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CONTENTS

Editor-in-Chief Rob Miller MB BS(Hons) FRCP CBiol FRSB Editor Rebecca Linssen MA rebecca.linssen@markallengroup.com Editorial assistant Grace Elliott MSci grace.elliott@markallengroup.com Commercial Manager Colin Williams Colin.Williams@markallengroup.com Classified Sales Manager Daniel Doherty daniel.doherty@markallengroup.com Production Manager Kyri Apostolou Publishing Director Chloe Benson Managing Director Anthony Kerr Chief Executive Officer Ben Allen

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Volume 83

EDITORIALS

72 Long delays to admission in emergency departments cause higher mortality: implications for the 4-hour target Stephen Black 75 Safety and transparency in surgical innovation Jane M Blazeby, Sian Cousins, Anne Pullyblank

REVIEWS

Part of www.markallengroup.com

British Journal of Hospital Medicine is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: +44 (0)20 7738 5454 Website: www.bjhm.co.uk

© MA Healthcare 2022. All rights reserved. No part of the British Journal of Hospital Medicine may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without written permission of the Publishing Director. The views expressed do not necessarily represent those of the editor or the British Journal of Hospital Medicine. Advertisements in the journal do not imply endorsement of the products or services advertised. Our privacy policy (http://privacypolicy. markallengroup.com) explains how we process, use and safeguard your data. ISSN 1750-8460 Printed by: Pensord Press Ltd, Blackwood, Gwent NP12 2YA

78 Primary biliary cholangitis:

advances in understanding and management Alex Smith, Benjamin Giles, Richard J Aspinall 87 When can anterior dislocations of the shoulder with an isolated fracture of the greater tuberosity be safely reduced in the emergency department? Derek N Effiom, Jonathan D Bartlett, Hassan Raja, Nick Aresti 96 Rhinosinusitis and its impact on quality of life in children Sabahat Ahmed, Amtul S Sami

ROUNDTABLE DISCUSSION

L t d l t h c a r e

H e a

M A

2 0 2 2

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104 The nutritional needs of moderate–late preterm infants Mark J Johnson, Caroline King, Bethany Boddy, Stan Craig, Joanna Males, Tom McEwan, Stephanie Tagani

March–April 2022

EDUCATION AND TRAINING UPDATE

113 Difficulties and educational challenges faced by international medical graduates in trust grade roles in the UK Melroy Rasquinha

QUALITY IMPROVEMENT

120 Improving delirium screening in older adults at the Royal United Hospital, Bath Christopher AJ Trew, Rachael Cross, Kate Howell, Chris Dyer

CASE REPORTS

125 Posterolateral migration of a sequestrated disc: magnetic resonance imaging findings demystified Winfred XT Goh, Steven BS Wong, Angela PY Chong, Phey M Yeap 128 A rare complication of retroperitoneoscopic radical nephrectomy: chylous ascites Julia Gibb, George Tanasescu, Yih Chyn Phan, Peter Osborn, Richard Robinson

IMAGES IN MEDICINE 131, 134

PERIOPERATIVE MEDICINE IN A NUTSHELL

132 Perioperative considerations for elective surgical patients following the COVID-19 pandemic Jason Patel, Manpreet Singh

British Journal of Hospital Medicine  March–April 2022

71

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