practice. Br J Gen Practice 2018; 68: e378–87.

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    Ulipristal acetate (Esmya): restrictions on use

    Safety alert: Esmya (ulipristal acetate) for symptoms of uterine fibroids: restrictions to use and requirement to check liver function before, during and after treatment.1,2

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    Ideal model of care for multimorbidity: the search continues

    Imagine you are one of the 65% of adults in the UK with multimorbidity. You will have several long-term conditions, including depression, and may be taking five or more medicines. There will be many visits to your general practice surgery each year: twice for the diabetes clinic with appointments for blood tests beforehand and another for retinal screening; appointments with the nurse for a chronic obstructive pulmonary disease review, a blood pressure check and influenza vaccination; and a handful of consultations with the GP to address depression and osteoarthritis. Most of these will be dealing with one problem at a time, following single-condition guidelines that may be based on evidence of limited applicability to you.1 You will make regular trips to the community pharmacy and may be offered an annual Medicines Use Review with the pharmacist. Being on the receiving end of all this care can feel...

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    Correction: An update on the management of gout

    In the article 'An update on the management of gout' (DTB 2018;56:9–12), the following statement is incorrect: 'Prophylaxis should be considered when starting ULT, and based on the evidence from two recent systematic reviews, BSR recommends colchicine 500mg once or twice daily for up to 6 months.'

    The sentence should read: 'Prophylaxis should be considered when starting ULT, and based on the evidence from two recent systematic reviews, BSR recommends colchicine 0.5mg once or twice daily for up to 6 months.'

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