Interhospital transfer neurological deterioration in patients with spontaneous intracerebral haemorrhage: incidence and risk factors
Conclusions
About one-sixth of referred not comatose patients with SICH developed IHTND. Some risk factors were identified for the first time. Modifying procedures for proper transfer of patients at high-risk for IHTND might help in safely transferring patients with SICH. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Fan, J.-S., Chen, Y.-C., Huang, H.-H., Yen, D. H.-T., How, C.-K., Huang, M.-S. Tags: Nursing, Hypertension Original article Source Type: research
Association and interaction analysis of diabetes mellitus and SCN10A for cardiovascular autonomic neuropathy in a Chinese population
Conclusions
Our findings suggest that there are interaction effects of DM and SCN10A (rs7375036) that influence the development of CAN.
Trial registration number
NCT02461342 (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Lv, Y., Zhou, L., Tang, Z., Dong, J. Tags: Diabetes, Metabolic disorders Original article Source Type: research
High prevalence of antithyroid peroxidase and antiparietal cell antibodies among patients with type 1 diabetes mellitus attending a tertiary diabetes centre in South Africa
Conclusions
Among patients with T1DM in this study, there was a high prevalence of coexistent AITD and gastric autoimmunity. Screening for hypothyroidism and thyroid autoimmunity should be undertaken in all patients at initial presentation. However, to assess the feasibility and optimal timing of subsequent testing in the African setting with limited resources, more collaborative research with longitudinal studies is required. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Paruk, I. M., Ganie, Y., Maharaj, S., Pirie, F. J., Naidoo, V. G., Nkwanyana, N. M., Dinnematin, H. L., Ramdial, P. K., Motala, A. A. Tags: Immunology (including allergy), Drugs: CNS (not psychiatric), Malnutrition, Ophthalmology, Epidemiology, Diabetes, Metabolic disorders, Thyroid disease Original article Source Type: research
Vaccination practices in patients with inflammatory bowel disease among general internal medicine physicians in the USA
Conclusions
Current knowledge and degree of comfort among PCPs in the USA in preventing opportunistic infections in IBD population remain low. Management of patients with IBD requires structured approach to their healthcare maintenance in everyday practice, including enhanced educational policy aimed at primary care physicians. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Gurvits, G. E., Lan, G., Tan, A., Weissman, A. Tags: Inflammatory bowel disease, Patients, General practice / family medicine, Immunology (including allergy), Drugs: infectious diseases, Epidemiology Original article Source Type: research
Common toxidromes in movement disorder neurology
Conclusion
There are several toxidromes that have the potential to become a serious life-threatening emergency if there is a delay in recognition of key clinical features and instituting the appropriate treatment at the earliest is crucial. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Malek, N., Baker, M. R. Tags: Emergency medicine, Drugs: CNS (not psychiatric), Drugs: psychiatry, Drugs: musculoskeletal and joint diseases, Epidemiology, Internet, Occupational and environmental medicine Original article Source Type: research
Associations with resident physicians' early adoption of electronic cigarettes for smoking cessation
Conclusions
Few residents report recommending electronic cigarettes to patients who smoke. These residents consider the electronic cigarette less addicting than traditional cigarettes, supporting harm reduction strategies over strict abstinence. Most residents require further evidence-based education on efficacy and long-term safety of electronic cigarettes before recommending to their patients. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Egnot, E., Jordan, K., Elliott, J. O. Tags: Journalology Original article Source Type: research
Who to handover: a case-control study of a novel scoring system to prioritise handover of internal medicine inpatients
Conclusions
The iHAND score had moderate ability to predict which patients required assessment overnight, while MEWS score and current gestalt approach correlated poorly, suggesting the iHAND score may help prioritisation of patients likely to be seen overnight for handover. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Bittman, J., Tam, P., Little, C., Khan, N. Tags: Patients, Epidemiology Original article Source Type: research
The anticoagulation choices of internal medicine residents for stroke prevention in non-valvular atrial fibrillation
Conclusions
Canadian internal medicine residents favoured warfarin over NOACs for patients with NVAF, which is in discordance with the evidence-based CCS guidelines. This finding persisted throughout the 3 years of core internal medicine training. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Moulson, N., McIntyre, W. F., Oqab, Z., Yazdan-Ashoori, P., Quinn, K. L., van Oosten, E., Hopman, W. M., Baranchuk, A. Tags: Drugs: cardiovascular system, Stroke, Arrhythmias Original article Source Type: research
Palliative care series: an overview
"The only certainty is that every one of us will die. Nothing else in healthcare in the UK applies to 100% of our population." So stated Baroness Professor Finlay of Llandaff when she introduced the Access to Palliative Care Bill in the House of Lords.1 This was an apt reminder of the importance of good end-of-life care for every dying person and their loved ones, no matter where they die or which healthcare professionals are caring for them at the end of their life. Palliative care is defined by the WHO2 as ‘an approach that improves the quality of life of patients and their families facing the problems associated w...
