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A beginner's guide to sexEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Launer, J. Tags: On reflection Source Type: journals

Diagnosis and new treatments in muscular dystrophiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD) and limb girdle muscular dystrophies (LGMD) represent a significant proportion of paediatric and adult neuromuscular neurology practice. The proactive symptom-based multidisciplinary team (MDT) management and access to non-invasive ventilation have enabled improved survival into adulthood. Nevertheless the severe disability imposed by conditions such as DMD poses a challenge for successful transition of care and management for paediatric and adult neurology teams. DMD is discussed in detail as a paradigm illustrating diagnosis, management and role for diffe...
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Manzur, A Y, Muntoni, F Tags: Reviews Source Type: journals

The metabolic syndrome: common origins of a multifactorial disorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The metabolic syndrome (MetS) represents a combination of cardiometabolic risk determinants including obesity (central adiposity), insulin resistance, glucose intolerance, dyslipidaemia, non-alcoholic fatty liver disease and hypertension. MetS is rapidly increasing in prevalence worldwide as a consequence of the continued obesity "epidemic", and as a result will have a considerable impact on the global incidence of cardiovascular disease and type 2 diabetes. Currently, there is debate concerning whether the risk of cardiovascular disease is greater in patients diagnosed with MetS than that of the sum of the individual risk...
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Bruce, K D, Byrne, C D Tags: Reviews Source Type: journals

Hybrid SPECT/CT: the end of "unclear" medicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The emergence of hybrid imaging, combining anatomical computed tomography (CT) and functional scintigraphic imaging has increased the armoury of techniques available to image disease. Single photon emission computed tomography/CT (SPECT/CT) is a dual modality technique which increases the sensitivity and specificity of existing radionuclide imaging and helps characterise equivocal lesions detected by other imaging methods. In addition to the many established clinical applications for SPECT/CT, there are new clinical uses emerging in a spectrum of benign and malignant diseases. In this article, we will discuss the establish...
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Patel, C N, Chowdhury, F U, Scarsbrook, A F Tags: Reviews Source Type: journals

Multimodality imaging in hyperparathyroidismEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Imaging of patients with hyperparathyroidism has evolved over the last decade and transformed surgical management of the disease. Traditional bilateral neck dissection and exploratory surgery has been overtaken by focused, minimally invasive procedures in patients with single-gland disease. Accurate preoperative localisation of the involved parathyroid gland is the cornerstone for success of the new surgical techniques. In this article, the strengths, limitations and respective roles of different imaging modalities used to evaluate patients with hyperparathyroidism will be reviewed. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Patel, C N, Scarsbrook, A F Tags: Reviews Source Type: journals

Parkinson disease and impulse control disorders: a review of clinical features, pathophysiology and managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Impulse control disorders (ICDs) are a heterogeneous group of conditions involving repetitive, excessive and compulsive activities that interfere with life functioning. Examples are pathological gambling, compulsive shopping and hypersexuality. Over the last decade, ICDs have become increasingly recognised as being associated with Parkinson disease (PD), with the literature highlighting a link between dopamine replacement therapy and the development of ICDs. Patients who develop ICDs in the context of compulsive anti-Parkinsonian drug use are described as having dopamine dysregulation syndrome (DDS), which is associated wi...
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Wu, K, Politis, M, Piccini, P Tags: Reviews Source Type: journals

How well prepared are medical students for their first year as doctors? The views of consultants and specialist registrars in two teaching hospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Overall, F1s in the study were not well prepared either to perform the tasks that await them or in terms of most of the specific background knowledge and skills necessary for the successful execution of those tasks. The level of preparedness raises important issues about medical training and transition from medical graduate to first year doctor. Further research is needed to determine whether this situation exists in other regions of the UK. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Matheson, C, Matheson, D Tags: Original article Source Type: journals

