The proverbial really has hit the fan. The Francis report on the Mid Staffs Hospitals investigation is damning against the culture of an organisation that seemed to have lost its ethos of “Caring for Patients” as the primary objective. Rather the obsession was to hit the “targets” imposed by regional and national policy. Managers colluded with clinicians to garner favourable scores with the wilful neglect of tending to the sick and needy. How have we travelled so far back so quickly? The recent revelation of a whistleblower, who has broken his £500K payment gagging clause, that his concern over deaths in the Lincolnshire Hospitals were ignored at senior managerial level, begs the question how widespread is this lack of transparency.
The assessment and interpretation of albuminuria is crucial in people with CKD. We will discuss recent developments in the field, the rationale for these changes, and the clinical implications of albuminuria.
Hirsutism is the term used for excessive terminal hair of male pattern distribution seen in women. Hirsutism is different from hypertrichosis which is a generalised excessive hair growth of non sexual distribution. Studies on hirsutism and scoring systems have shown that about 5 percent of women of reproductive age group have hirsutism. There are ethnic differences in normal hair distribution. It is rare for women with mild hirsutism and regular periods to have a serious medical problem but on the other hand rapidly progressive or new onset hirsutism especially if associated with virilising features may point towards a more serious diagnosis.
