Objectives: To ascertain whether doctors were experiencing higher rates of distress during Covid-19 and whether this was impacted by demographic factors. Our hypotheses were that being a junior doctor, having a previous mental health diagnosis and treating Covid-19 positive patients would predict higher rates of distress. Methods: Cross-sectional survey conducted via Survey Monkey. Voluntary participants were recruited from the mailing list of a national-based referral service for doctors to psychiatrists. Distress was measured using the Kessler Psychological Distress Scale (K10). Demographic factors were analysed for predictive value of a higher rating on the K10. Areas of concern in relation to Covid-19 and preference for support services were measured on a Likert scale and compared to levels of distress. Results: The rate of very high distress was 15%. Being a junior doctor and having a previous mental health diagnosis were predictive factors of a higher K10 score. K10 was not affected by likelihood of contact with Covid-19-positive patients. Social isolation had a larger impact on mental health in the context of a previous psychiatric diagnosis. Face-to-face assessments were preferred. Conclusions: Rates of distress in doctors have been higher than baseline during Covid-19. Some groups have been particularly vulnerable.

Coined in 1961 by Hirsch and Helwig, the term chondroid syringoma refers to a rare mixed tumour of subcutaneous tissue. Histologically, these tumours are almost identical to pleomorphic adenomas, arising from salivary glands. With the obvious difference being the presence of sweat gland tissue (syringoma) within a matrix of cartilage (chondroid). These mixed tumours remain scarce throughout the world, with an incidence of less than 0.098%. The vast majority of cases are reported in middle-aged and older adults, where they typically present as painless swellings in the head and neck, which gradually grow in size.

infectious. Yet the infection is certainly not by contagion ; it is transmitted by the mosquito. The pathogenic microorganism has not yet been found. Can it be that the infectious diseases of temperate climates are transmitted in a similar fashion ? 7 It seems possible, but unlikely. Even so, we are not any nearer either the cause of the disease or the reason for the long immunity. But I believe that the discoverer of the cause will find with it the key to the innermost temple of the Theory of Immunity.

generally more or less red and inflamed; if cancerous, not so. Tenderness and heat indicate tuberculosis rather than cancer.In the diagnosis between tuberculous and primary cancerous lymph glands in old people the chief indications of cancer are hardness, close-clustering, deep-seated attachments and quick increase. In the cervical glands, which in old persons are the most frequent seats of both tubercle and cancer, the lower glands are generally tuberculous, the upper cancerous; the soft primary cancerous disease is very rare in the old. Cancerous disease in the old is often secondary to some comparatively trivial primary disease, tuberculous is very rarely so.As age advances rest and warmth and nourishing food become more important than any treatment by cod-liver oil or iron or iodine, or even sea or mountain air.It is remarkable that many persons have attained a great age under very insanitary conditions-in defiance of them, as it were. We sometimes hear the great ages of certain persons in a district quoted as evidence of the good sanitary state of the village or town, whereas a large proportion of the inhabitants may have died young, while some survivors, inured to the evil surroundings, may have attained to great age, thus exemplifying the ability of the human body to adapt itself to varying and even unfavourable conditions.The power of repair after injury and disease which is shown by some very old people is interesting and remarkable. Fractures (excepting the well-known fracture of the neck of femur) often unite as quickly as in younger persons, and wounds and ulcers often heal rapidly. It seems as though the nutritive efforts requisite for the work of healing may possibly take place more quietly and smoothly, with less of that nerve irritation and of haste which is incompatible with good speed or safe progress.It is always of the greatest importance to ensure regular and efficient action of the bowels by attention to diet and the administration of laxative drugs with tonic action, for example, cascara, colocynth, or aloin, with belladonna and strychnine. Saline aperients are as a rule too "cold" for the aged, and when administered must be combined with aromatics.A dose of calomel may frequently be given with much benefit to the old and those who are not very unsound. Its marked antiseptic qualities are very beneficial in purifying the alimentary tract, and so clearing out noxious bacterial toxirsa of gastro-intestinal -origin which give rise to many cases of chronic toxaemia ending even in general paralysis or tabes dorsalis. Few remedies are more useful in many cases of bronchitis with dyspnoea and inefficient expectoration in old people than a good purge, for example, the pulv. jalapa co.;it not only produces copious serous motions, but also acts on the kidneys, and thus, so to speak, drains the lungs.Diuretics, especially potassium acetate, are valuable where the skin is altered in structure with advancing years, and does not perspire. They seem to take the place of diaphoretics, which often fail in ...

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