Invasive zygomycosis in India: experience in a tertiary care hospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Zygomycosis is a threat in uncontrolled diabetes. New risk factors such as renal failure and chronic liver disease require attention. A elegans is an emerging agent in India. The need for surgical debridement in addition to medical treatment is emphasised. GCS is an independent marker of prognosis in cases of invasive zygomycosis. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Chakrabarti, A, Chatterjee, S S, Das, A, Panda, N, Shivaprakash, M R, Kaur, A, Varma, S C, Singhi, S, Bhansali, A, Sakhuja, V Tags: Liver disease, Urology, Statistics and research methods, Drugs: infectious diseases, Epidemiology, Diabetes, Metabolic disorders Original article Source Type: journals

"X marks the spot" is not a pleural guaranteeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Medford, A R L, Entwisle, J J Tags: Journalology, Haematology (incl blood transfusion), Drugs: cardiovascular system, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics Images in medicine Source Type: journals

A doctor's experience of resuscitation decision making for older patients: coping with changeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There has been a dramatic change in the way that resuscitation decisions are made for older hospital inpatients in the UK. In less than 20 years many geriatric medicine wards have moved from an "opt-in" policy (where the default position is not to provide resuscitation) to a position where resuscitation is widely available to older patients and clinicians are much more reluctant to make "do not attempt cardiopulmonary resuscitation" decisions on medical grounds alone. The drivers for this change are rooted in societal changes rather than scientific or legal advances. Older patients are increasingly educated and have higher...
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Bowker, L Tags: Interventional cardiology Ethics and law Source Type: journals

Factors that influence decisions about cardiopulmonary resuscitation: the views of doctors and medical studentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Doctors would benefit from greater support for their decision making in relation to resuscitation to reduce variability in clinical practice and to promote appropriate patient care. Identification of factors that influence doctors’ individual beliefs, attitudes and values towards resuscitation and improvement in the quality of patient communication may help to guide policy in this area. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Tyrer, F, Williams, M, Feathers, L, Faull, C, Baker, I Tags: Patients, Interventional cardiology, Communication Ethics and law Source Type: journals

The resuscitation game continues: what is really going on?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - November 5, 2009 Category: Journals (General) Authors: Doyal, L., Doyal, L., Sokol, D. Tags: Emergency medicine, End of life decisions (geriatric medicine), Interventional cardiology, End of life decisions (palliative care), Ethics, Legal and forensic medicine Editorials Source Type: journals

The three second consultation [On reflection]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Launer, J. Tags: On reflection Source Type: journals

A UK consensus on the management of the bladder in multiple sclerosis [Reviews]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bladder symptoms in multiple sclerosis (MS) are common and distressing but also highly amenable to treatment. A meeting of stakeholders involved in patients’ continence care, including neurologists, urologists, primary care, MS nurses and nursing groups was recently convened to formulate a UK consensus for management. National Institute for Health and Clinical Excellence (NICE) criteria were used for producing recommendations based on a review of the literature and expert opinion. It was agreed that in the majority of cases, successful management could be based on a simple algorithm which includes using reagent stick...
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Fowler, C J, Panicker, J N, Drake, M, Harris, C, Harrison, S C W, Kirby, M, Lucas, M, Macleod, N, Mangnall, J, North, A, Porter, B, Reid, S, Russell, N, Watkiss, K, Wells, M Tags: Reviews Source Type: journals

Narrow complex (supraventricular) tachycardias [Reviews]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the management of narrow complex arrhythmias likely to be encountered, including the ubiquitous atrial fibrillation. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Linton, N W F, Dubrey, S W Tags: Reviews Source Type: journals

How-to guide on biomarkers: biomarker definitions, validation and applications with examples from cardiovascular disease [Reviews]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A biomarker is a characteristic that can be objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacological responses to a therapeutic intervention. Many commonly used tests in clinical practice can serve as biomarkers. The majority have been identified on the basis of insight or underlying physiology or biological mechanisms. With increasing knowledge and practical experience, some of these tests have evolved into a measurable end point in clinical research, applied as an indicator of change, for the better or worse. The traditional identification of biomarkers as...
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Puntmann, V O Tags: Reviews Source Type: journals

