Harveian Oration 2014: Stem cells and cell replacement prospects .
PMID: 25824069 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Gurdon J Tags: Clin Med Source Type: research
FitzPatrick Lecture: King George III and the porphyria myth - causes, consequences and re-evaluation of his mental illness with computer diagnostics.
This article explores some of the causes of this misdiagnosis and the consequences of the misleading claims, also reporting on the nature of the king's recurrent mental illness according to computer diagnostics. In addition, techniques of cognitive archaeology are used to investigate the nature of the king's final decade of mental illness, which resulted in the appointment of the Prince of Wales as Prince Regent. The results of this analysis confirm that the king suffered from bipolar disorder type I, with a final decade of dementia, due, in part, to the neurotoxicity of his recurrent episodes of acute mania.
PMID...
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Peters T Tags: Clin Med Source Type: research
Management of patients with Graves' orbitopathy: initial assessment, management outside specialised centres and referral pathways.
Abstract
Graves' orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diagnosis, initial management and referral pathways are highlighted.
PMID: 25824071 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Perros P, Dayan CM, Dickinson AJ, Ezra D, Estcourt S, Foley P, Hickey J, Lazarus JH, MacEwen CJ, McLaren J, Rose GE, Uddin J, Vaidya B Tags: Clin Med Source Type: research
Alcoholic liver disease - the extent of the problem and what you can do about it.
Abstract
It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This process is silent and symptom free and can easily be missed in primary care, usually presenting with advanced cirrhosis. At this late stage, management consists of expert supportive care, with prompt identification and treatment of bleeding, sepsis and renal problems, as well as support to change behaviour and stop harmful alcohol consumption. There are opportunities to improve care by bringing liver care everywhere up to the standards o...
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Hazeldine S, Hydes T, Sheron N Tags: Clin Med Source Type: research
Non-alcoholic fatty liver disease: when to intervene and with what.
Abstract
Non-alcoholic fatty liver disease (NAFLD) is increasingly common due to the rising prevalence of obesity in both children and adults. It is associated with metabolic risk factors such as diabetes mellitus, dyslipidaemia and hypertension, and is associated with increased mortality both from cardiovascular-related and liver-related deaths. Identification of those individuals with significant inflammation and fibrosis is a critical part of the patient pathway. Current treatments for NAFLD include weight loss from lifestyle modification or bariatric surgery, management of underlying metabolic risk fac...
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Than NN, Newsome PN Tags: Clin Med Source Type: research
New insights in the management of chronic hepatitis B.
This article focuses on the unmet needs in CHB today; a better definition of disease phase, the timing of therapeutic intervention, optimising treatment strategies with current therapies and the development of novel agents; all with HBsAg loss as the therapeutic goal.
PMID: 25824074 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Gill US, Kennedy PT Tags: Clin Med Source Type: research
Chronic hepatitis C - what do the new drugs offer and who should get them first?
Abstract
Until recently in the UK the treatment of HCV depended on combination regimes of interferon (IFN) and the antiviral drug ribavirin. These regimes required regular injections and were of variable duration (generally for a minimum of 12 weeks), and the use of IFN often caused unacceptable side effects (thrombocytopenia, leukopenia and depression). Of the common HCV genotypes in the UK, genotype 1 responded relatively poorly to these regimes (50-60% viral clearance), while most (80% plus) of genotype 3 patients responded with sustained viral clearance. Patients with severe liver disease (decompensate...
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Ryder SD Tags: Clin Med Source Type: research
Management of patients with decompensated cirrhosis.
Abstract
During the assessment of a patient with liver disease, finding the patient has decompensated cirrhosis, as defined by the presence of jaundice, ascites, variceal haemorrhage or hepatic encephalopathy, has major implications regarding management and prevention of cirrhosis-related complications, as well as consideration for a referral for liver transplantation evaluation. Prognosis is markedly worse in patients with decompensated compared with compensated cirrhosis. In general, any patient with decompensated cirrhosis should receive evaluation and medical care by a hepatologist. Since patients freq...
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Harrison PM Tags: Clin Med Source Type: research
CME Hepatology SAQs (95275): Self-assessment questionnaire.
PMID: 25824077 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Hodgson H, Chowdhury T Tags: Clin Med Source Type: research
Lesson of the month 1: A rash decision.
We describe the case of a patient with anaplastic large cell lymphoma masquerading as a lower leg cellulitis. The patient had failed to respond to intravenous antibiotics and a skin biopsy confirmed her diagnosis. She received radical radiotherapy to the lower leg but later developed shortness of breath and was identified to have pulmonary infiltration of the lymphoma. She died shortly afterwards from lobar pneumonia. This case highlights the importance of regularly reassessing patients with suspected cellulitis and considering alternative diagnoses in cases that fail to respond to treatment.
PMID: 25824078 [PubMe...
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Sedgwick CL, Hall PE, Ratnarajah A, Natkunarajah J, Hogh L Tags: Clin Med Source Type: research
Lesson of the month 2: Cough and right hypochondrial discomfort.
Abstract
Cystic echinococcosis, commonly known as hydatid disease, is caused by the larval stage of the tapeworm Echinococcus granulosus. Humans are an accidental host to this rare disease in the UK, with around 10-20 new cases reported each year. Once suspected, the diagnosis is confirmed through a combination of relevant history, imaging studies and serological testing. This lesson presents a case of hydatid disease and outlines the significant management issues when cysts rupture and the disease becomes disseminated.
PMID: 25824079 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Kurunadalingam H, Dubrey SW, Chiodini PL Tags: Clin Med Source Type: research
Myositis and metastatic melanoma.
PMID: 25824080 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Karsan N, Barker R, Wren D Tags: Clin Med Source Type: research
Book review.
PMID: 25824081 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Macbeth F Tags: Clin Med Source Type: research
Brucella and Coxiella; if you don't look, you don't find.
Authors:
PMID: 25824082 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Tags: Clin Med Source Type: research
Myasthenia gravis as a 'stroke mimic'.
PMID: 25824083 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Patel HC, Hayward C, Manohar S Tags: Clin Med Source Type: research
