4,201 results match your criteria Clinical Medicine [Journal]


The National Early Warning Score 2 (NEWS2) in patients with hypercapnic respiratory failure.

Authors:
Bryan Williams

Clin Med (Lond) 2019 Jan;19(1):94-95

University College London, London, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-1-94DOI Listing
January 2019
2 Reads

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
January 2019
1 Read

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://dx.doi.org/10.7861/clinmedicine.19-1-92aDOI Listing
January 2019
4 Reads

Response.

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

Queen Elizabeth Hospital Birmingham, Birmingham, UK.

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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
January 2019
1 Read

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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
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
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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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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January 2019
2 Reads

Response.

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

Royal Adelaide Hospital, Adelaide, Australia.

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January 2019
1 Read

Mis-attribution of ectopic corticotropin-releasing hormone secretion (causing eutopic secondary adrenocorticotropic hormone secretion) to ectopic adrenocorticotropic hormone secretion?

Authors:
Richard Quinton

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

Institute of Genetic Medicine, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK.

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January 2019
1 Read

Response.

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

St George's Hospital, London, UK.

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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
January 2019
3 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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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
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://dx.doi.org/10.7861/clinmedicine.19-1-82DOI Listing
January 2019
6 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
January 2019
2 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
January 2019
2 Reads

Nephrology: thrombotic microangiopathy (haemolytic-uraemic syndrome).

Authors:
John Firth

Clin Med (Lond) 2019 Jan;19(1):72-74

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http://dx.doi.org/10.7861/clinmedicine.19-1-72DOI Listing
January 2019
2 Reads

Endocrinology: phaeochromocytoma.

Authors:
John Firth

Clin Med (Lond) 2019 Jan;19(1):68-71

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http://dx.doi.org/10.7861/clinmedicine.19-1-68DOI Listing
January 2019
1 Read

Respiratory medicine: bronchiectasis.

Authors:
John Firth

Clin Med (Lond) 2019 Jan;19(1):64-67

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http://dx.doi.org/10.7861/clinmedicine.19-1-64DOI Listing
January 2019
1 Read

Haematology: multiple myeloma.

Authors:
John Firth

Clin Med (Lond) 2019 Jan;19(1):58-60

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http://dx.doi.org/10.7861/clinmedicine.19-1-58DOI Listing
January 2019
2 Reads

Harveian Oration 2018: Improving quality and safety in healthcare .

Authors:
Mary Dixon-Woods

Clin Med (Lond) 2019 Jan;19(1):47-56

The Health Foundation professor of healthcare improvement studies and director of The Healthcare Improvement Studies Institute (THIS Institute) in the Department of Public Health and Primary Care, University of Cambridge, UK; professorial fellow, Homerton College, Cambridge, UK

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http://dx.doi.org/10.7861/clinmedicine.19-1-47DOI Listing
January 2019
1 Read

How I treat… alcohol-related liver disease.

Clin Med (Lond) 2019 Jan;19(1):43-46

Imperial College Healthcare NHS Trust, London, UK.

Age-standardised mortality from liver disease in the United Kingdom has risen by 400% since 1970, with three-quarters of deaths from alcohol-related liver disease (ARLD). The 2013 National Confidential Enquiry into Patient Outcome and Death report found that only 47% of the patients dying in hospital from liver disease experienced 'good' care. We discuss common complications in the care of patients with ARLD and the evidence-based best practice that can improve patient outcomes, with a focus on the initial management of patients presenting acutely to the medical take. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-43DOI Listing
January 2019
1 Read

Calorie restriction for long-term remission of type 2 diabetes.

Authors:
Roy Taylor

Clin Med (Lond) 2019 Jan;19(1):37-42

Newcastle University, Newcastle upon Tyne, UK

Starting with a hypothesis which postulated a simple explanation arising from the basic cause of type 2 diabetes, a series of studies has introduced a paradigm shift in our understanding of the condition. Gradual accumulation of fat in the liver and pancreas leads eventually to beta cell dedifferentiation and loss of specialised function. The consequent hyperglycaemia can be returned to normal by removing the excess fat from liver and pancreas. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-37DOI Listing
January 2019
3 Reads

The utility of phenomics in diagnosis of inherited metabolic disorders.

