Clinical Medicine
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Severe hypercalcaemia mimicking acute myocardial infarction.
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PMID: 19891057 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Falk RH Tags: Clin Med Source Type: journals
Sepsis and septic shock: inching forwards.
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PMID: 19891058 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Inada-Kim M Tags: Clin Med Source Type: journals
Quality of care.
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PMID: 19886093 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Allan R Tags: Clin Med Source Type: journals
Vitiligo: what general physicians need to know.
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PMID: 19886094 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Gawkrodger DJ Tags: Clin Med Source Type: journals
Recruiting physicians to core medical training: how should it be done?
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PMID: 19886095 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Berkin L, Burr B Tags: Clin Med Source Type: journals
Teaching professionalism to junior doctors: experience of a multidisciplinary approach in the Foundation Programme.
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The Foundation Programme curriculum describes 'generic skills' for doctors, which illustrate many of the attributes of medical professionalism. Educators from the Dorset acute trusts have worked with faculty members of the School of Health and Social Care at Bournemouth University to create a course in professionalism for Foundation Programme Year 2 doctors. The course, held away from the hospital setting but facilitated by consultants as well as university staff, has six themes taught on different days: professionalism and judgement, relationship with society, accountability, teamworking and leadership, relationship w...
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Masding MG, McConnell W, Lewis C Tags: Clin Med Source Type: journals
Presenting the results of clinical trials to participants.
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PMID: 19886097 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Darbyshire JL, Holman RR, Price HC Tags: Clin Med Source Type: journals
New machine-marked tests for selection into core medical training: evidence from two validation studies.
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This study examined whether two machine-marked tests (MMTs; a clinical problem-solving test and situational judgement test), previously validated for selection into U.K. general practice (GP) training, could provide a valid methodology for shortlisting into core medical training (CMT). A longitudinal design was used to examine the MMTs' psychometric properties in CMT samples, and correlations between MMT scores and CMT interview outcomes. Independent samples from two years were used: in 2008, a retrospective analysis was conducted (n=1711), while in 2009, CMT applicants completed the MMTs for evaluation purposes (n=2265). ...
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Patterson F, Carr V, Zibarras L, Burr B, Berkin L, Plint S, Irish B, Gregory S Tags: Clin Med Source Type: journals
Britain's alcohol market: how minimum alcohol prices could stop moderate drinkers subsidising those drinking at hazardous and harmful levels.
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Discounting of alcoholic products is universal in U.K. supermarkets with some chains selling own brand spirits for less than the duty payable per item. Eighty per cent of alcohol purchases are made by 30% of the population and this group are the main beneficiaries. In December 2008 the government announced its intention to consult on modifications to the Licensing Act 2003 to enable the introduction of mandatory conditions for the sale of alcoholic products in order to curtail alcohol harm. In this article it is shown that families in Britain have nothing to fear from the introduction of a 50 p/unit minimum price of al...
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Record C, Day C Tags: Clin Med Source Type: journals
Factors influencing hospital readmission rates after acute medical treatment.
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It is a concern that increasing pressure to diagnose, treat and discharge patients rapidly is leading to unacceptably high readmission rates. Readmissions were studied over a two-month period. Patients were identified through the hospital coding system, and electronic discharge summaries provided details of each admission. In total, 69 readmissions were identified, representing 4.34% of medical admissions. Readmitted patients were older than those with single admissions (median age 75 and 71 years, respectively; p < 0.05). Initial length of stay was greater in those patients who would go on to be readmitted (median ...
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Shalchi Z, Saso S, Li HK, Rowlandson E, Tennant RC Tags: Clin Med Source Type: journals
Should thrombolysis have a greater role in the management of pulmonary embolism?
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Pulmonary embolism (PE) continues to be associated with significant mortality despite advances in the diagnostic techniques available for its detection. Anticoagulation remains standard treatment in PE although there is a consensus view that 'step-up' to thrombolytic therapy in addition to anticoagulation is indicated in those patients who are systemically shocked at presentation--a group defined as having suffered 'massive pulmonary embolism'. Considerable research has been directed at attempting to identify further groups of patients with PE who are at high risk of morbidity and mortality--notably those who are label...