A case study of translating ACGME practice-based learning and improvement requirements into reality: systems quality improvement projects as the key component to a comprehensive curriculum [Quality improvement report]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: A PBLI curriculum that is centred around practice-based quality improvement projects can fulfil the objectives of this ACGME competency while accomplishing sustained outcomes in quality improvement. A comprehensive curriculum is an investment but offers organisational rewards. We propose a more realistic and informative representation of rapid PDSA cycle changes. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Tomolo, A M, Lawrence, R H, Aron, D C Tags: Quality improvement report Source Type: journals

Efficacy of low dose dexamethasone in severe thrombocytopenia caused by dengue fever: a placebo controlled study [Original articles]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: At a low dose regimen, dexamethasone was not effective in achieving a higher rise of platelet count in dengue infection. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Kularatne, S A M, Walathara, C, Mahindawansa, S I, Wijesinghe, S, Pathirage, M M K, Kumarasiri, P V R, Dissanayake, A M S D M Tags: Drugs: infectious diseases, Travel medicine, Tropical medicine (infectious diseases), Headache (including migraine), Pain (neurology), Hypertension Original articles Source Type: journals

A gene-based risk score for lung cancer susceptibility in smokers and ex-smokers [Original articles]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: When numeric scores were assigned to both the SNP and demographic data, and sequentially combined by a simple algorithm in a risk model, the composite score was found to be linearly related to lung cancer risk with a bimodal distribution. Genetic data may therefore be combined with other risk variables from smokers or ex-smokers to identify individuals who are most susceptible to developing lung cancer. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Young, R P, Hopkins, R J, Hay, B A, Epton, M J, Mills, G D, Black, P N, Gardner, H D, Sullivan, R, Gamble, G D Tags: Genetics, Lung cancer (oncology), Lung cancer (respiratory medicine), Epidemiology Original articles Source Type: journals

Radiological "bone within a bone" appearance with atraumatic fractures [Images in medicine]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: van den Broek, T, Bulk, S, Pruijs, J E H, Beek, F J A Tags: Journalology, Genetics, Pain (neurology), Ophthalmology, Radiology, Physiotherapy, Sports and exercise medicine, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Calcium and bone Images in medicine Source Type: journals

The ethical imperative to scale up health care services for people with severe mental disorders in low and middle income countries [Ethics and law]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Most mentally ill people in low and middle income countries, where clinical services are typically scarce and mental health legal provisions often inadequate, do not receive requisite evidence based treatment. The unfortunate consequence is compromised health and well-being and lack of social integration in the community. Recent initiatives, such as the Movement for Global Mental Health, aim to improve the situation and, in so doing, take into account ethical factors that play a role in the face of inadequate care and mental health legislative frameworks. Two composite case vignettes based on the narratives of actual patie...
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Patel, V, Bloch, S Tags: Health economics Ethics and law Source Type: journals

Clinical and moral uncertainty in psychiatry: the problem of scarce resources [Editorials]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Doyal, L., Doyal, L., Sokol, D. Tags: Stroke Editorials Source Type: journals

Progress in the study of genetic disease: bringing new light to complex problems [Editorials]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 29, 2009 Category: Journals (General) Authors: Shelling, A. Tags: Genetics, Diet Editorials Source Type: journals

[On reflection] The three second consultationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Launer, J. Tags: On reflection Source Type: journals

[Reviews] A UK consensus on the management of the bladder in multiple sclerosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bladder symptoms in multiple sclerosis (MS) are common and distressing but also highly amenable to treatment. A meeting of stakeholders involved in patients’ continence care, including neurologists, urologists, primary care, MS nurses and nursing groups was recently convened to formulate a UK consensus for management. National Institute for Health and Clinical Excellence (NICE) criteria were used for producing recommendations based on a review of the literature and expert opinion. It was agreed that in the majority of cases, successful management could be based on a simple algorithm which includes using reagent stick...
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Fowler, C J, Panicker, J N, Drake, M, Harris, C, Harrison, S C W, Kirby, M, Lucas, M, Macleod, N, Mangnall, J, North, A, Porter, B, Reid, S, Russell, N, Watkiss, K, Wells, M Tags: Reviews Source Type: journals

