Search Our Scientific Publications & Authors

Postgrad Med J 2019 Feb 20. Epub 2019 Feb 20.

Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Postgrad Med J 2019 Feb 20. Epub 2019 Feb 20.

Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

Clinical rotations are an essential part of Internal Medicine (IM) residency programmes, where curricular objectives are carried out. To our knowledge, there are no validated instruments to assess IM clinical rotations. Our objective was to develop an instrument for residents to assess the quality of clinical rotations in an IM residency programme, and to test the psychometric properties of the instrument. Read More

Postgrad Med J 2019 Feb 18. Epub 2019 Feb 18.

Department of Cardiology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China

Background: Coronary artery disease (CAD) is the most frequent multifactorial disease worldwide and is characterised by endothelial injury, lipid deposition and coronary artery calcification. The purpose of this study was to determine the allelic and genotypic frequencies of two loci (rs2026458 and rs9349379) of phosphatase and actin regulator 1 (PHACTR1) to the risk of developing CAD in the Chinese Han population.

Methods: A case-control study was conducted including 332 patients with CAD and 119 controls. Read More

Postgrad Med J 2019 Feb 14. Epub 2019 Feb 14.

Department of Liaison Psychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK

Background: Busy emergency departments (EDs) are not the optimum environment for assessment of patients in mental health crisis. The Psychiatric Decisions Unit (PDU) was developed by the Birmingham and Solihull Mental Health Foundation Trust as an enhanced assessment service to ensure patients in mental health crisis receive optimal care.

Aims: To evaluate the activities of the PDU and its impact on the frequency of ED presentations and inpatient admissions, and to explore patient satisfaction. Read More

Postgrad Med J 2019 Feb 6. Epub 2019 Feb 6.

Retired, Edinburgh EH12 8UB, UK

Postgrad Med J 2019 Feb 6. Epub 2019 Feb 6.

Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Postgrad Med J 2019 Feb 5. Epub 2019 Feb 5.

Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Postgrad Med J 2019 Feb 1. Epub 2019 Feb 1.

Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, China

Postgrad Med J 2019 Feb 1. Epub 2019 Feb 1.

Academic Cardiovascular Group, School of Medicine, University of Central Lancashire, Preston, UK

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a major development in the prevention of cardiovascular disease (CVD) and is one of the most significant discoveries since the development of statin therapy. Administration of two human monoclonal antibodies to PCSK9 (alirocumab and evolocumab) can significantly reduce low-density lipoprotein cholesterol (LDL-c) concentrations, thus improving lipid management. Accordingly, guidelines on the specific indications for alirocumab and evolocumab usage have been released. Read More

Postgrad Med J 2018 Dec;94(1118):675-677

Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia

Postgrad Med J 2019 Jan 30. Epub 2019 Jan 30.

Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Background: Previous studies have revealed that plasma levels of free fatty acids (FFAs) are related to cardiovascular risk. However, whether FFAs could predict periprocedural myocardial injury (PMI) following percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) remains unclear.

Purpose: This study aimed to investigate the relationship of FFAs to PMI in untreated patients with CAD who underwent PCI. Read More

Postgrad Med J 2019 Jan 30. Epub 2019 Jan 30.

Department of Endocrinology, Post Graduate Institute for Medical Education and Research, Chandigarh, India

Postgrad Med J 2019 Jan 30. Epub 2019 Jan 30.

Department of GastroSurgical Research and Education, Sahlgrenska universitetssjukhuset, Goteborg, Sweden.

For millennia, the smile has been recognised as a powerful communication device, offering benefits to both giver and receiver with few drawbacks. A sign of compassion, empathy and friendliness, smiling can benefit healthcare professionals and their patients, helping to build a relationship of trust. But beware the false smile, which is all too easily identified and may do more harm than good. Read More

Postgrad Med J 2019 Jan 29. Epub 2019 Jan 29.

Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China

China has the largest stroke population and at-risk population in the world. However, it has a lower thrombolytic therapy rate and longer onset-to-needle time/door-to-needle time for patients who had an acute stroke compared with developed countries, which might be due to redundant procedures or inefficient systems. Things are changing due to some new initiatives. Read More

Postgrad Med J 2019 Jan 25. Epub 2019 Jan 25.