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Jenkins PO, Sultanzadeh J, Bhagwat M, Jenkins PF Tags: Clin Med Source Type: journals
Implementing NICE clinical guidelines on Parkinson's disease.
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Implementing national guidance such as that produced by the National Institute for Health and Clinical Excellence should be a priority for NHS trusts. The best way of managing successful implementation is through collaboration across the healthcare community. This helps to improve communication, ensures progress is being made and enables healthcare professionals to concentrate on the whole pathway of care, not just specific aspects of it. The Sheffield Parkinson's Stakeholder Group has successfully engaged all who are involved with providing the service across the city and has also received national recognition for its...
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Ryton BA, Liddle BJ Tags: Clin Med Source Type: journals
Post-certificate of completion of training fellowships.
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This article discusses the pros and cons of another more controversial alternative: a post-CCT fellowship.
PMID: 19886103 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Medford AR Tags: Clin Med Source Type: journals
Infection for the acute physician.
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PMID: 19886104 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Bewick T, Lim WS Tags: Clin Med Source Type: journals
Current issues in palliative care: third national conference.
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This recent conference provided an all-round review of the current issues to be considered in palliative care. A list of the top 10 points that one hospital physician found most useful is presented.
PMID: 19886105 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Looi YC Tags: Clin Med Source Type: journals
Breathlessness, fatigue and the respiratory muscles.
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Breathlessness is a common symptom in respiratory, cardiovascular and malignant disease. It reduces exercise tolerance and mobility, and is an important determinant of quality of life. The multifactorial nature of the symptom often presents difficulties in understanding why individual patients are breathless, and how breathlessness should best be palliated, especially in advanced disease. However, insights into the neurophysiological factors underlying the symptom can be gained by considering the balance between the load on, and capacity of, the respiratory muscles and increased neural respiratory drive, reflecting inc...
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Mioxham J, Jolley C Tags: Clin Med Source Type: journals
The best of times, the worst of times: a story of haemophilia.
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PMID: 19886107 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Lee CA Tags: Clin Med Source Type: journals
21st century endocrinology.
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This article reviews the latest significant treatments which have the potential to impact greatly on a wide variety of disease states in the not too distant future.
PMID: 19886108 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Grant P, Lipscomb D Tags: Clin Med Source Type: journals
Professor Sir John Bell, president of the Academy of Medical Sciences.
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PMID: 19886109 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Watts G Tags: Clin Med Source Type: journals
Hugo Karl Liepmann and apraxia.
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This article summarises the history of this important and common pattern of motor dysfunction.
PMID: 19886110 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Pearce JM Tags: Clin Med Source Type: journals
Testing for HIV: concise guidance.
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This article summarises the recommendations from the U.K. national guidelines for HIV testing 2008. The guidelines provide the information needed to enable any clinician to perform an HIV test within good clinical practice and encourage 'normalisation' of HIV testing. The full version is available at www.bhiva.org/cmsl 222621.asp.
PMID: 19886111 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Palfreeman A, Fisher M, Ong E, , Wardrope J, Stewart E, Castro-Sanchez E, Peto T, Rogstad K, Sheather J, Gazzard B, Pillay D, O'Brien J, Delpech V, Lowbury R, Fleet R, Azad Y, Lyall H, Hardie J, Adegbite G, Rooney G, Whitehead R Tags: Clin Med Source Type: journals
Training good prescribers: what are the best methods?
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PMID: 19886112 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Ross S, Loke YK Tags: Clin Med Source Type: journals
Rational prescribing: the principles of drug selection.
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PMID: 19886113 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Maxwell S Tags: Clin Med Source Type: journals
Modern methods of pharmacovigilance: detecting adverse effects of drugs.
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PMID: 19886114 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Norén GN, Edwards IR Tags: Clin Med Source Type: journals
Pharmacoeconomics: principles and relevance to the activities of drug and therapeutics committees.
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PMID: 19886115 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Hughes D, Reynolds DJ Tags: Clin Med Source Type: journals
The applications of pharmacogenetics to prescribing: what is currently practicable?
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PMID: 19886116 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Pirmohamed M Tags: Clin Med Source Type: journals
Rheumatoid hands.
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PMID: 19886117 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Takhar G, Suthahar Y, Stratton R Tags: Clin Med Source Type: journals
Herpes zoster brachial plexopathy with predominant radial nerve palsy.