[Reviews] Narrow complex (supraventricular) tachycardiasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the management of narrow complex arrhythmias likely to be encountered, including the ubiquitous atrial fibrillation. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Linton, N W F, Dubrey, S W Tags: Reviews Source Type: journals

[Reviews] How-to guide on biomarkers: biomarker definitions, validation and applications with examples from cardiovascular diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A biomarker is a characteristic that can be objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacological responses to a therapeutic intervention. Many commonly used tests in clinical practice can serve as biomarkers. The majority have been identified on the basis of insight or underlying physiology or biological mechanisms. With increasing knowledge and practical experience, some of these tests have evolved into a measurable end point in clinical research, applied as an indicator of change, for the better or worse. The traditional identification of biomarkers as...
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Puntmann, V O Tags: Reviews Source Type: journals

[Quality improvement report] A case study of translating ACGME practice-based learning and improvement requirements into reality: systems quality improvement projects as the key component to a comprehensive curriculumEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: A PBLI curriculum that is centred around practice-based quality improvement projects can fulfil the objectives of this ACGME competency while accomplishing sustained outcomes in quality improvement. A comprehensive curriculum is an investment but offers organisational rewards. We propose a more realistic and informative representation of rapid PDSA cycle changes. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Tomolo, A M, Lawrence, R H, Aron, D C Tags: Quality improvement report Source Type: journals

[Original articles] Efficacy of low dose dexamethasone in severe thrombocytopenia caused by dengue fever: a placebo controlled studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: At a low dose regimen, dexamethasone was not effective in achieving a higher rise of platelet count in dengue infection. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Kularatne, S A M, Walathara, C, Mahindawansa, S I, Wijesinghe, S, Pathirage, M M K, Kumarasiri, P V R, Dissanayake, A M S D M Tags: Drugs: infectious diseases, Travel medicine, Tropical medicine (infectious diseases), Headache (including migraine), Pain (neurology), Hypertension Original articles Source Type: journals

[Original articles] A gene-based risk score for lung cancer susceptibility in smokers and ex-smokersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: When numeric scores were assigned to both the SNP and demographic data, and sequentially combined by a simple algorithm in a risk model, the composite score was found to be linearly related to lung cancer risk with a bimodal distribution. Genetic data may therefore be combined with other risk variables from smokers or ex-smokers to identify individuals who are most susceptible to developing lung cancer. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Young, R P, Hopkins, R J, Hay, B A, Epton, M J, Mills, G D, Black, P N, Gardner, H D, Sullivan, R, Gamble, G D Tags: Genetics, Lung cancer (oncology), Lung cancer (respiratory medicine), Epidemiology Original articles Source Type: journals

[Images in medicine] Radiological "bone within a bone" appearance with atraumatic fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: van den Broek, T, Bulk, S, Pruijs, J E H, Beek, F J A Tags: Journalology, Genetics, Pain (neurology), Ophthalmology, Radiology, Physiotherapy, Sports and exercise medicine, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Calcium and bone Images in medicine Source Type: journals

[Ethics and law] The ethical imperative to scale up health care services for people with severe mental disorders in low and middle income countriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Most mentally ill people in low and middle income countries, where clinical services are typically scarce and mental health legal provisions often inadequate, do not receive requisite evidence based treatment. The unfortunate consequence is compromised health and well-being and lack of social integration in the community. Recent initiatives, such as the Movement for Global Mental Health, aim to improve the situation and, in so doing, take into account ethical factors that play a role in the face of inadequate care and mental health legislative frameworks. Two composite case vignettes based on the narratives of actual patie...
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Patel, V, Bloch, S Tags: Health economics Ethics and law Source Type: journals

[Editorials] Clinical and moral uncertainty in psychiatry: the problem of scarce resourcesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Doyal, L., Doyal, L., Sokol, D. Tags: Stroke Editorials Source Type: journals

