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Oh no--it's Donald Hunter!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Seaton, A. Tags: Coda Source Type: journals

The Regent Park's three royal medical collegesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: James, D. G. Tags: Coda Source Type: journals

Profound hypokalaemia mimicking acute myocardial infarctionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Dalzell, J.R., Jackson, C.E., Petrie, M.C. Tags: Correspondence Source Type: journals

Embolic complication of Tako-Tsubo cardiomyopathyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Figueredo, V.M., Gupta, S. Tags: Correspondence Source Type: journals

Primary prevention of cardiovascular disease with statins: cautionary notesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Goldstein, M.R., Mascitelli, L., Pezzetta, F. Tags: Correspondence Source Type: journals

Small bowel volvulus and the whirl signEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Lin, C.-H., Kao, P.-C., Wang, H.-P., Lien, W.-C. Tags: Clinical pictures Source Type: journals

Haemorrhagic cardiac tamponade: a rare complication of pneumoniaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Natarajan, B., Stephens, J.W. Tags: Clinical pictures Source Type: journals

Severe back pain in a hemodialysis patientEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Hsiao, P.-J., Diang, L.-K., Lin, S.-H., Wang, C.-W. Tags: Clinical pictures Source Type: journals

The nervous heart: a case report and discussion of an under-recognized clinical problemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Agarwal, S., Lyon, A., Nachev, P., Everitt, A. Tags: Case report Source Type: journals

Early onset type 2 diabetes mellitus: a harbinger for complications in later years--clinical observation from a secondary care cohortEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: Early onset T2DM subjects are at substantial risk of developing diabetes complications in later years but at an earlier stage than later onset cohort and prolonged exposure to adverse diabetic milieu is an important contributing factor. Management of risk factors for diabetes complications was inadequate among early onset subjects. (Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Song, S.H., Hardisty, C.A. Tags: Original papers Source Type: journals

Clinical phenotype of cystic fibrosis patients with the G551D mutationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Mutations on different chromosomes are not independent of each other for the overall impact on the amount of functional CFTR. This study suggests that patients with the G551D mutation and a second severe mutation have a milder clinical phenotype than F508del homozygous patients, but the phenotype is not as mild as patients with the R117H mutation. (Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Comer, D.M., Ennis, M., McDowell, C., Beattie, D., Rendall, J., Hall, V., Elborn, J.S. Tags: Original papers Source Type: journals

Poisoning with the S-Alkyl organophosphorus insecticides profenofos and prothiofosEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Compared with other commonly used OP insecticides, profenofos and prothiofos are of moderately severe toxicity, causing relatively delayed respiratory failure and death. There was no apparent response to oxime therapy. The lack of correlation between red cell AChE activity and clinical features suggests that this parameter may not always be a useful marker of synaptic AChE activity and severity after OP pesticide poisoning. (Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Eddleston, M., Worek, F., Eyer, P., Thiermann, H., Von Meyer, L., Jeganathan, K., Sheriff, M. H. R., Dawson, A. H., Buckley, N. A. Tags: Original papers Source Type: journals

Faecal transplant for recurrent Clostridium difficile-associated diarrhoea: a UK case seriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: In our experience, this technique is an effective and safe treatment for recurrent CDAD. Faecal transplantation via a nasogastric tube could be considered in patients with refractory relapsing CDAD. (Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: MacConnachie, A.A., Fox, R., Kennedy, D.R., Seaton, R.A. Tags: Original papers Source Type: journals

A multi-centre survey of inpatient pharmacological management strategies for alcohol withdrawalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: In response to these findings, we suggest that a simplified national approach is required for what is now recognized to be an epidemic problem. (Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Ward, D., Murch, N., Agarwal, G., Bell, D. Tags: Original papers Source Type: journals

Genetics and the general physician: insights, applications and future challengesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Scientific and technological advances in our understanding of the nature and consequences of human genetic variation are now allowing genetic determinants of susceptibility to common multifactorial diseases to be defined, as well as our individual response to therapy. I review how genome-wide association studies are robustly identifying new disease susceptibility loci, providing insights into disease pathogenesis and potential targets for drug therapy. Some of the remarkable advances being made using current genetic approaches in Crohn's disease, coronary artery disease and atrial fibrillation are described, together with ...
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Knight, J.C. Tags: Review Source Type: journals

