Legal landmark?
Reported to-day is the £5million pound outcome of a ruling hailed as one of the most important on negligence for decades - but is it? What seems surprising is that the claim had been twice rejected in Scotland. Apparently in 1999 a 40 year old type1 diabetic mother had complications during PV delivery leading to severe brain damage in her son. The problem seems to have been shoulder dystocia which may be difficult to predict but increased birth weight and diabetes are factors  It seems the obstetrician chose not to discuss this potential complication and to see if the mother would opt for a CS (which she says sh...
Source: Doc2Doc BMJ Cardiology - March 12, 2015 Category: Cardiology Authors: sken Source Type: forums

What's the diagnosis? 70 yo male with sob and lymphoedema in legs
70 yo male with sob and lymphoedema in legs. Also complains of burning pain in fingers, abnormal sweating, easy fatiguability and abdominal cramps Ecg shows minor repolarisation abnormalities. Echo shows concentric lvh without cavity dilatation, normal LV systolic function, mitral valve prolapse with mild MR. He is normotensive. Urine dipstick - mild proteinuria What's the unifying diagnosis? Clue.....not amyloid! (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 9, 2015 Category: Cardiology Authors: heart doc Source Type: forums

Clinical question of the week: what's the diagnosis here?
46 year-old male with no significant past medical history and excellent exercise tolerance (2-3 miles jogging/day) symptoms of palpitations, some mild chest pain, and evolution of a rash 4-6 weeks prior of note pt frequently visits SE Massachussetts, had a significant other living in that area, and area is known to have a high incidence of 'tick infestations’. EKG in ER showed:   Skin exam showed: 1. What is the most likely diagnosis? 2. Would you treat empirically? What would you start? 3. Is it appropriate to try atropine or isoproterenol? 4. Is a pacemaker indicated? 5. Is there any othe...
Source: Doc2Doc BMJ Cardiology - March 9, 2015 Category: Cardiology Authors: Heartfelt Source Type: forums

Inner city fast food outlets linked to diabetes and obesity
From Diabetes.co.uk web site14 November A new study has revealed there are twice the number of fast-food outlets in inner cities, which can be linked to diabetes and obesity. Research from the University of Leicester found these outlets were within 500 metres of high density non-white ethnic minority groups and socially deprived neighbourhoods. The study was based on 10,000 people in the UK, with researchers warning that important implications for diabetes prevention can be taken from these findings. The researchers, writing in the journal Public Health Nutrition, said that two additional outlets per neighbou...
Source: Doc2Doc BMJ Cardiology - March 2, 2015 Category: Cardiology Authors: diabetesMD Source Type: forums

A large cohort study suggests that aspirin prophylaxis only benefits people with a prior cardiovascular event
Conclusions In patients with stable coronary artery disease and hypertension, aspirin use was associated with reduced risk for adverse cardiovascular outcomes among those with prior ischemic events. Among patients with no prior ischemic events, aspirin use was not associated with a reduction in risk. COMMENT: The determining the risk/benefit ratio of prophylactic aspirin use for the prevention of cardiovascular events has become a complicated issue.  The current recommendations from the CDC http://www.cdc.gov/heartdisease/aspirin.htm recommend aspirin prophylaxis in those with prior cardiovascular events.  Th...
Source: Doc2Doc BMJ Cardiology - March 2, 2015 Category: Cardiology Authors: diabetesMD Source Type: forums

Higher Whole Grain Intake Linked to Lower Mortality
In preparation for my case ofthe week i ran accoss severay articles on diet that I felt would be of interest to the readers of the Cardiology forum.  i am posting them today. Higher Whole Grain Intake Linked to Lower Mortality By Jenni Whalen from 6 January 2015 NEJM Journal Watch Edited by David G. Fairchild, MD, MPH Higher intake of whole grains is associated with reduced overall mortality and especially cardiovascular mortality, according to a JAMA Internal Medicine study. Researchers followed approximately 74,000 women from the Nurses' Health Study from 1984 to 2010, and nearly 44,000 men from the Health...
Source: Doc2Doc BMJ Cardiology - March 2, 2015 Category: Cardiology Authors: diabetesMD Source Type: forums

Low carbohydrate diet improves weight loss and cardiovascular risk factors
Conclusion: The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors. COMMENT: While a study this small can not answer definitively the question of the ideal nutrient mix for weight loss and reduction of cardiovascular risk factors, this study does suggest that reducing carbohydrate is an effective strategy to accomplish both weight loss and improvement in cardiovascular risk factors.   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 2, 2015 Category: Cardiology Authors: diabetesMD Source Type: forums