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Herpes zoster or shingles is the reactivation of dormant varicella zoster virus (VZV) in the dorsal root ganglia. Segmental motor paresis is rare and only few cases of brachial plexitis have been reported in the literature. This case reports herpes zoster resulting in unilateral brachial plexitis with predominant radial nerve palsy. The patient was treated successfully with aciclovir, gabapentin and physiotherapy with good recovery. Radial neuritis secondary to active herpes zoster has been rarely reported in the past.
PMID: 19886118 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Jeevarethinam A, Ihuoma A, Ahmad N Tags: Clin Med Source Type: journals
Severe hypercalcaemia mimicking acute myocardial infarction.
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PMID: 19886119 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Sado DM, Greaves K Tags: Clin Med Source Type: journals
The story of Axel Munthe.
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PMID: 19886120 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Quinton R Tags: Clin Med Source Type: journals
A history of the gardens of the Royal College of Physicians of London.
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PMID: 19886121 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Hilson A Tags: Clin Med Source Type: journals
Influenza vaccination: a cross-sectional prospective audit of influenza vaccination in patients admitted to a London hospital.
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PMID: 19886122 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Authors: Styles K, Rastogi A, Hussain S, Abraham S Tags: Clin Med Source Type: journals
We only have one life.
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Authors:
PMID: 19886123 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 1, 2009 Category: Journals (General) Tags: Clin Med Source Type: journals
What is the point of care?
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PMID: 19728496 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Allan R Tags: Clin Med Source Type: journals
Are you taking the lead?
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PMID: 19728497 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Friedland JS Tags: Clin Med Source Type: journals
Women and medicine: the future.
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PMID: 19728498 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Dacre J, Shepherd S Tags: Clin Med Source Type: journals
Climate change: how grave the threat?
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There is now no dispute about climate change: it is happening, and human activity is driving it. Each day, the threat this poses becomes clearer--threatening our civilisation and also the survival of our species. The immediacy of this threat is also now recognised: it is not something 'for the next millenium' but for our lifetimes and those of our children. Without urgent action, the future is grim. But we can all respond to make the difference. And the time to do so is now.
PMID: 19728499 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Montgomery H Tags: Clin Med Source Type: journals
Timely discharge of older patients from hospital: improving the process.
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Elderly patients represent a large number of admissions to hospital, accounting for a disproportionate number of hospital bed days. Discharge planning can improve the safety and appropriateness of discharge from hospital, and can have a positive impact on length of stay and efficiency. Despite this, discharge planning is often neglected. This review, both evidence and experience based, is provided to aid with the safe discharge of elderly patients back into the community.
PMID: 19728500 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Dainty P, Elizabeth J Tags: Clin Med Source Type: journals
Doctors with disabilities: licensed to practice?
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Doctors deal with patient's disabilities every day but many in the profession have been nonplussed to see the focus of the disability rights lobbies shift from the recipients of care to the carers themselves. Until recently the number of practising doctors known to have significant disabilities was very low and for many reasons potential medical students were deterred from entering medical education. This piece would not even have been commissioned 14 years ago when the U.K. Disability Discrimination Act 1995 was passed. It is a measure of the change in society's view of disability, reinforced by law, that the issue of...
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Snashall D Tags: Clin Med Source Type: journals
Should we implement 'opt-out' HIV testing for patients with lymphoma?
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Patients with HIV are dying due to late diagnosis and physicians are being encouraged to increase HIV testing. The uptake of opt-in HIV screening for 113 lymphoma patients was audited at University College London Hospital. Of the 113 patients, 46 were not tested (41%). Previous research in the antenatal setting suggests that adopting opt-out screening would increase testing rates.
PMID: 19728502 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Cave J, Edwards SG, Miller RF, Ardeshna KM, Lee SM Tags: Clin Med Source Type: journals
The value of the post-take ward round: are new working patterns compromising junior doctor education?
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This prospective observational study assessed the impact of the changes in junior doctors' working hours and waiting-time initiatives on teaching and learning opportunities for junior doctors in acute medicine. An audit cycle of post-take ward rounds including all medical admissions to an urban teaching hospital was conducted. During two seven-day periods in July 2006 and 2008, 317 and 354 patients were admitted respectively. In the two-year interval a number of changes were implemented resulting in a significant increase in patients reviewed by a consultant within 24 hours of admission. Target waiting times were being...