Elements: in this month's issueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - October 23, 2009 Category: Internal Medicine Authors: Bannon, M. Tags: Editorial Source Type: journals

Lunch with Richard AsherEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Seaton, A. Tags: Coda Source Type: journals

Variability in the prevalence of radiographic stigmata and in their use for profiling disease severity makes comparisons more complicatedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Jolobe, O. Tags: Correspondence Source Type: journals

History of the cholesterol hypothesis in BritainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Thompson, G. Tags: Correspondence Source Type: journals

The limitations of routine total digoxin immunoassay in patients with advanced chronic kidney diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Sharma, R., Guy, M., Rudenski, A., Lamerton, E., Kalra, P.A. Tags: Correspondence Source Type: journals

The enigma of pulmonary hypertension after splenectomy--does the megakaryocyte provide a clue?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pulmonary hypertension is a common and debilitating condition which is increasingly being recognized in haematological patients. This is particularly so in haemolytic diseases like thalassaemia and myeloproliferative conditions like idiopathic myelofibrosis. Recently, splenectomy, which may be required for some of these conditions, have been linked to this complication although the exact pathophysiology is still not established. The manuscript explains the role of the less recognized ‘lung megakaryocytes’ in the development of this complication. (Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Thachil, J. Tags: Commentary Source Type: journals

Isolated pulmonary Langerhans cell histiocytosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Kasmani, R., Narwal-Chadha, R., Naveed, S., Sahoo, D. Tags: Clinical picture Source Type: journals

A case of ST-elevation and nystagmus--when coronary thrombosis is not to blameEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present the case of a post-menopausal female who, following a prolonged period of vomiting and diarrhoea, presented acutely with Wernicke's; encephalopathy, chest pain, ST-segment elevation and congestive cardiac failure associated with hypotension. Coronary angiography demonstrated no abnormality. Haemodynamics improved significantly in the short-term following intravenous thiamine replacement, with complete resolution of all ST-segment abnormalities and normalization of left ventricular function at six-week follow-up. Shoshin beriberi in the context of metabolic alkalosis, secondary to severe electrolyte depletion, is...
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Daly, M.J., Dixon, L.J. Tags: Case reports Source Type: journals

Bilateral neck paragangliomasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a case of a 62- year-old woman with a diagnosis of bilateral neck paragangliomas where surgical removal was judged burdened by excessive risk because of the size of the tumor (Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Mumoli, N., Cei, M., Pauletti, M., Ferrito, G., Scazzeri, F. Tags: Case reports Source Type: journals

Use of oral dimercaptosuccinic acid (succimer) in adult patients with inorganic lead poisoningEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Oral DMSA 30 mg/kg/day is an effective antidote for lead poisoning, though there is a wide inter- and intra-individual variation in response. (Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Bradberry, S., Sheehan, T., Vale, A. Tags: Original papers Source Type: journals

Globalization, immigration and diabetes self-management: an empirical study amongst immigrants with type 2 diabetes mellitus in IrelandEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Those providing diabetes education and care need to be aware of differing patient expectations regarding family involvement in the care of their diabetes and the possible contribution of language problems and lower health literacy to a limited understanding of diabetes self-care. (Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Thabit, H., Shah, S., Nash, M., Brema, I., Nolan, J.J., Martin, G. Tags: Original papers Source Type: journals

Prehypertension is associated with insulin resistanceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: Our data show that prehypertension is associated with IR. The subjects with prehypertension have clinical characteristics of the IR syndrome. It seems that the prehypertension group cannot handle oral glucose challenge as well as the normotension, probably a consequence of IR in prehypertension. (Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Hwu, C.-M., Liou, T.-L., Hsiao, L.-C., Lin, M.-W. Tags: Original papers Source Type: journals

