4,258 results match your criteria Clinical Medicine [Journal]


The National Early Warning Score and the acutely confused patient.

Authors:
Bryan Williams

Clin Med (Lond) 2019 Mar;19(2):190-191

University College London, London, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-2-190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454357PMC

Care of the older surgical patient.

Clin Med (Lond) 2019 Mar;19(2):189

ST7 in anaesthesia and intensive care medicine, Royal London Hospital, Bart's Health NHS Trust, London, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-2-189aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454368PMC

Donepezil - QT prolongation and torsades de pointes.

Clin Med (Lond) 2019 Mar;19(2):189

ST4 geriatric medicine and general internal medicine, Colchester, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-2-189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454374PMC

Haematology: Multiple Myeloma.

Authors:
Jonathan Cullis

Clin Med (Lond) 2019 Mar;19(2):188

Salisbury NHS Foundation Trust, Salisbury, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-2-188aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454351PMC

Splenic rupture.

Authors:
David Fegan

Clin Med (Lond) 2019 Mar;19(2):188-189

Vila Central Hospital, Port Vila, Vanuatu.

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http://dx.doi.org/10.7861/clinmedicine.19-2-188DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454373PMC

Stroke mortality audit using the Structured Judgement Review method.

Clin Med (Lond) 2019 Mar;19(2):185-187

Royal Cornwall Hospital, Truro, UK

Mortality data provided by the Sentinel Stroke National Audit Programme demonstrated the Royal Cornwall Hospitals Trust (RCHT) to have a higher than national average mortality ratio. In response to this, the RCHT stroke department undertook a mortality review of patients admitted with stroke making use of the Structured Judgement Review (SJR) process.The review found all patients were deemed as receiving adequate, good or excellent care. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454352PMC
March 2019
1 Read

Head injury in the elderly - an overview for the physician.

Clin Med (Lond) 2019 Mar;19(2):177-184

Southmead Hospital, Bristol, UK

Head injury is a common cause for hospital admission and additionally 250,000 UK inpatients fall during hospital admissions annually. Head injury most commonly occurs as a result of falls from standing height in older adults. Older adults are frequently frail and multi-morbid; many have indications for anticoagulation and antiplatelet agents. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454360PMC
March 2019
6 Reads

Neuromyelitis optica spectrum disorders.

Clin Med (Lond) 2019 Mar;19(2):169-176

Walton Centre NHS Foundation Trust, Liverpool, UK.

Neuromyelitis optica spectrum disorder (NMOSD) is an uncommon antibody-mediated disease of the central nervous system. Long segments of spinal cord inflammation (myelitis), severe optic neuritis, and/or bouts of intractable vomiting and hiccoughs (area postrema syndrome) are classic presentations of the disease and may alert the clinician to the diagnosis. Untreated, approximately 50% of NMOSD patients will be wheelchair users and blind, and a third will have died within 5 years of their first attack. Read More

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http://www.clinmed.rcpjournal.org/lookup/doi/10.7861/clinmed
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http://dx.doi.org/10.7861/clinmedicine.19-2-169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454358PMC
March 2019
3 Reads

How should complete lung collapse secondary to primary spontaneous pneumothorax be managed? .

Clin Med (Lond) 2019 Mar;19(2):163-168

Royal Stoke University Hospital, Stoke-on-Trent, UK.

Management of primary spontaneous pneumothorax (PSP) depends on the symptoms and size of lung collapse. The British Thoracic Society recommends needle aspiration (NA) for all PSP requiring intervention, followed by intercostal drain (ICD) if NA fails. We compared the role of NA versus ICD as the first step in PSP with 'complete lung collapse'. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454361PMC

Neglected tropical diseases: elimination and eradication.

Clin Med (Lond) 2019 Mar;19(2):157-160

London School of Hygiene and Tropical Medicine, London, UK.

The term neglected tropical diseases (NTDs) describes a disparate group of diseases which affect populations living in poverty and are important causes of morbidity and mortality worldwide. Global programmes for the control of NTDs benefit large-scale donations made by pharmaceutical companies. A number of NTDs have internationally agreed targets for their control, elimination and eradication. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454364PMC

Imported malaria: key messages in an era of elimination.