[Editorials] Progress in the study of genetic disease: bringing new light to complex problemsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 28, 2009 Category: Journals (General) Authors: Shelling, A. Tags: Genetics, Diet Editorials Source Type: journals

[On reflection] Medically unexplored storiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Launer, J. Tags: On reflection Source Type: journals

[Images in medicine] An unusual case of gastrointestinal bleedingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Raphael, C E, Shariff, M, Cohen, P, Smith, G Tags: Endoscopy, GI bleeding, Urology, Immunology (including allergy), Drugs: infectious diseases, Pain (neurology), Hypertension, Pregnancy, Colon cancer, Radiology, Dermatology, Surgical diagnostic tests, Gastrointestinal surgery, General surgery, Ear, nose a Source Type: journals

[Reviews] Late-onset retinal macular degeneration: clinical insights into an inherited retinal degenerationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Raised awareness of L-ORMD should lead to earlier diagnosis and improved care for patients. New antivascular endothelial growth factor treatment may provide a new possibility for management. A deeper insight into molecular and genetic mechanisms of L-ORMD may suggest avenues to explore new treatments of this disorder. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Borooah, S, Collins, C, Wright, A, Dhillon, B Tags: Reviews Source Type: journals

[Reviews] Venous thromoboembolic disease and pregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article provides an overview of the pathophysiology, diagnosis, treatment and prevention of VTE in pregnancy and refers the reader to recent evidence based guidelines. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Martineau, M, Nelson-Piercy, C Tags: Reviews Source Type: journals

[Reviews] Cold damage to the extremities: frostbite and non-freezing cold injuriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The treatment of cold injuries to the periphery has advanced substantially in the last 10 years and optimal outcomes are only likely to be achieved if a multidisciplinary team uses the full range of diagnostic and treatment modalities that are now available. The internet and satellite phones with digital images allow immediate access by patients from remote geographical locations to hospital based specialists who can assess cold injuries and advise on early field care. The severity of frostbite injuries can now be assessed with triple phase bone scanning, allowing early prediction of likely subsequent tissue loss. Early hy...
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Imray, C, Grieve, A, Dhillon, S, The Caudwell Xtreme Everest Research Group Tags: Reviews Source Type: journals

[Reviews] Preventing type 2 diabetes: can we make the evidence work?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article highlights findings from diabetes prevention programmes and discusses key issues involved in translating research into practice. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Yates, T, Davies, M, Khunti, K Tags: Reviews Source Type: journals

[Original articles] Medical mortality in Pakistan: experience at a tertiary care hospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Infections, including septicaemia and pneumonia, are the leading causes of hospital mortality in our setting, followed by malignancy and cardiovascular causes. The overall mortality rate is comparable to published mortality data from other hospital settings. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Tariq, M, Jafri, W, Ansari, T, Awan, S, Ali, F, Shah, M, Jamil, S, Riaz, M, Shafqat, S Tags: Drugs: cardiovascular system, Ischaemic heart disease, Pneumonia (respiratory medicine), Epidemiology Original articles Source Type: journals

[Original articles] Predicting mortality of psychogeriatric patients: a simple prognostic frailty risk scoreEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: We developed and validated a risk score for the prediction of 3 year mortality. This risk score can be used to stratify patients into different risk categories, thereby informing patient counselling and tailored diagnostic and therapeutic decisions in clinical practice. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Pijpers, E, Ferreira, I, van de Laar, R J J, Stehouwer, C D A, Nieuwenhuijzen Kruseman, A C Tags: Psychogeriatrics, Drugs: cardiovascular system, Psychiatry of old age, Epidemiology Original articles Source Type: journals

[Original articles] Are verbal orders a threat to patient safety?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: The use of verbal orders has been identified as a potential contributor to poor quality and less safe care. As a result, many organisations have encouraged changing the verbal orders process and/or reducing/eliminating verbal orders altogether (Joint Commission (2005), Institute of Medicine (2001), Leapfrog organisation, Institute of Safe Medication Practices). Ironically there is a paucity of research evidence to support the widespread concern over verbal order. Aims: This paper describes the very limited existing research on verbal orders, presents a model of verbal order use identifying potential error trig...
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Wakefield, D S, Wakefield, B J Tags: Medical management, Patients Original articles Source Type: journals