Progression of cardiac dysfunction in patients with atherosclerotic renovascular diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Patients with ARVD exhibit a high prevalence of LVH at diagnosis and progressive left ventricular dilatation over the first year after diagnosis. This dilatation is associated with severe renal impairment at baseline and not associated with anatomical severity of renal artery disease. (Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Wright, J. R., Shurrab, A. E., Cooper, A., Kalra, P. R., Foley, R. N., Kalra, P. A. Tags: Original papers Source Type: journals

New developments in the management of malaria in adultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In dealing with malaria, the challenge that remains is prompt diagnosis and initiation of specific and supportive treatment. Physicians should be aware of the therapeutic and prognostic implications of life-threatening falciparum vs. non-falciparum malaria and be able to at least recognize the severe manifestations of malaria which may require an increased level of care or referral to a specialist unit. The most important new developments in managing malaria in patients are the increasing problem of drug resistance, the availability of new antimalarial agents (most notably the artemisinins) and general advances in the mana...
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Roe, J.K., Pasvol, G. Tags: Reviews Source Type: journals

Q fever: persistence of antigenic non-viable cell residues of Coxiella burnetii in the host--implications for post Q fever infection fatigue syndrome and other chronic sequelaeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion/Review: We advance a concept of long-term persistence of a non-infective, non-biodegraded complex of coxiella cell components with its antigens and specific LPS [so called Immunomodulatory complex (IMC)] associated with traces of genomic DNA that signalled its presence in our earlier studies. The IMC's survival in patients for at least 12 years, and in one patient for 70 years implies a capacity for serial passage in macrophages with effective down-regulation of their biodegrading functions. The review assesses the compatibility of the IMC concept in relation to cogent literature on C. burnetii interactions with...
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Marmion, B.P., Sukocheva, O., Storm, P.A., Lockhart, M., Turra, M., Kok, T., Ayres, J., Routledge, H., Graves, S. Tags: Reviews Source Type: journals

Elements: In this month's issueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - September 22, 2009 Category: Internal Medicine Authors: Bannon, M. Tags: Editorial Source Type: journals

Red-green blindnessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Seaton, A. Tags: Coda Source Type: journals

Dyslipidemia and cardiovascular risk: the importance of early preventionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Strategies aimed at primary prevention provide an outstanding opportunity for reducing the onset and burden of cardiovascular (CV) disease. Lipid abnormalities, including high levels of low-density lipoprotein cholesterol (LDL-C), elevated triglycerides and low levels of high-density lipoprotein cholesterol (HDL-C), are associated with an increased risk of CV events, thereby serving as contributors to this process. By consensus, lowering LDL-C, generally with statin therapy, is the primary target of lipid-lowering therapy. However, statin therapy may be insufficient for patients with mixed dyslipidemia, especially those wi...
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Miller, M. Tags: Commentary Source Type: journals

Life-threatening scrotal painEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Sun, J.-T., Tsai, K.-C., Wu, C.-J., Lien, W.-C., Wang, H.-P. Tags: Clinical picture Source Type: journals

Incomplete Carney triad--a review of two casesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report here two patients with incomplete expression of Carney's triad. (Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Sawhney, S.A., Chapman, A.D., Carney, J.A., Gomersall, L.N., Dempsey, O.J. Tags: Case report Source Type: journals

The Association of Physicians of Great Britain and Ireland 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Tags: Annual General Meeting Source Type: journals

Statin therapy, muscle function and falls risk in community-dwelling older adultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Statin use may exacerbate muscle performance declines and falls risk associated with aging without a concomitant decrease in muscle mass, and this effect may be reversible with cessation. (Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Scott, D., Blizzard, L., Fell, J., Jones, G. Tags: Original papers Source Type: journals

Perceived fatigue is comparable between different disease groupsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Perceived fatigue is similar between patient groups. Increasing scores were not related to simply reaching the maximum threshold in the physical domain. Studies have confirmed a positive-structured approach to symptom management in one fatigue-associated chronic disease, primary biliary cirrhosis, leads to significant improvements in quality of life. We suggest that, with a similar approach, the same might be true in other chronic diseases where moderate fatigue is a significant problem. (Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Jones, D.E.J., Gray, J.C., Newton, J. Tags: Original papers Source Type: journals