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Chaponda M, Borra M, Beeching NJ, Almond DS, Williams PS, Hammond MA, Price VA, Tarry L, Taegtmeyer M Tags: Clin Med Source Type: journals
A postal survey of doctors' attitudes to becoming mentally ill.
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A postal survey of 3512 doctors in Birmingham was carried out to assess attitudes to becoming mentally ill. The response rate for the questionnaire was 70% (2462 questionnaires). In total, 1807 (73.4%) doctors would choose to disclose a mental illness to family and friends rather than to a professional. Career implications were cited by 800 (32.5%) respondents as the most frequent reason for failure to disclose. For outpatient treatment, 51.1% would seek formal professional advice. For inpatient treatment, 41.0% would choose a local private facility, with only 21.1% choosing a local NHS facility. Of respondents 12.4% i...
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Hassan TM, Ahmed SO, White AC, Galbraith N Tags: Clin Med Source Type: journals
HIV-related admissions to a district general hospital in the U.K.: a single centre study.
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This study evaluates the patient and disease characteristics, potential cost implications and short-term outcomes of 64 adult patients admitted with HIV-related illnesses. The majority (65.6%) were black Africans and 75% were immigrants to the U.K. Of the 64 patients, 61% were unaware of their HIV status at admission; 50% had CD4 count <50 cells/microl and 48% had viral load >10(5) copies/ml. Thirty-eight patients had AIDS and this accounted for 66% of the total 897 inpatient days (equivalent to 16.5-30.2 patient years of highly active antiretroviral therapy (HAART), depending on the type of HAART regimen used). Fift...
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Udayaraj UP, Tang A, Vaux E, Barker L, Naik R Tags: Clin Med Source Type: journals
Opium, tobacco and alcohol: the evolving legitimacy of international action.
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There is a broad consensus that international trade in goods is beneficial, providing of course that it is fair. Yet not all things that are traded are goods. Some can more appropriately be considered as 'bads'. The way things are viewed can change over time. Over a century ago the U.K. fought a war with China for the right to trade in narcotics yet now interdicts such shipments on the high seas. More recently, the international community has agreed the Framework Convention on Tobacco Control, showing that tobacco is moving from a good to a bad. However, there are other things that are legitimately traded where restric...
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: McKee M Tags: Clin Med Source Type: journals
Human umbilical cord blood stem cells, myocardial infarction and stroke.
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Myocardial infarction (MI) and stroke are the first and third leading causes of death in the U.S.A. accounting for more than 1 in 3 deaths per annum. Despite interventional and pharmaceutical advances, the number of people diagnosed with heart disease is on the rise. Therefore, new clinical strategies are needed. Cell-based therapy holds great promise for treatment of these diseases and is currently under extensive preclinical as well as clinical trials. The source and types of stem cells for these clinical applications are questions of great interest. Human umbilical cord blood (hUCB) appears to be a logical candidate...
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Copeland N, Harris D, Gaballa MA Tags: Clin Med Source Type: journals
Discrepancies between histology and serology for the diagnosis of coeliac disease in a district general hospital: is this an unrecognised problem in other hospitals?
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This study shows that a small but significant number of cases of coeliac disease will be missed by relying on serology alone. As the diagnosis and management of disease shifts further towards general physicians and primary care, it is important that the limitations of serological testing are recognised.
PMID: 19728508 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Sweis R, Pee L, Smith-Laing G Tags: Clin Med Source Type: journals
Chairman of the Joint Formulary Committee, British National Formulary.
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PMID: 19728509 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Kendall M Tags: Clin Med Source Type: journals
Management of type 2 diabetes: NICE guidelines.
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PMID: 19728510 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Sibal L, Home PD Tags: Clin Med Source Type: journals
Advances in endocrinology.
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PMID: 19728511 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Monson JP Tags: Clin Med Source Type: journals
Recent advances in the imaging of adrenal and neuroendocrine tumours.
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PMID: 19728512 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - July 31, 2009 Category: Journals (General) Authors: Narayanan P, Reznek R Tags: Clin Med Source Type: journals