[Original articles] Social networking sites: a novel portal for communicationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Facebook is providing a readily accessible portal for patients, carers and healthcare professionals to share their experiences of investigation, diagnosis and management of disease. Furthermore, this technology is being used for research, education and fundraising. Further research is warranted to explore the further potential of this new technology. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Farmer, A D, Bruckner Holt, C E M, Cook, M J, Hearing, S D Tags: Drugs: cardiovascular system Original articles Source Type: journals

[Ethics and law] Consultation activities of clinical ethics committees in the United Kingdom: an empirical study and wake-up callEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Despite a sharp increase in the absolute numbers of CECs across the UK, the number of cases considered by the majority of CECs is low. The findings presented here suggest we must reflect on the reasons for such low caseloads and pause to consider whether the committee model is most appropriate for the UK context. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Whitehead, J M, Sokol, D K, Bowman, D, Sedgwick, P Tags: Ethics Ethics and law Source Type: journals

[Editorials] Moral and legal uncertainty within medicine: the role of clinical ethics committeesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - September 3, 2009 Category: Journals (General) Authors: Doyal, L., Doyal, L. Tags: Prostate cancer, Urological cancer, Interventional cardiology, Adult intensive care, Ethics Editorials Source Type: journals

[On reflection] In our nameEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - July 22, 2009 Category: Journals (General) Authors: Launer, J. Tags: On reflection Source Type: journals

[Reviews] Diagnosis and treatment in inflammatory neuropathiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The inflammatory neuropathies are a large diverse group of immune-mediated neuropathies that are amenable to treatment and may be reversible. Their accurate diagnosis is essential for informing the patient of the likely course and prognosis of the disease, informing the treating physician of the appropriate therapy and informing the scientific community of the results of well-targeted, designed and performed clinical trials. With the advent of biological therapies able to manipulate the immune response more specifically, an understanding of the pathogenesis of these conditions is increasingly important. This review present...
Source: Postgraduate Medical Journal - July 22, 2009 Category: Journals (General) Authors: Lunn, M P T, Willison, H J Tags: Reviews Source Type: journals

[Reviews] Genetic susceptibility to the respiratory effects of air pollutionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is large variation between individuals in their response to air pollutants. This review summarises the existing evidence that genetic factors influence the mechanisms of lung injury caused by air pollutants. Genetic association studies have compared the adverse effects of air pollutants between subjects with specific genotypes in biologically relevant genes. In human studies of ozone exposure, polymorphisms in oxidative stress genes (NQO1, GSTM1, GSTP1) modify respiratory symptoms, lung function, biomarkers and risk of asthma. Inflammatory gene polymorphisms (TNF) influence the lung function response to ozone, and th...
Source: Postgraduate Medical Journal - July 22, 2009 Category: Journals (General) Authors: Yang, I A, Fong, K M, Zimmerman, P V, Holgate, S T, Holloway, J W Tags: Reviews Source Type: journals

[Reviews] Initial management of suspected transient cerebral ischaemia and stroke in primary care: implications of recent researchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Strategies are required to reduce the personal, societal and healthcare burden caused by cerebrovascular disease. Urgent medical intervention after transient ischaemic attack (TIA) can prevent recurrent stroke, and modern healthcare has to respond rapidly to the patient with TIA. The primary care practitioner contributes to stroke prevention by rapidly and accurately diagnosing TIA and arranging urgent specialist assessment. Diagnosis of TIA in primary care is difficult, as transient symptoms are common. Stroke-screening tools are available, but there is no evidence base for diagnostic support tools for TIA in primary care...
Source: Postgraduate Medical Journal - July 22, 2009 Category: Journals (General) Authors: Lasserson, D S Tags: Reviews Source Type: journals