Drug treatment of pruritus in liver diseases.
Abstract
Pruritus (itch) is a common complication of cholestatic liver diseases (CLD). It can be a distressing and debilitating symptom, causing significant impairment in quality of life. Treatment of pruritus in liver diseases can be challenging and requires specific management with early initiation and a step-wise approach using specific drugs. Clinical trials are ongoing with novel agents that demonstrate potential efficacy. Patients with cholestatic pruritus are likely to present to a variety of clinicians who would benefit from medical awareness of available treatment options. In this review, we outli...
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Hegade VS, Kendrick SF, Jones DE Tags: Clin Med Source Type: research
Working on the front line.
This article reflects on challenges faced working in an Ebola treatment centre and what future research may offer.
PMID: 26407385 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: O'Hara G Tags: Clin Med Source Type: research
The acute management of ST-segment-elevation myocardial infarction .
Abstract
Acute ST-segment-elevation myocardial infarction (STEMI) results from complete obstruction to coronary artery blood flow accompanied by the appearance of ST-segment-elevation on the electrocardiogram. Emergency treatment is required to restore coronary perfusion, thereby limiting the extent of damage to the myocardium and the likelihood of early death or future heart failure. This concise guideline summarises key recommendations from the National Institute for Health and Care Excellence clinical guideline on acute management of STEMI (CG167), of relevance to all healthcare professionals involved. ...
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Carville SF, Henderson R, Gray H Tags: Clin Med Source Type: research
The up-to-date management of venous thromboembolism .
Abstract
There have been a number of developments in the management of venous thromboembolism over the past few years. Old questions, such as thrombolysis, have been revisited in recent trials. New initiatives, such as ambulatory care pathways, are being established across the country. This conference brought together doctors from the UK, USA, Spain and Australia to review the up-to-date management of venous thromboembolism.
PMID: 26407387 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Chakrabarti AM Tags: Clin Med Source Type: research
Quantifying bile acid malabsorption helps predict response and tailor sequestrant therapy.
PMID: 26407388 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Orekoya O, McLaughlin J, Leitao E, Johns W, Lal S, Paine P Tags: Clin Med Source Type: research
Clinical and scientific letters: Survey on the attitudes of hospital doctors towards the terms 'acopia' and 'social admission' in clinical practice.
Authors:
PMID: 26407389 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Tags: Clin Med Source Type: research
Acute presentation of the pregnant patient.
This article focuses on women presenting with shortness of breath, chest pain and palpitations.
PMID: 26407390 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Neuberger F, Nelson-Piercy C Tags: Clin Med Source Type: research
Frailty at the front door.
This article discusses the background to frailty, and a number of validated frailty scores which can be applied by non-specialists in the acute environment. It highlights other resources which are available to help with the management of this complex group of patients, and discusses potential local and national service developments in this area.
PMID: 26407391 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Wyrko Z Tags: Clin Med Source Type: research
Radiotherapy in the acute medical setting.
Abstract
Radiotherapy is an effective treatment modality and an essential tool in the management of cancer. As the incidence of malignant disease rises it is inevitable that physicians will increasingly encounter patients who have presented acutely and require radiotherapy or with a complication from irradiation. This paper explores the basic principles of radiotherapy tailored to the perspective of the acute medical physician and how to manage acute complications. We also discuss the role of radiotherapy in the acutely ill patient and define the need for radiotherapy pathways to ensure that patients recei...
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Brown S, Kirkbride P, Marshall E Tags: Clin Med Source Type: research
Critical care admission for acute medical patients.
Abstract
Demand for intensive care is growing. There are no contemporaneous consensus guidelines on which patients should be referred to intensive care. Prognostic scoring systems predict survival, but are of limited use for individual patients. Some groups of patients have historically been regarded as having a very high mortality after admission to intensive care, raising questions about the appropriateness of advanced organ support in these patients. We reviewed the existing literature on outcomes of patients admitted to intensive care with chronic obstructive pulmonary disease, liver cirrhosis and haem...
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Packham V, Hampshire P Tags: Clin Med Source Type: research
CME Acute medicine SAQs (95277): Self-assessment questionnaire.
Authors:
PMID: 26407394 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Tags: Clin Med Source Type: research
Lesson of the month 1: Seeing snowflakes.
We describe a patient with this condition who presented with persistent visual symptoms.
PMID: 26407395 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Patel A, Aslam A, Orr G, Perkins W Tags: Clin Med Source Type: research
Lesson of the month 2: IgG4-related renal mass with spontaneous resolution.
We describe a case of IgG4-related renal mass, which resolved spontaneously. The patient presented with right loin pain, constitutional symptoms and raised inflammatory markers. Magnetic resonance imaging (MRI) showed a large infiltrative mass centered on the right renal hilum and biopsy demonstrated histological changes in keeping with IgG4-RD. A careful 'watch-and-wait' approach was taken and at six months following initial presentation, the patient's symptoms had fully resolved and inflammatory markers had normalised. Repeat MRI showed almost complete resolution of the mass. We propose that a careful 'watch-and-wait' ap...
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Ramasamy VB, Trefor R, Rajamani K, Santosh D, Griffiths D, Donovan K Tags: Clin Med Source Type: research
A hidden bomb behind hypertension.
PMID: 26407397 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Yeh YT, Chuang W Tags: Clin Med Source Type: research
Book review.
PMID: 26407398 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Marshall M Tags: Clin Med Source Type: research