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Whitburn, T., Selman, L. E. Tags: Editorials Source Type: research
Faith and loss: masterpieces from the Middlesex Hospital
Hospitals originated as religious institutions. In both the Islamic and Christian worlds, they were built alongside places of worship and made no distinction between physical and spiritual healing. Many of the world’s great hospitals still bear evidence of this, and some still have beautiful ancient chapels within their precincts. Although medicine and nursing gradually became secularised in Europe from the Renaissance onwards, religious faith and regular attendance at services remained the norm, and hospitals continued to provide for these until well into the 20th century. One of the last traditional hospital chapel...
Source: Postgraduate Medical Journal - April 26, 2017 Category: Journals (General) Authors: Launer, J. Tags: On reflection Source Type: research
Inadvertent transfer of surgical skin marking could potentiate wrong site surgery
Wrong site surgery (WSS) is a preventable but serious error. It is well accepted that preoperative marking is a fundamental part of the preoperative verification process to prevent devastating incident of WSS.1 For this purpose, WHO guidelines for safe surgery recommend that the site of surgery should be marked with permanent felt-tip marker prior to surgery.2 However, a correct initial surgical mark that is displaced could also potentially lead to WSS. In our recent experience, at preoperative cataract ward round we noticed that a surgical mark was inadvertently transferred from one patient's forehead (figure 1A) onto the...
Source: Postgraduate Medical Journal - April 26, 2017 Category: Journals (General) Authors: Ng, J. Y., Stirling, R. Tags: Journalology, Ophthalmology, Ethics Images in medicine Source Type: research
Vanishing bone disease: a manifestation of diabetic Charcot's neuropathic osteoarthropathy
A 50-year-old man with type 2 diabetes mellitus for 13 years presented with painless swelling of the left foot over the previous 18 weeks. He had earlier received multiple courses of antibiotics without improvement. There was no history of trauma, foot ulceration, rheumatoid arthritis or inflammatory arthropathy. His HbA1c was 7.6%, erythrocyte sedimentation rate 19 mm/hour, white blood cell count 9600/mm3 and uric acid 4.3 mg/dL. Examination revealed a swollen, erythematous, deformed left foot with rocker bottom deformity and loss of longitudinal, transverse arch (figure 1A). He had distal symmetric sensori...
Source: Postgraduate Medical Journal - April 26, 2017 Category: Journals (General) Authors: Rastogi, A., Bhansali, A. Tags: Journalology, General practice / family medicine, Genetics, Immunology (including allergy), Drugs: infectious diseases, Drugs: cardiovascular system, Orthopaedics, Connective tissue disease, Rheumatoid arthritis, Dermatology, Orthopaedic and trauma surger Source Type: research
Behind the (bilateral) fungus ball
A 54-year-old man with AIDS and a history of Pneumocystis jirovecii pneumonia presented with chronic cough and weight loss for 1 year. There was no haemoptysis. He had normal vital signs and was afebrile. Lung auscultation was normal. Laboratory evaluation was unremarkable. Chest radiography revealed bilateral upper lobe cavities with internal densities (figure 1). CT of the chest demonstrated these apical cavities to contain material consistent with a mycetoma (fungus ball). Adjacent pleural thickening and areas of consolidation and fibrosis were also present (figure 2). A CT scan performed 2 years previously showed ...
Source: Postgraduate Medical Journal - April 26, 2017 Category: Journals (General) Authors: Epelbaum, O., Rashidfarokhi, M., Patel, G. Tags: Immunology (including allergy), Drugs: infectious diseases, Radiology, Adult intensive care, Pneumonia (respiratory medicine), Dermatology, Clinical diagnostic tests, Radiology (diagnostics) Images in medicine Source Type: research
Diabetes insipidus induced by suspected eosinophilic granulomatous with polyangiitis
A 54-year-old man with a history of allergic rhinitis, chronic productive cough and shortness of breath presented with symptoms of ophthalmalgia, polydipsia, polyuria, ≥8 L daily urine output and 5 kg weight loss within 2 months. Physical examination revealed a haemorrhage under the sclera on the temporal side of the left eye (figure 1). The results of the fluid deprivation–vasopressin test showed central diabetes insipidus. Laboratory investigations showed circulating eosinophilia: 560x106/L (normal 50–300x106/L ), 5% (normal 0.5–5%); plasma antineutrophil cytoplasm antibodies (ANCA) an...
Source: Postgraduate Medical Journal - April 26, 2017 Category: Journals (General) Authors: Xie, Y., Shao, H., Dai, C., Ma, Z. Tags: Urology, Journalology, Immunology (including allergy), Drugs: CNS (not psychiatric), Ophthalmology, Radiology, Surgical diagnostic tests, General surgery, Ethics, Diabetes, Metabolic disorders, Pituitary disorders Images in medicine Source Type: research
Obesity and recurrent vulvovaginal bacterial infections in women of reproductive age
This study was conducted at the gynaecology clinics at Texas Tech University Health Sciences... (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - April 26, 2017 Category: Journals (General) Authors: Ventolini, G., Khandelwal, N., Hutton, K., Lugo, J., Gygax, S. E., Schlabritz-Loutsevitch, N. Tags: Open access Letter Source Type: research