Department of Medicine, Greenwich University Hospital, London SE19 3PS, UK

Paget's disease of bone is characterised by overactive osteoclasts that resorb bone at a higher rate than normal. Osteoblasts attempt to repair the damage by laying down new bone which in turn is resorbed leaving a chaotic pattern of lytic and dense sclerotic bone behind. Deformed bone enlarges, becomes vascularised, bends and fractures. Read More

Postgrad Med J 2019 Jan 25. Epub 2019 Jan 25.

Division of Nephrology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in non-diabetic Caucasian adults over 40 years of age. It has an estimated incidence of 8-10 cases per 1 million. Fifty per cent of patients diagnosed with primary MN continue to have nephrotic syndrome and 30% of patients may progress to end-stage renal disease over 10 years. Read More

Postgrad Med J 2019 Jan 23. Epub 2019 Jan 23.

3rd Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle Unversity of Thessaloniki, Thessaloniki, Greece.

Postgrad Med J 2018 Dec 23;94(1118):731-732. Epub 2019 Jan 23.

Postgraduate Medical Journal, London WC1B 5DN, UK

Postgrad Med J 2019 Jan 23. Epub 2019 Jan 23.

Department of Medicine, Stanford University, Stanford, California, USA.

Background: Decreasing delays for hospitalised patients results in improved hospital efficiency, increased quality of care and decreased healthcare expenditures. Delays in subspecialty consultations and procedures can cause increased length of stay due to reasons outside of necessary medical care.

Objective: To quantify, describe and record reasons for delays in consultations and procedures for patients on the general medicine wards. Read More

Postgrad Med J 2019 Jan 23. Epub 2019 Jan 23.

Department of Medicine, Laniado Hospital, Sanz Medical Centre, Netanya, Israel

Postgrad Med J 2018 Dec 22;94(1118):716-719. Epub 2019 Jan 22.

Spectrum Health Office of Research Administration, Grand Rapids, Michigan, USA.

Introduction: The Choosing Wisely guidelines advise against ordering routine blood tests for hospitalised patients unless they change management. Unnecessary testing can lead to adverse effects (eg, iatrogenic anaemia, poor sleep quality, risk for infections and increased cost of care).

Methods: An 8-week quality initiative aimed at reducing unnecessary blood tests was implemented in three internal medicine resident inpatient services. Read More

Postgrad Med J 2018 Dec 21;94(1118):678-693. Epub 2019 Jan 21.

Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, Shiyan, China

Study Design: Systematic review with meta-analysis.

Objectives: To evaluate the effects of enhanced recovery after surgery (ERAS) on the postoperative recovery of patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Methods: The PubMed, Embase, Cochrane and ISI Web of Science databases were searched to identify literature including randomised controlled trials (RCTs), cohort studies and case-control studies through 2 May 2018. Read More

Postgrad Med J 2019 Jan 21. Epub 2019 Jan 21.

NIHR Doctoral Clinical Research Fellow, University of Bristol, Bristol, UK.

Postgrad Med J 2019 Jan 21. Epub 2019 Jan 21.

Department of Medicine, Dumfries and Galloway Royal Infirmary, Dumfries, UK

Objective: To establish the diagnostic value of prespecified ECG changes in suspected pulmonary embolism (PE).

Methods: Retrospective case-control study in a district general hospital setting. We identified 189 consecutive patients with suspected PE whose CT pulmonary angiogram (CTPA) was positive for a first PE and for whom an ECG taken at the time of presentation was available. Read More

Postgrad Med J 2019 Jan 21. Epub 2019 Jan 21.

Department of Medical Education, Brighton & Sussex Medical School, Brighton, United Kingdom.

Postgrad Med J 2019 Jan 21. Epub 2019 Jan 21.

Postgraduate Medical Journal, London WC1H 9JP, UK

Postgrad Med J 2019 Jan 21. Epub 2019 Jan 21.

UCL Institute for Liver and Digestive Health, Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK.