Dietary cholesterol consumption no longer of concern
An expert panel in the US on healthy eating has published its dietary recommendations this week in a 570 page report. 'Current evidence suggests that there is no appreciable relationship between heart disease and dietary cholesterol consumption'. They have also concluded that 3 to 5 cups of coffee per day can form part of a healthy balanced diet http://www.medscape.com/viewarticle/840328?nlid=77207_1985&src=wnl_edit_medn_card&uac=103682HR&spon=2 Crazy advice or welcome evidence based challenge to dogma? .....You decide (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 28, 2015 Category: Cardiology Authors: heart doc Source Type: forums

Clinical question of the week: what are the next management steps for this patient with mitral stenosis?
A 45-year-old female is currently being followed in a cardiology clinic due to a mitral stenosis diagnosed incidentally during a physical exam 5 years ago. The patient was prescribed atenolol 50mg/d despite minimal symptoms, and remained stable during follow up. She returned to her cardiologist for a clinical evaluation complaining of dyspnea on exertion, with a NYHA functional class III. No orthopnea or other symptoms. The patient denied palpitations or any other complaint. On physical examination, no signs of right heart failure (liver, edema, etc.) were noted, and lung auscultation was unremarkable. The ECG demons...
Source: Doc2Doc BMJ Cardiology - February 4, 2015 Category: Cardiology Authors: MBittencourt Source Type: forums

Free access to BMJ cardiology content in February
To mark National Heart Month in the UK, BMJ is offering free access to a selection of content from its cardiology journals and products (see full list here) and 15% off the article publishing charge when you publish your cardiology research in one of its open access journals (Open Heart, BMJ Open, Lupus Science & Medicine). To claim the 15% use promotion code ZJ6UJR3 upon payment after your article has been accepted. Here are some of the free modules from BMJ Learning: 10 minute consultation - diagnosis and management of chronic heart failure Chest pain of recent origin - assessment and diagnosis: in as...
Source: Doc2Doc BMJ Cardiology - February 3, 2015 Category: Cardiology Authors: Sabreena Source Type: forums

MRCP Part 1 Question of the Day from BMJ OnExamination - systolic murmur
A 60-year-old woman has a systolic murmur. As part of the evaluation you listen to the murmur during a Valsalva manoeuvre and the murmur becomes louder. (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 3, 2015 Category: Cardiology Authors: Sabreena Source Type: forums

Follow up to Alien abductions or Can biology be quantified?
The attached paper was promised to explain male abductions but is really a crude attempt to define the power of entropy in biology and perhaps quantify biologic process.  Refining this concept into a usable methodology requires great effort from multiple disciplines.  This method will be an attempt at quantifying biological processes.  Entropy is not time dependent but does depend on the current state of organization and all of the probable conditions that are available; thus, defining the next stage of development.  Traversing each stage gives a sense of time dependency since order of processes is dete...
Source: Doc2Doc BMJ Cardiology - February 1, 2015 Category: Cardiology Authors: Houckster Source Type: forums

Diagnosing and treating MI in women - a paper to change practice
There has been a lot of publicity for this BMJ cohort study of 1126 patients presenting with “suspected acute coronary syndrome” to the Edinburgh Royal Infirmary over a three month period. The use of high sensitivity troponin testing made little difference to the diagnosis rate in men but doubled the number of women diagnosed with myocardial infarction. This is an important and well reported study and I think it calls for an immediate change in practice followed by a series of further studies. I think we are still some way short of knowing how best to diagnose and treat MI in women. (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 28, 2015 Category: Cardiology Authors: Richard Lehman Source Type: forums

heart disease is harmful in ages 20's?
Can you tell me information regarding the doctors to whom i have to consult? Can any one suggest best heart hospital in Madhapur? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 22, 2015 Category: Cardiology Authors: innovatemedical Source Type: forums

tips on preparing for medical appraisal
Medical appraisals are essential for all doctors in the UK. Please see below a useful link on how to prepare for this http://careers.bmj.com/careers/advice/view-article.html?id=20015063&utm_medium=email&utm_campaign=18781&utm_content=BMJ%20Careers%20latest%20-%20interview%20skills%2C%20CV%20tips%20and%20other%20job%20hunting%20help%21&utm_term=How%20to%20prepare%20for%20medical%20appraisals&utm_source=Adestra_BMJ%20Careers (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 4, 2015 Category: Cardiology Authors: heart doc Source Type: forums