Clin Med (Lond) 2019 Mar;19(2):153-156

Hospital for Tropical Diseases, London, UK.

Despite concerted efforts to eliminate malaria, it remains a major global cause of morbidity and mortality with over 200 million annual cases. Significant gains have been made, with the annual global malaria incidence and mortality halving over the past twenty years, using tools such as long-lasting insecticide-treated bed nets and artemisinin-based therapies. Malaria is also a significant cause of life-threatening imported infection in the UK. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454370PMC
March 2019
2 Reads

Global warming and arboviral infections.

Clin Med (Lond) 2019 Mar;19(2):149-152

Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.

Climate change is already expanding the geographic footprint of arboviral infections. In this article we consider the impact of climate change on three arboviruses with particular consideration of the effect on Europe. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454362PMC
March 2019
1 Read

Implementation science: point-of-care diagnostics in HIV and tuberculosis.

Clin Med (Lond) 2019 Mar;19(2):145-148

Division of Infectious Diseases, Department of Medicine Johns Hopkins School of Medicine, Baltimore, USA.

Implementation science uses methods to promote the scaling up and use of evidence-based practices by health systems to improve quality and outcomes. Its use is vital to maximise the efficiency of limited resources for health care in tropical settings. HIV and tuberculosis (TB) are two of the major causes of morbidity and mortality in sub-Saharan Africa, and globally. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-145DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454356PMC
March 2019
3 Reads

Outbreak science: recent progress in the detection and response to outbreaks of infectious diseases.

Clin Med (Lond) 2019 Mar;19(2):140-144

Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.

The frequency of reported outbreaks of infectious diseases has increased over the past 3 decades, with predictions that this rise will continue. Outbreak response continues to follow nine basic principles: establish the presence of an outbreak, verify the diagnosis, make a case definition, find cases and contacts, conduct basic epidemiology, test hypotheses, institute control measures, communicate the situation and establish ongoing surveillance. Within each of these areas, significant advances have been made over the past 5 years using progress in digital, laboratory, epidemiology and anthropological equipment or techniques. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454359PMC
March 2019
1 Read

An update on multidrug-resistant tuberculosis .

Clin Med (Lond) 2019 Mar;19(2):135-139

Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK

Of the 10 million incident cases of tuberculosis (TB) globally in 2017, around 558,000 cases were rifampicin-resistant of which 82% were multidrug-resistant (MDR) TB. In England, 5,102 cases were recorded of which 55 cases (1.8%) were MDR-TB. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454369PMC
March 2019
2 Reads

Idiopathic CD4 lymphopenia in a case of disseminated cryptococcosis with brain, vertebral spine and reproductive organ involvement.

Clin Med (Lond) 2019 Mar;19(2):133-134

Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.

Cryptococcosis is an opportunistic fungal infection commonly seen in HIV cases. We present a case of disseminated cryptococcosis with multiple non-continuous infective foci in a non-HIV, non-transplant case. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454367PMC
March 2019
1 Read

Image of the month: Ventricular myxoma mimicking hypertrophic cardiomyopathy.

Clin Med (Lond) 2019 Mar;19(2):131-132

Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India; Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.

A 5-year-old boy with an incidentally detected cardiac murmur was referred for evaluation. Tall R waves were noted in the electrocardiogram in leads V3 and V4. Transthoracic echocardiography suggested asymmetric septal hypertrophy with diffuse thickening of the inter-ventricular septum with normal thickness of the posterior left ventricular wall. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454353PMC
March 2019
1 Read

Lesson of the month 2: A case of nitrous oxide-induced pancytopenia.

Clin Med (Lond) 2019 Mar;19(2):129-130

Imperial College Healthcare NHS Trust, London, UK.

An 18-year-old female patient presented to the emergency department with non-specific neurological and gastrointestinal symptoms and was found to be pancytopenic. Her vitamin B level was low with a normal mean corpuscular volume and her full blood count 2 months previously had been within normal range. She reported heavy use of nitrous oxide over the previous 2 weeks and other investigations revealed no cause for her pancytopenia. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454366PMC
March 2019
1 Read

Lesson of the month 1: A rare adverse reaction between flucloxacillin and paracetamol.