Clin Med (Lond) 2019 Jan;19(1):30-36

UCL Great Ormond Street Institute of Child Health, London, UK

Inherited metabolic disorders (IMDs) are debilitating inherited diseases, with phenotypic, biochemical and genetic heterogeneity, frequently leading to prolonged diagnostic odysseys. Mitochondrial disorders represent one of the most severe classes of IMDs, wherein defects in >350 genes lead to multi-system disease. Diagnostic rates have improved considerably following the adoption of next-generation sequencing (NGS) technologies, but are still far from perfect. Read More

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January 2019
1 Read

Unique palliative care needs of patients with advanced chronic kidney disease - the scope of the problem and several solutions.

Clin Med (Lond) 2019 Jan;19(1):26-29

Medical College of Wisconsin, Milwaukee, USA.

Patients with advanced chronic kidney disease (CKD), including end-stage renal disease (ESRD), have a life-threatening illness complicated by high morbidity and mortality and, therefore, should be suitable candidates for early intervention by palliative care specialists. However, the average patient with CKD does not have an advanced care plan, has multiple debilitating symptoms, and does not utilise hospice care at the end of life. In this review, we outline the scope of the problem of unmet palliative care needs for patients with advanced CKD and ESRD, barriers to improving palliative care for patients with renal failure, and possible future directions for palliative nephrology. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-26DOI Listing
January 2019
2 Reads

Five centuries of medical contributions from the Royal Navy.

Clin Med (Lond) 2019 Jan;19(1):22-25

Queen Elizabeth Hospital Birmingham, Birmingham, UK.

Royal Naval ships' companies, isolated by hundreds of miles of sea with contacts to the outside world tightly regulated, provided perfect environments to study the epidemiology of disease. In 1747, James Lind organised one of the earliest clinical trials, demonstrating that scurvy could be treated by lemon juice. A century later, Alexander Bryson proved the value of careful epidemiological data collection and observation of infectious diseases encountered on the West Africa station. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-22DOI Listing
January 2019
3 Reads

Hindsight bias critically impacts on clinicians' assessment of care quality in retrospective case note review.

Clin Med (Lond) 2019 Jan;19(1):16-21

Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

To determine whether hindsight bias impacts on retrospective case note review using a five point scoring system based on modern clinical governance toolkits. Survey. Clinicians of varying grades invited to complete a short internet survey. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-16DOI Listing
January 2019
2 Reads

Medicine and the media: the ethics of virtual medical encounters.

Clin Med (Lond) 2019 Jan;19(1):11-15

University of Sheffield, Sheffield, UK.

The expansion of new forms of public media, including social media, exposes clinicians to more illness experiences/narratives than ever before and increases the range of ways to interact with the people depicted. Existing professional regulations and ethics codes offer very limited guidance for such situations. We discuss the ethics of responding to such scenarios through presenting three cases of clinicians encountering television or social media stories involving potential unmet healthcare needs. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-11DOI Listing
January 2019
1 Read

Experience of the impact of physician associates on -postgraduate medical training: A mixed methods -exploratory study .

Clin Med (Lond) 2019 Jan;19(1):4-10

Leeds Institute of Health Sciences, Leeds, UK.

The introduction of new professional roles to the multidisciplinary team has been heralded as a way to facilitate medical education in the face of increasing service pressures. However, concerns have been raised that the training of new healthcare professionals will dilute the availability of learning opportunities, thereby detracting from postgraduate medical education. As part of a mixed methods exploratory study, the experienced impact of newly qualified physician associates on medical training was explored. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-4DOI Listing
January 2019
1 Read

All change, all change.

Authors:
Ed Nicol

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

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http://dx.doi.org/10.7861/clinmedicine.19-1-1DOI Listing
January 2019
1 Read

Should point-of-care ultrasound be in the new internal medicine curriculum?

Authors:
Gethin Hosford

Clin Med (Lond) 2018 Oct;18(5):440

Worcestershire Acute Hospitals NHS Trust, Worcestershire, UK.

