Response.
PMID: 25824084 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Emsley HC Tags: Clin Med Source Type: research
Diabetes CME.
PMID: 25824085 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Gwilt C, Mustafa O, Hall E Tags: Clin Med Source Type: research
Sudden onset postural livedo reticularis, cyanotic toes and multiorgan failure.
PMID: 25824086 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Al-Attia HM Tags: Clin Med Source Type: research
At what cost are resuscitation discussions avoided in general practice?
PMID: 25824087 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Cork N, Charlton R Tags: Clin Med Source Type: research
Increased risk of ischaemic stroke while initiating warfarin in patients with atrial fi brillation.
PMID: 25824088 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Adhiyaman V, O'mahony K Tags: Clin Med Source Type: research
CARE - A risk-reduction acronym for clinical communications.
PMID: 25824089 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - April 1, 2015 Category: Journals (General) Authors: Stubington SR Tags: Clin Med Source Type: research
Consultation and informed opinion.
PMID: 25650187 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Hodgson H Tags: Clin Med Source Type: research
A minimum unit price: the 'holy grail' of alcohol policy.
PMID: 25650188 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Gilmore I Tags: Clin Med Source Type: research
Team assessment of behaviour: a high stakes assessment with potential for poor implementation and impaired validity.
This study reports an audit of invalid TAB submissions over a three-year cycle in the West Midlands' Foundation Programme. In 2010, large numbers of TABs were invalid, owing to an incorrect selection or number of assessors. Introduction of validity checking before sign-off greatly improved the numbers of valid assessments in 2011. This was partially sustained in 2012. Assurance of assessment validity is important to ensure delivery of appropriate constructive feedback and to allow early detection and remediation of signs of poor professional behaviours in foundation doctors.
PMID: 25650189 [PubMed - in process] (S...
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Whitehouse A, Higginbotham L, Nathavitharana K, Singh B, Hassell A Tags: Clin Med Source Type: research
Requiem for the grand round.
Abstract
The time-honoured tradition of Grand Round is firmly rooted in medical education, but has little evidence for its effectiveness or its impact on patient management. A mode of didactic teaching, Grand Round has lost its appeal in modern medical education with dwindling attendance at Grand Rounds worldwide. Once a platform for eminence-based medicine and a cross fertilisation of medical ideas, emphasis on sub-specialisation and clinical governance, combined with rota, trainee engagement and attendance failures has made Grand Round obsolete. To survive, Grand Round must have evidence for its effectiv...
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Stanyon M, Khan SA Tags: Clin Med Source Type: research
Omitted medications: a continuing problem.
Abstract
Failure to provide prescribed medicines to inpatients has the potential to cause significant patient harm, to delay the resolution of the pathology and to increase the length of hospital stay. We measured the frequency at which medications were omitted in the non-admitting medical wards of a district general hospital, using two point-prevalence studies spaced one month apart. The results showed that the omission of prescribed medications remains a problem throughout the hospital stay of the patient. Among the charts studied, 73% had omitted medications. The most common cause of omission was patien...
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Shandilya S, Nizamuddin K, Faisal MW, Noor S, Abraham S Tags: Clin Med Source Type: research
Relationship between input and output in acute medicine - secondary analysis of the Society for Acute Medicine's benchmarking audit 2013 (SAMBA '13).
Abstract
The performance of acute medical units (AMUs) against published quality indicators is variable. We aimed to identify the impact of case-mix and unit resources on timely assessment and discharge of patients admitted to 43 AMUs on a single day in June 2013, as part of the Society for Acute Medicine's benchmarking audit 2013. Performance against quality indicators was at its worst in the early evening hours. Units admitting fewer than 40 patients performed better. Patients who were more frail, as measured by the Clinical Frailty Scale, were also more likely to have significant physiological abnormali...
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Subbe CP, Burford C, Jeune IL, Masterton-Smith C, Ward D Tags: Clin Med Source Type: research
Inpatient hyponatraemia: adequacy of investigation and prevalence of endocrine causes.
This study assessed the effect of endocrine input on the investigation of hyponatraemia and examined the prevalence of endocrine causes of hyponatraemia. This single-centre, retrospective study included 139 inpatients (median age, 74 years) with serum sodium (Na) levels ≤128 mmol/l during hospitalisation at a UK teaching hospital over a three-month period. In total, 61.9% of patients underwent assessment of volume status and 28.8% had paired serum and urine osmolality, and Na measured. In addition, 14.4% of patients received endocrine input; 80% of these patients underwent full work-up of hyponatraemia compared with 5%...
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Tzoulis P, Bouloux PM Tags: Clin Med Source Type: research
Vestibular impairment in older people frequently contributes to dizziness as part of a geriatric syndrome.
Abstract
Research to identify whether dizziness is a geriatric syndrome has largely overlooked often treatable vestibular causes. To ascertain the degree to which vestibular and other causes of dizziness interact in older people, an eight-month retrospective case-note review was undertaken in patients aged ≥: 65 years referred with dizziness or imbalance to an audiovestibular medicine clinic. Of 41 patients aged 65-93 years old, 15 (37%) had multiple symptom triggers, 23 (56%) had recent dizziness-related falls, 24 (59%) and 10 (24%) had peripheral and central vestibular causes for dizziness respective...
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Ahearn DJ, Umapathy D Tags: Clin Med Source Type: research
Decision making in venous thromboembolism prophylaxis: Is LWMH being inappropriately withheld from patients admitted with chronic liver disease?
Abstract
Although chronic liver disease (CLD) constitutes a significant proportion of acute medical admissions, it is not known how CLD influences venous thromboembolism (VTE) prophylaxis decision making and low molecular weight heparin (LMWH) prescription. Furthermore, recent evidence suggests that VTE risk has been underestimated in CLD and that prophylactic LMWH is safe and may improve outcome in this patient group. We therefore evaluated VTE prophylaxis in patients with CLD and aimed to determine the factors contributing to decisions to prescribe LMWH. Prescription of LMWH was significantly less likely...
Source: Clinical Medicine - February 1, 2015 Category: Journals (General) Authors: Lau C, Burd C, Abeles D, Sherman D Tags: Clin Med Source Type: research