Clin Med (Lond) 2019 Mar;19(2):127-128

Institute of Infection and Immunity, St George's, University of London, London, UK.

Flucloxacillin, a beta-lactam antibiotic, is a commonly prescribed antibiotic for the treatment of infections caused by staphylococci and streptococci, most notably Paracetamol is one of the most dispensed medications by NHS England and is used for the treatment of fever and pain. However most doctors are unaware that concurrent use of these drugs can cause a potentially fatal drug interaction due to pyroglutamic acidosis (PGA), also known as 5-oxoprolinaemia. PGA is a rare cause of raised anion gap metabolic acidosis due to disruption of the γ-glutamyl cycle. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454371PMC
March 2019
1 Read

Hyperacute neurology at a regional neurosciences centre: a 1-year experience of an innovative service model.

Clin Med (Lond) 2019 Mar;19(2):119-126

St George's University Hospitals NHS Foundation Trust, London, UK.

St George's Hospital hyperacute neurology service (HANS) is a comprehensive, consultant-delivered service set in a teaching hospital regional neuroscience centre. The service addresses deficiencies in acute neurological care previously highlighted by the Royal College of Physicians and the Association of British Neurologists. HANS adopts a disease-agnostic approach to acute neurology, prioritising the emergency department (ED) management of both stroke and stroke mimics alike alongside proactive daily support to the acute medical unit and acute medical take. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454365PMC
March 2019
2 Reads

Recognition and treatment of depression in older adults admitted to acute hospitals in England.

Clin Med (Lond) 2019 Mar;19(2):114-118

Royal College of Psychiatrists, London, UK.

Levels of awareness and treatment of depression in older adults admitted to acute hospitals are unclear. This study aims to examine the proportion of older adults diagnosed with depression in acute hospitals, treatment, referral, and communication between secondary and primary healthcare services following discharge. Retrospective examination of records of 766 older adults admitted to 27 acute hospitals in England was carried out. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454375PMC

The impact of the NHS electronic-alert system on the recognition and management of acute kidney injury in acute medicine.

Authors:

Clin Med (Lond) 2019 Mar;19(2):109-113

To address inconsistencies in the recognition and management of acute kidney injury (AKI), an electronic-alert (e-alert) system was implemented by NHS England in 2015. This study aimed to describe its impact within acute medicine in the West Midlands. All admissions to included acute medical units were screened for AKI in two phases, before and after the e-alert was introduced. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-2-109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454355PMC
March 2019
2 Reads

The inclusion of delirium in version 2 of the National Early Warning Score will substantially increase the alerts for escalating levels of care: findings from a retrospective database study of emergency medical admissions in two hospitals .

Clin Med (Lond) 2019 Mar;19(2):104-108

Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Grimsby, UK.

Background: The National Early Warning Score (NEWS) is being replaced with NEWS2 which adds 3 points for new confusion or delirium. We estimated the impact of adding delirium on the number of medium/high level alerts that are triggers to escalate care.

Methods: Analysis of emergency medical admissions in two acute hospitals (York Hospital (YH) and Northern Lincolnshire and Goole NHS Foundation Trust hospitals (NH)) in England. Read More

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http://www.clinmed.rcpjournal.org/lookup/doi/10.7861/clinmed
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http://dx.doi.org/10.7861/clinmedicine.19-2-104DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454350PMC
March 2019
3 Reads

Reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism in medical inpatients.

Clin Med (Lond) 2019 Mar;19(2):100-103

Elderly Care Unit, Gloucestershire Royal NHS Trust, Gloucester, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-2-100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454363PMC

Age adjusted D-dimers.

Authors:
Andrew Thompson

Clin Med (Lond) 2019 Jan;19(1):93

Musgrove Park Hospital, Taunton, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-93DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399634PMC
January 2019
4 Reads

CYP24A1 mutations and hypervitaminosis D.

Clin Med (Lond) 2019 Jan;19(1):92-93

Newcastle University, Newcastle upon Tyne, UK.

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http://www.clinmed.rcpjournal.org/lookup/doi/10.7861/clinmed
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http://dx.doi.org/10.7861/clinmedicine.19-1-92aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399622PMC
January 2019
8 Reads

Response.