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http://dx.doi.org/10.7861/clinmedicine.18-5-440bDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334105PMC
October 2018
1 Read

Gardening injuries.

Authors:
Tony Hall

Clin Med (Lond) 2018 Oct;18(5):440

Hospital for Tropical Diseases, London, UK.

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http://dx.doi.org/10.7861/clinmedicine.18-5-440aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334095PMC
October 2018
1 Read

Response.

Clin Med (Lond) 2018 Oct;18(5):440

Imperial College Healthcare NHS Trust, London, UK.

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http://dx.doi.org/10.7861/clinmedicine.18-5-440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334119PMC
October 2018
1 Read

Vitamin E - a cause for concern?

Authors:
Peter E Donnelly

Clin Med (Lond) 2018 Oct;18(5):439-440

Royal Prince Alfred Hospital, Sydney, Australia.

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http://dx.doi.org/10.7861/clinmedicine.18-5-439aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334118PMC
October 2018
3 Reads

Patient power - Kidd Gloves.

Clin Med (Lond) 2018 Oct;18(5):437

Royal Surrey County Hospital, Guildford, Surrey, UK.

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http://dx.doi.org/10.7861/clinmedicine.18-5-437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334117PMC
October 2018
1 Read

Lesson of the month 2: An unusual cause of depression in an older man: Cushing's syndrome resulting from metastatic small cell cancer of the prostate.

Clin Med (Lond) 2018 Oct;18(5):432-434

Royal Adelaide Hospital, Adelaide, Australia.

This article describes the case of an older patient whose main presenting problem was depression. A constellation of clinical and biochemical features led to a search for medical causes of his low mood, which uncovered ectopic adrenocorticotropic hormone (ACTH) secretion. Post-mortem examination showed that the source of ACTH was small cell neuroendocrine carcinoma of the prostate, and that the patient had died from the sequelae of profound immune suppression. Read More

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http://dx.doi.org/10.7861/clinmedicine.18-5-432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334104PMC
October 2018
3 Reads

Lesson of the month 1: Sodium valproate-induced encephalopathy.

Authors:
Lara Camilleri

Clin Med (Lond) 2018 Oct;18(5):430-432

Mater Dei Hospital, Tal-Qroqq, Malta.

A 69-year-old man developed reduced consciousness of sudden onset. Examination and parameters were normal, except for a Glasgow Coma Scale (GCS) score of six. Brain imaging and blood tests were also normal, except for high plasma ammonia. Read More

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http://dx.doi.org/10.7861/clinmedicine.18-5-430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334110PMC
October 2018
6 Reads

Assessment of acute headache in adults - what the general physician needs to know.

Clin Med (Lond) 2018 Oct;18(5):422-427

St George's Hospital, London, UK

Headache is common. Up to 5% of attendances to emergency departments and acute medical units are due to headache. Headache is classified as either primary (eg migraine, cluster headache) or secondary to another cause (eg meningitis, subarachnoid haemorrhage). Read More

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http://dx.doi.org/10.7861/clinmedicine.18-5-422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334100PMC
October 2018
4 Reads

Acute neurology: a suggested approach.

Clin Med (Lond) 2018 Oct;18(5):418-421

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

Acute neurological problems are common, accounting for 10-20% of medical admissions. In the coming years, there will be increased neurology involvement in the acute care of these patients complementing traditional outpatient-based services. Models of acute neurology are reliant on close collaboration between the emergency department, acute medicine and neurology and should integrate with existing hyperacute stroke pathways. 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.18-5-418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334111PMC
October 2018
2 Reads

Functional neurological disorders: acute presentations and management.

Clin Med (Lond) 2018 Oct;18(5):414-417

Institute of Molecular and Clinical Sciences, St George's University of London, London, UK

Functional neurological disorders (FND) are common and associated with significant morbidity and healthcare costs. Patients with FND often present acutely, particularly with dissociative seizures (resembling epilepsy) or persistent weakness resembling a stroke. History and careful observation and examination are critical to diagnosis, as investigations will often be normal or non-contributory. 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.18-5-414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334101PMC
October 2018
7 Reads