Ultrasound (US) is usually the first and most commonly used tool in the diagnostic algorithm for liver disease. It is widely available, non-invasive and offers a real-time assessment of the liver in several anatomic planes, using different US modalities such as greyscale imaging, Doppler, elastography and contrast-enhanced US. This multiparametric ultrasound (MPUS) provides more information of the examined structures and allows for a faster and more accurate diagnosis, usually at the point of care, thus reducing the requirement for some invasive and more expensive methods. Read More

Postgrad Med J 2019 Jan 21. Epub 2019 Jan 21.

Department of Medicine, Michigan State University, East Lansing, Michigan, USA.

Objective: To evaluate if imaging studies such as CT pulmonary angiography (CTPA) or ventilation-perfusion (V/Q) scan are ordered according to the current guidelines for the diagnosis of pulmonary embolism (PE).

Methods: We performed a retrospective observational cohort study in all adult patients who presented to the Sparrow Hospital Emergency Department from January 2014 to December 2016 and underwent CTPA or V/Q scan. We calculated the Wells' score retrospectively, and d-dimer values were used to determine if the imaging study was justified. Read More

Postgrad Med J 2019 Jan 12. Epub 2019 Jan 12.

Department of Gastroenterology, Inflammatory Bowel Diseases Section, University of Manchester, Manchester, UK

Acute severe ulcerative colitis is a life-threatening medical emergency, which can be associated with significant morbidity and is preventable through prompt and effective management. Corticosteroids remain the cornerstone of initial therapy, although a third of patients will not respond. Further management hinges on timely decisions with use of rescue therapy with ciclosporin or infliximab, without compromising the health or safety of the patient, or timely surgery. Read More

Postgrad Med J 2019 Jan 12. Epub 2019 Jan 12.

Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland.

According to the current recommendations on the management of chronic non-specific low back pain (CNLBP), the intervention in this group of patients should include a programme of exercises. Pilates is a system of exercises widely used in patients with low back pain. The practices based on this method have promoted the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles. Read More

Postgrad Med J 2018 Nov;94(1117):634-640

Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, UK.

Objective: Junior doctors have the highest rates of prescribing errors, yet no study has set out to understand the differences between completely novice prescribers (Foundation year one (FY1) doctors) and those who have gained some experience (Foundation year two (FY2) doctors). The objective of this study was to uncover the causes of prescribing errors made by FY2 doctors and compare them with previously collected data of the causes of errors made by FY1 doctors.

Design: Qualitative interviews, using the critical incident technique, conducted with 19 FY2 doctors on the causes of their prescribing errors and compared with interviews previously conducted with 30 FY1 doctors. Read More

Postgrad Med J 2018 Nov;94(1117):627-633

Research Department, Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado, USA.

Purpose Of Study: The aim of the study is to describe the prevalence of illicit drug use in England and Wales using data from the UK Survey of Non-Medical Use of Prescription Drugs (NMURx) programme and to compare against the well-established Crime Survey England and Wales (CSEW). The rationale is that recreational and illicit drug use is common, but the prevalence is difficult to estimate with personal interviewing methods.

Study Design: We compared two cross-sectional population surveys (NMURx, n=8903 and CSEW, n=20 685) with data regarding self-reported recreational drug use and demographics. Read More

Postgrad Med J 2018 Nov;94(1117):617-620

Department of Paediatrics, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

Introduction: Drug errors are common and can be detrimental to patients, even resulting in death. Junior doctors write most prescriptions and are therefore responsible for most errors. There is little literature about the effect of legibility of the prescriber's handwriting on the rate of drug errors. Read More

Postgrad Med J 2019 Jan 5. Epub 2019 Jan 5.

Brighton and Sussex University Hospitals, Brighton, UK.

Postgrad Med J 2019 Jan 5. Epub 2019 Jan 5.

Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

Postgrad Med J 2018 Dec 22. Epub 2018 Dec 22.

Eye Centre, Pinderfields Hospital, Wakefield, UK

Postgrad Med J 2018 Dec 22;94(1118):730. Epub 2018 Dec 22.

Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA

Postgrad Med J 2018 Dec 22. Epub 2018 Dec 22.

Department of Neurosurgery, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran

Postgrad Med J 2018 Dec 21. Epub 2018 Dec 21.

Department of General Medicine, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, TN 603108, India

Postgrad Med J 2018 Dec 20;94(1118):714-715. Epub 2018 Dec 20.

Department of Diabetes, Metabolic Diseases and Endocrinology, Fortis CDOC Hospital, New Delhi, India.

Postgrad Med J 2018 Dec 20. Epub 2018 Dec 20.

Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK

Postgrad Med J 2018 Dec 17;94(1118):709-713. Epub 2018 Dec 17.

Department of Internal Medicine, Divisions of Nephrology and Cardiology, University Hospital Würzburg, Würzburg, Germany

Fabry disease is a rare inborn error of the enzyme α-galactosidase (α-Gal) and results in lysosomal substrate accumulation in tissues with a wide range of clinical presentations. The disease has attracted a lot of interest over the last years, in particular since enzyme replacement therapy (ERT) has become widely available in 2001. With rising awareness and rising numbers of (diagnosed) patients, physicians encounter new challenges. Read More

Postgrad Med J 2018 Dec 17. Epub 2018 Dec 17.

Department of Cardiology, Royal Adelaide Hospital, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.

Postgrad Med J 2018 Dec 15;94(1118):694-699. Epub 2018 Dec 15.

Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.

Purpose: To characterise determinants of resident maternity leave and their effect on maternal and infant well-being. Among non-parents, to identify factors that influence the decision to delay childbearing STUDY DESIGN: In 2016, a survey was sent to female residents at a large academic medical centre on their experiences with maternity leave, the impact of personal and programme factors on length of leave, reasons for delaying childbearing and measures of well-being.

Results: Forty-four percent (214/481) of residents responded. Read More

Postgrad Med J 2018 Nov 15;94(1117):671-672. Epub 2018 Dec 15.

Postgraduate Medical Journal, London WC1H 9JP, UK

Postgrad Med J 2018 Nov 15;94(1117):659-661. Epub 2018 Dec 15.

Aurora Health Care - Green Bay, Hobart, Wisconsin, USA

For physicians in training and their mentors, the process of learning and teaching clinical medicine has become challenging in the electronic medical record (EMR) era. Trainees and their mentors exist in a milieu of incessant box checking and laborious documentation that has no clinical educational value, limits the time for teaching and curtails clinical cognitive skill development. These unintended consequences of the EMR are juxtaposed against the EMR's intended benefits of improved patient care and safety with reduced medical errors, improved clinical support systems, reduced potential for negligence with clinical data and metadata data supporting compliance with the standard of care. Read More

Postgrad Med J 2018 Dec 15;94(1118):673-674. Epub 2018 Dec 15.

Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China

Postgrad Med J 2018 Nov 6;94(1117):653-658. Epub 2018 Dec 6.

Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland.

Circadian rhythms are endogenously generated recurring patterns of around 24 hours with well-established roles in physiology and behaviour. These circadian clocks are important in both the aetiology and treatment of various psychiatric and metabolic diseases. To maintain physiological homeostasis and optimal functioning, living life synchronised to these clocks is desirable; modern society, however, promotes a '24/7' lifestyle where activity often occurs during the body's 'biological night', resulting in mistimed sleep and circadian misalignment. Read More

Postgrad Med J 2018 Nov 6;94(1117):621-626. Epub 2018 Dec 6.

UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK

Background: Workforce studies show a declining proportion of UK junior doctors proceeding directly to specialist training, with many taking career breaks. Doctors may be choosing to delay this important career decision.

Aim: To assess doctors' views on the timing of choosing a clinical specialty. Read More

Postgrad Med J 2018 Nov 6;94(1117):641-646. Epub 2018 Dec 6.

Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China

BACKGROUND : Elevation of hepatic enzymes is associated with insulin resistance, dyslipidaemia and obesity. However, the factors behind elevation of liver enzymes remain unclear. The aim of this study was to compare the role of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in relation with serum alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) in middle-aged Chinese adults. Read More