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A population based study in Oxfordshire looks at underinvestigation of older patients with transient ischaemic attack and stroke and comes to predictable but important conclusions. The incidence of symptomatic carotid stenosis increases steeply with age, but in routine clinical practice older patients, especially those aged 80 or older, are substantially underinvestigated. Unfortunately, this is despite good evidence of major benefit from carotid endarterectomy in these patients and their willingness to have surgery.
Pressure ulcers are unwelcome and theories on how best to avoid them plentiful. So a meta-analysis of the evidence is timely. Using support surfaces, repositioning the patient, optimising nutritional status, and moisturising sacral skin are all appropriate strategies to prevent pressure ulcers. Unsurprisingly, many of the 59 randomised trials had important methodological limitations.
Neurostimulation of the …
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