Vitamin B12 deficiency - A 21st century perspective.
Abstract
OVERVIEWPlease submit letters for the editor's consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine@rcplondon.ac.uk.
PMID: 26407399 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Oo TH Tags: Clin Med Source Type: research
Response.
PMID: 26407400 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Thachil J Tags: Clin Med Source Type: research
Point-of-care cardiac ultrasound in acute internal medicine: how can it be delivered?
Abstract
OVERVIEWLetters not directly related to articles published in Clinical Medicine and presenting unpublished original data should be submitted for publication in this section. Clinical and scientific letters should not exceed 500 words and may include one table and up to five references.
PMID: 26407401 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Chambers JB, Rajani R, Short N, Victor K, O'kane K Tags: Clin Med Source Type: research
Educating clinician leaders: can the NHS benefit from the US MD/MBA experience?
PMID: 26407402 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Cork N, Devine CA Tags: Clin Med Source Type: research
Letter to the Royal College of Physicians regarding the suitability of the National Early Warning Score in the assessment of the unwell spinal cord injury patient.
PMID: 26407403 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Asafu-Adjaye K, Gall A Tags: Clin Med Source Type: research
Osteoporotic vertebral fractures in older patients.
PMID: 26407404 [PubMed - as supplied by publisher] (Source: Clinical Medicine)
Source: Clinical Medicine - August 1, 2015 Category: Journals (General) Authors: Akintade O Tags: Clin Med Source Type: research
A national support service.
PMID: 26031966 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Hodgson H Tags: Clin Med Source Type: research
Registration at the time of graduation.
PMID: 26031967 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Kopelman P Tags: Clin Med Source Type: research
Testing the AMB score - can it distinguish patients who are suitable for ambulatory care?
Abstract
The Royal College of Physicians' Acute care toolkit 10 has recommended the use of the AMB score as an aid to determining patients suitable for ambulatory care. As this score has only been previously validated in one centre, the present study calculated the score of 200 patients referred to the medical take to see if it successfully identified patients who had a length of stay of less than 12 hours. In our test centre, the score was found to have a reduced sensitivity compared with the original centre (88 vs 96%) and a positive predictive value of 39%. Therefore in our hospital this was not a use...
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Thompson A, Wennike N Tags: Clin Med Source Type: research
Implementation of NICE clinical guideline 95 on chest pain of recent onset: experience in a district general hospital.
In conclusion, implementing NICE CG95 is feasible but presents challenges. Staff require training to follow the protocol consistently. Functional testing had no benefits over anatomical testing with CTCA, which may allow cost savings in some departments.
PMID: 26031969 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Ormerod JO, Wretham C, Beale A, Haynes D, Harries I, Ramcharitar S, Foley PW, McCrea WA, Chandrasekaran B, Barnes E Tags: Clin Med Source Type: research
Diabetes patient at risk score - a novel system for triaging appropriate referrals of inpatients with diabetes to the diabetes team.
Abstract
The acceptability, uptake and effectiveness of a new referral tool - the diabetes patient at risk (DPAR) score - were evaluated and the timeliness of review of referred inpatients by the diabetes team was measured. For this, a snapshot survey of ward healthcare professionals (HCPs) and a review of all DPAR referrals to the diabetes team between 1 September 2013 and 31 January 2014 were undertaken. All referrals in November 2013 were audited for timeliness of review. 77% of HCPs agreed/strongly agreed that the tool improved access to the diabetes team. 76% of referrals were from nurses. 80% of who ...
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Rajendran R, Round RM, Kerry C, Barker S, Rayman G Tags: Clin Med Source Type: research
Comparison of ESC and NICE guidelines for patients with suspected coronary artery disease: evaluation of the pre-test probability risk scores in clinical practice.
Abstract
The European Society of Cardiology (ESC) and UK National Institute for Health and Care Excellence (NICE) have recently published guidelines for investigating patients with suspected coronary artery disease (CAD). Both provide a risk score (RS) to assess the pre-test probability for CAD to guide clinicians to undertake the most effective investigation. The aim of the study was to establish whether there is a difference between the two RS models. We retrospectively reviewed records of 479 patients who presented to a UK district general hospital with chest pain between August 2011 and April 2013. Th...
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Demir OM, Dobson P, Papamichael ND, Byrne J, Plein S, Alfakih K Tags: Clin Med Source Type: research
Serum potassium levels as an outcome determinant in acute medical admissions.
Abstract
The relationship between serum potassium levels and mortality in acute medical admissions is uncertain. In particular, the relevance of minor abnormalities in potassium level or variations within the normal range remains to be determined. We performed a retrospective cohort study of all emergency medical admissions to St James's Hospital (Dublin, Ireland) between 2002 and 2012. We used a stepwise logistic regression model to predict in-hospital mortality, adjusting risk estimates for major predictor variables. There were 67,585 admissions in 37,828 patients over 11 years. After removing long-stay...
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Conway R, Creagh D, Byrne DG, O'Riordan D, Silke B Tags: Clin Med Source Type: research
Blood alanine aminotransferase levels >1,000 IU/l - causes and outcomes.
In this study, we have confirmed that the main causes of a dramatic ALT rise are ischaemic liver injury, DILI and viral hepatitis. Common bile duct stones and hepatitis E are two causes for which there needs to be a high index of suspicion as the necessary tests may not be in the clinician's first-line investigation panel. Failing to find a cause and determining that the cause was ischaemic both have poor prognostic implications.
PMID: 26031973 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Galvin Z, McDonough A, Ryan J, Stewart S Tags: Clin Med Source Type: research
MTHFR 677C/T and 1298A/C mutations and non-alcoholic fatty liver disease.
Abstract
Common genetic mutations encountered in folate metabolism may result in increased homocysteine (Hcy) levels. It has been reported that increased serum Hcy levels may affect the intracellular fat metabolism and may cause enhanced fatty infiltration in the liver resulting in non-alcoholic fatty liver disease (NAFLD). In total, 150 patients diagnosed with FLD by ultrasound examination and 136 healthy control patients that do not have any fatty infiltration in the liver were included in the study. Patients were grouped as mild (n = 88), moderate (n = 38) or severe (n = 24) according to the stage of fa...
Source: Clinical Medicine - June 1, 2015 Category: Journals (General) Authors: Kasapoglu B, Turkay C, Yalcin KS, Kosar A, Bozkurt A Tags: Clin Med Source Type: research
