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Education: Royal College of Physicians

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Total 344 results found since Jan 2013.

Latest developments in clinical stroke care.
Authors: Minhas JS, Robinson TG Abstract Stroke medicine has seen rapid developments in diagnosis and management, and consequently improved prognosis. Management of ischaemic stroke, in particular, has benefited from these advances. The approach to management has evolved from one of historical passivity to active intervention with time of the essence following stroke onset. The last decade has seen the comparative effectiveness of several pharmacological agents being tested, creating significant randomised controlled trial evidence to support the management of common clinical problems following acute stroke. While ...
Source: Journal of the Royal College of Physicians of Edinburgh - March 16, 2018 Category: General Medicine Tags: J R Coll Physicians Edinb Source Type: research

The increasing burden of atrial fibrillation in acute medical admissions, an opportunity to optimise stroke prevention.
Conclusions Atrial fibrillation prevalence is significantly increasing among acute hospital admissions; these patients have high risk of cardioembolic stroke. Careful screening and identification in secondary care can lead to improved rates of anticoagulation. PMID: 29537402 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - March 16, 2018 Category: General Medicine Tags: J R Coll Physicians Edinb Source Type: research

Quantitative data analysis of perceived barriers and motivators to physical activity in stroke survivors.
CONCLUSION: Participants felt capable of increasing physical activity but fatigue was often perceived as a barrier to physical activity. This needs to be considered when encouraging stroke survivors to be more active. PMID: 29465097 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - February 24, 2018 Category: General Medicine Tags: J R Coll Physicians Edinb Source Type: research

Standardising care for heart attack (STEMI) patients, Ireland
Under a reform agenda, the Health Service Executive (HSE) in Ireland initiated the National Clinical Programme for Acute Coronary Syndrome (ACS) in 2010, as a joint venture with the Royal College of Physicians of Ireland (RCPI). Early attention was focussed on treatment of patients with ST elevation myocardial infarction (STEMI) as treatment varied nationally depending on distance from a Cardiac centre offering 24/7 primary Percutaneous Coronary Intervention (PPCI) (direct clot removal), a more effective treatment with less complications but requiring specialised facilities compared with thrombolysis (clot dissolving drug ...
Source: International Journal of Integrated Care - August 1, 2017 Category: Nursing Source Type: research

Clinical Stroke prevention in atrial fibrillation.
Authors: Voukalis C, Shantsila E, Lip GY Abstract Oral anticoagulation therapy has reduced the risk of ischaemic stroke and improved the outcomes for patients with atrial fibrillation considerably. The emergence of the non-vitamin K oral anticoagulants as alternatives to vitamin K antagonists has significantly changed the practice of stroke prevention in atrial fibrillation. As the main complication with antithrombotic therapy is bleeding, physicians should always balance the risk of ischaemic stroke against intracranial haemorrhage and intervene where appropriate to reduce both risks. Individual approach is often ...
Source: Journal of the Royal College of Physicians of Edinburgh - June 3, 2017 Category: General Medicine Tags: J R Coll Physicians Edinb Source Type: research

A practical approach to the new oral anticoagulants used for stroke prevention in patients with atrial fibrillation.
Authors: Bashir S, Al-Mohammed A, Gupta S Abstract This review evaluates the research undertaken in the last six years on the use of new oral anticoagulants for stroke prevention in atrial fibrillation and provides evidence-based answers to common clinical questions. Two types of new oral anticoagulants - direct thrombin (IIa) inhibitors, and Xa inhibitors - are currently available. These drugs have similar pharmacokinetics and pharmacodynamics. They are more predictable than, though in many respects comparable to, warfarin. They do not require frequent laboratory tests, nor do they have a narrow therapeutic window...
Source: Journal of the Royal College of Physicians of Edinburgh - December 10, 2016 Category: Journals (General) Tags: J R Coll Physicians Edinb Source Type: research

Short runs of atrial arrhythmia and stroke risk: a European-wide online survey among stroke physicians and cardiologists.
Conclusion Short runs of atrial fibrillation create a dilemma for physicians across Europe. Stroke physicians and cardiologists differ in their diagnosis and management of these patients. PMID: 27929570 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - December 10, 2016 Category: Journals (General) Tags: J R Coll Physicians Edinb Source Type: research

Disappearance of the hyperdense MCA sign after stroke thrombolysis: implications for prognosis and early patient selection for clot retrieval.
Conclusion Disappearance of HMCAS is associated with better clinical and radiological outcomes. A shorter thrombus is more likely to disappear postthrombolysis. The data highlight the limitation of intravenous thrombolysis in patients with longer hyperattenuated vessels, and the potential role for clot retrieval in such patients. PMID: 27929569 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - December 10, 2016 Category: Journals (General) Tags: J R Coll Physicians Edinb Source Type: research

Scan suspected stroke patients within 1 hour, says RCP
Royal College of Physicians launches new guidance Related items fromOnMedica Stroke patients still not getting care they need NHS stroke care getting better NICE wants GPs to prevent 8,000 strokes a year Aspirin after mini-stroke reduces risk of major stroke Stroke can often be avoided, claims study
Source: OnMedica Latest News - October 4, 2016 Category: UK Health Source Type: news

Antibiotic prophylaxis is ineffective in preventing pneumonia post-stroke.
Authors: Rae N, Chalmers JD PMID: 27070889 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - April 15, 2016 Category: Journals (General) Tags: J R Coll Physicians Edinb Source Type: research

Editorial Postacute stroke care: same standards as acute care?
The Sentinel Stroke National Audit Programme (SSNAP), led by the Royal College of Physicians, has released the first comprehensive audit into 604 of 756 postacute stroke care services throughout the UK. Although vast improvements have been achieved in acute stroke care in recent years, progress in postacute care for long-term rehabilitation has been left behind in comparison.
Source: LANCET - December 11, 2015 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research

The history of stress hyperglycaemia.
Authors: Balasanthiran A, Shotliff K Abstract Stress hyperglycaemia, is a common phenomenon, frequently associated with adverse outcomes in a number of prevalent conditions including myocardial infarction and stroke. Knowledge on stress hyperglycaemia evolved in tandem with knowledge relating to homeostasis, stress and disease and involved some of the world's most eminent thinkers. Despite this, it still remains under-recognised. This paper illustrates significant points in the history of stress hyperglycaemia, from antiquity through to the present day, as well as the challenges faced in translating research into c...
Source: Journal of the Royal College of Physicians of Edinburgh - November 30, 2015 Category: Journals (General) Tags: J R Coll Physicians Edinb Source Type: research

Pre-hospital notification is associated with improved stroke thrombolysis timing.
Conclusion Pre-hospital notification is associated with earlier stroke physician review, CT imaging and delivery of thrombolysis. Referral to an out of hours thrombolysis service was not associated with additional delay. PMID: 26517096 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - November 30, 2015 Category: Journals (General) Tags: J R Coll Physicians Edinb Source Type: research

Comparison of predictive scores of symptomatic intracerebral haemorrhage after stroke thrombolysis in a single centre.
CONCLUSION: The haemorrhage after thrombolysis score uses the least variables and has the best predictive value for symptomatic intracerebral haemorrhage. Using predictive scores for clinical decision making depends on estimation of overall benefits as well as risk. PMID: 26181528 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - November 30, 2015 Category: Journals (General) Tags: J R Coll Physicians Edinb Source Type: research