Resistance exercise plus to aerobic activities is associated with better lipids' profile among healthy individuals: the ATTICA studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: These data suggest that combining aerobic and resistance-type activities may confer a better effect on lipoprotein profile in healthy individuals than aerobic activities alone. (Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Pitsavos, C., Panagiotakos, D.B., Tambalis, K.D., Chrysohoou, C., Sidossis, L.S., Skoumas, J., Stefanadis, C. Tags: Original papers Source Type: journals

Nocturnal hypoglycaemia in type 1 diabetes--frequency and predictive factorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Our data show that in normal day to day settings, NH is common and that the bedtime glucose level is a significant predictive factor. (Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Woodward, A., Weston, P., Casson, I.F., Gill, G.V. Tags: Original papers Source Type: journals

Commissioned article: management of exotic snakebitesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Exotic (foreign or non-native) snakes, including venomous species, are becoming increasingly popular pets in Western countries. Some of them are kept illegally (as defined by the UK Dangerous Wild Animals Act of 1976). There is a large international market for such animals, with contraventions of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). In the UK, several other European countries and the USA the reported numbers of bites by venomous exotic snakes, although small, are increasing but still underestimate the occurrence of these occasionally fatal events because of the victim...
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Warrell, D.A. Tags: Review Source Type: journals

Elements: In this month's issueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - August 18, 2009 Category: Internal Medicine Authors: Bannon, M. Tags: Editorial Source Type: journals

Did Darwin read Mendel?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: Galton, D. Tags: Coda Source Type: journals

European Working Time Directive in a stroke unit: hidden deficitsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: McCarroon, M.O., Armstrong, M., McCarron, P. Tags: Correspondence Source Type: journals

'Hospital at Night' improves outcomes: does the evidence support opinions?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: Cappuccio, F.P. Tags: Commentary Source Type: journals

Towards a more inclusive vision of the medical sciencesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Progress in the medical sciences is largely determined by two things: (i) the questions we ask, and (ii) how rigorously and vigorously we attempt to answer them. How do we know which questions are the right questions to ask, and thus the correct questions to spend our time and energies trying to answer? Such evaluative concerns bring into sharper focus the question—‘What is medicine for?’ The international study of rosuvastatin is important not simply because of the health benefits it may confer, but because it inspires a more robust and inclusive vision of the medical sciences. A vision which recognizes ...
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: Farrelly, C. Tags: Commentary Source Type: journals

Whitish thickening of the tongueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: Guarneri, C., Barbuzza, O., Vaccaro, M. Tags: Clinical Pictures Source Type: journals

Spontaneous haemopericardium with subacute cardiac tamponade in a patient with lung cancer receiving coumadinEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: QJM)
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: Braiteh, F., Plana, J. C. Tags: Clinical pictures Source Type: journals

Thomas Addison's disease after 154 years: modern diagnostic perspectives on an old conditionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Thomas Addison was first to describe adrenocortical failure in 1855. Despite advances in the treatment of this condition, the diagnosis is still often delayed and sometimes missed with potentially fatal consequences. From the same institution where Thomas Addison performed his original autopsy studies, we present four recent cases highlighting the wide clinical spectrum and discuss how modern biochemical and immunological tests could be utilized in early diagnosis and aetiological classification. (Source: QJM)
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: Leelarathna, L., Powrie, J.K., Carroll, P.V. Tags: Case report Source Type: journals

Failure of antivenom to improve recovery in Australian snakebite coagulopathyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: Antivenom did not appear to be effective for the coagulopathy in snake envenoming in Australia. FFP appeared to shorten the time of VICC recovery. (Source: QJM)
Source: QJM - July 21, 2009 Category: Internal Medicine Authors: Isbister, G.K., Duffull, S.B., Brown, S.G.A., for the ASP Investigators Tags: Original Papers Source Type: journals