Clin Med (Lond) 2019 Jan;19(1):92

Queen Elizabeth Hospital Birmingham, Birmingham, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-92DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399619PMC
January 2019
1 Read

Established endocrine practice.

Clin Med (Lond) 2019 Jan;19(1):91

St Bartholomew's Hospital, London, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-91aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399648PMC
January 2019
2 Reads

Response.

Clin Med (Lond) 2019 Jan;19(1):91

Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-91DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399629PMC
January 2019
1 Read

Feedback on CME haematology.

Authors:
Kaveh Manavi

Clin Med (Lond) 2019 Jan;19(1):90-91

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-90bDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399635PMC
January 2019
1 Read

Response.

Authors:
Benjamin Clayton

Clin Med (Lond) 2019 Jan;19(1):90

Royal Devon & Exeter Hospital, Exeter, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-90aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399626PMC
January 2019
1 Read

Atrial fibrillation.

Authors:
Kaushik Guha

Clin Med (Lond) 2019 Jan;19(1):90

Queen Alexandra Hospital, Portsmouth, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-90DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399643PMC
January 2019
2 Reads

Response.

Clin Med (Lond) 2019 Jan;19(1):89-90

Royal Adelaide Hospital, Adelaide, Australia.

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http://dx.doi.org/10.7861/clinmedicine.19-1-89bDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399652PMC
January 2019
1 Read

Response.

Clin Med (Lond) 2019 Jan;19(1):89

St George's Hospital, London, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-89DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399649PMC
January 2019
1 Read

Subarachnoid haemorrhage.

Clin Med (Lond) 2019 Jan;19(1):88-89

University Hospital Birmingham, Birminham, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-88aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399641PMC
January 2019
4 Reads

Splenic injuries.

Authors:
Eamon P McCarron

Clin Med (Lond) 2019 Jan;19(1):88

South West Acute Hospital, Enniskillen, Northern Ireland, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-88DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399639PMC
January 2019
1 Read

Severe Raynaud's phenomenon and Sjögren's syndrome with ferocious gangrene change and auto-amputation.

Clin Med (Lond) 2019 Jan;19(1):85

Division of Allergy, Immunology and Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwain; School of Medicine, National Yang-Ming University, Taipei, Taiwan.

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http://dx.doi.org/10.7861/clinmedicine.19-1-85DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399625PMC
January 2019
2 Reads

Lesson of the month 2: When steroids stop working - infective endocarditis, the great mimicker.

Clin Med (Lond) 2019 Jan;19(1):82-84

Royal Sussex County Hospital, Brighton, UK.

A 63-year-old man with an extensive travel history to South East Asia presented with generalised malaise, temporal headaches and high inflammatory markers. He was treated with corticosteroids for presumed giant cell arteritis. Unsuccessful attempts to wean him from prednisolone prompted further investigations by rheumatology, haematology and finally ophthalmology. Read More

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http://www.clinmed.rcpjournal.org/lookup/doi/10.7861/clinmed
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http://dx.doi.org/10.7861/clinmedicine.19-1-82DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399638PMC
January 2019
20 Reads

Lesson of the month 1: Prolonged QT syndrome due to donepezil: a reversible cause of falls?

Clin Med (Lond) 2019 Jan;19(1):80-81

Airedale General Hospital, Keighley, UK.

Prolonged QT syndrome precipitates cardiac arrhythmias such as torsades de pointes (TdP) resulting in cardiogenic syncope or sudden death. We report a case of prolonged QT syndrome caused by donepezil which resulted in a fall and hip fracture. In this case female sex, advanced age and diuretic use may have increased the risk of recurrent syncope and potential underlying TdP. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-80DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399646PMC
January 2019
3 Reads

Acute abdominal pain: Henoch-Schönlein purpura case in a young adult, a rare but important diagnosis.

Clin Med (Lond) 2019 Jan;19(1):77-79

Royal Victoria Hospital, Belfast, UK.

Henoch-Schönlein purpura (HSP), also known as IgA vasculitis, is a systemic vasculitis which is the most common vasculitis in children. The incidence in adults varies from 3.4 to 14. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-77DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399654PMC
January 2019
3 Reads