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Postgraduate Medical Journal

Walid Radwan, Brandon Lucke-Wold, Ibrahim Ahmed Robadi, Kymberly Gyure, Thomas Roberts, Sanjay Bhatia
BACKGROUND: Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%-15% of cases. Any part of the nervous system can be affected by sarcoidosis. CASES: Herein we describe three unusual patient presentations of neurosarcoidosis, one with optic neuritis, a second with hydrocephalus and a third with cervical myelopathy...
December 5, 2016: Postgraduate Medical Journal
Obioma J Ekeledo, Chris Scelsi, Jayanth H Keshavamurthy
No abstract text is available yet for this article.
December 5, 2016: Postgraduate Medical Journal
E C Russell-Jones, K Iliadis, C Wynne
No abstract text is available yet for this article.
November 29, 2016: Postgraduate Medical Journal
Zakariye Ashkir, Georgios Tsaknis, Andrew Jeffrey
No abstract text is available yet for this article.
November 29, 2016: Postgraduate Medical Journal
Bradley Field Bale, Amy Lynn Doneen, David John Vigerust
Periodontal disease (PD) is generated by microorganisms. These microbes can enter the general circulation causing a bacteraemia. The result can be adverse systemic effects, which could promote conditions such as cardiovascular disease. Level A evidence supports that PD is independently associated with arterial disease. PD is a common chronic condition affecting the majority of Americans 30 years of age and older. Atherosclerosis remains the largest cause of death and disability. Studies indicate that the adverse cardiovascular effects from PD are due to a few putative or high-risk bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola or Fusobacterium nucleatum There are three accepted essential elements in the pathogenesis of atherosclerosis: lipoprotein serum concentration, endothelial permeability and binding of lipoproteins in the arterial intima...
November 29, 2016: Postgraduate Medical Journal
Balaji Krishnaiah, Daniel McLaughlin, Jennifer Lee, David Good
No abstract text is available yet for this article.
November 25, 2016: Postgraduate Medical Journal
Michele Tonutti, Daniel S Elson, Guang-Zhong Yang, Ara W Darzi, Mikael H Sodergren
The diffusion of minimally invasive surgery has thrived in recent years, providing substantial benefits over traditional techniques for a number of surgical interventions. This rapid growth has been possible due to significant advancements in medical technology, which partly solved some of the technical and clinical challenges associated with minimally invasive techniques. The issues that still limit its widespread adoption for some applications include the limited field of view; reduced manoeuvrability of the tools; lack of haptic feedback; loss of depth perception; extended learning curve; prolonged operative times and higher financial costs...
November 22, 2016: Postgraduate Medical Journal
Philip D Welsby
No abstract text is available yet for this article.
November 21, 2016: Postgraduate Medical Journal
Parva K Bhatt, Tochi Okwuosa
No abstract text is available yet for this article.
November 21, 2016: Postgraduate Medical Journal
J George
Morbidity and mortality conferences (MMCs) have three potential aims-to improve patient safety by reducing adverse events and preventable deaths, to improve overall quality of care as part of the hospital governance structure and as educational learning events. At present, medical MMCs vary widely in format and attendance from hospital to hospital. The evidence for MMCs actually reducing adverse events and preventing avoidable deaths is disappointing. There is better evidence for their educational role. The majority of medical deaths in hospitals are frail older people with poor life expectancy in whom inadequate care is more likely to be due to errors of omission rather than commission...
November 21, 2016: Postgraduate Medical Journal
Laura Halliday, Abigail Walker, Stella Vig, John Hines, John Brecknell
PURPOSE OF THE STUDY: Grit is characterised by the ability to persevere during difficulties and maintain a sustained effort over an extended period of time. Throughout their careers, doctors will experience many periods of stress and difficulty. This may result in burnout, defined by the presence of exhaustion and disengagement from work. This study aims to characterise the relationship between grit and burnout in doctors and to establish whether there are differences between specialties and levels of training...
November 18, 2016: Postgraduate Medical Journal
I Mikolasevic, L Orlic, D Stimac, I Hrstic, I Jakopcic, S Milic
As a significant cause of cancer death worldwide, colorectal cancer (CRC) is still one of the most common cancers in the world. The most efficient strategies to reduce CRC incidence include identifying risk factors for CRC and performing a preventive colonoscopy in high-risk populations. Some well-established risk factors for CRC development include hereditary syndromes and inflammatory bowel disease. Of note, in recent years, attention has been given to new evidence indicating that more than 75%-95% of CRC occurs in individuals with little or no genetic risk...
November 16, 2016: Postgraduate Medical Journal
David R James, Nwanneka N Sargant, Nancy Bostock, Sophie Khadr
The environment in which young people are growing up has changed significantly with the growth in social communication, changes in migration patterns and the proliferation of gangs. These changes pose a real and present danger to the health and well-being of young people in the UK and around the world. However, recognition of the safeguarding needs for this group continues to lag behind those of younger children and services often remain patchy and incomplete. We present a review of current safeguarding concerns as well as practical suggestions on their recognition and response for professionals working with young people in all branches of healthcare as well as education and wider society...
November 15, 2016: Postgraduate Medical Journal
Ka-On Lam, Kin-Chung Lee, Joanne Chiu, Victor Ho-Fun Lee, Roland Leung, T S Choy, Thomas Yau
PURPOSE OF THE STUDY: To evaluate the benefits and tolerability of regorafenib in the real-world setting, we performed a multicentre analysis in Hong Kong. STUDY DESIGN: Individual patient data were retrieved from three leading oncology centres in Hong Kong for analyses. All patients with metastatic colorectal cancer (mCRC) treated with regorafenib after failure of all standard systemic options were included. RESULTS: From July 2013 to December 2015, 45 consecutive patients treated with regorafenib for mCRC were analysed...
November 11, 2016: Postgraduate Medical Journal
Mark Melzer, Liana Macpherson, Catherine Welch
BACKGROUND: The clinical and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) services are well described. We used a blood culture database as a novel approach to case finding and determined its utility in identifying inpatients suitable for OPAT. METHODS: From December 2012 to November 2013, consecutive adult inpatients with bacteraemia, and those recruited to OPAT, were prospectively studied. Univariate and multivariate logistic regression analysis were used to investigate the association between bacteraemic patient characteristics and OPAT recruitment...
November 7, 2016: Postgraduate Medical Journal
Ashu Rastogi, Anil Bhansali
No abstract text is available yet for this article.
November 3, 2016: Postgraduate Medical Journal
Shu-Zhen Xu, Peng Wang, Shi-Yang Guan, Hong-Miao Li, Rui-Xue Leng, Hai-Feng Pan, Dong-Qing Ye
OBJECTIVES: To derive a more precise comparison of flow-mediated dilatation (FMD%) of the brachial artery between patients with rheumatoid arthritis (RA) and normal controls by performing a meta-analysis of appropriate studies. METHODS: PubMed and EMBASE databases were searched for all relevant articles. STATA (V.12.0) software was used to perform the meta-analysis. Quality estimation of all appropriate studies was evaluated according to the Newcastle-Ottawa Scale (NOS)...
November 2, 2016: Postgraduate Medical Journal
Yinghui Xie, Hui Shao, Chenlin Dai, Zhongshu Ma
No abstract text is available yet for this article.
November 2, 2016: Postgraduate Medical Journal
Dan F Laney, Jayanth H Keshavamurthy, Shvetank Agarwal
No abstract text is available yet for this article.
October 28, 2016: Postgraduate Medical Journal
Irene Braithwaite, Bridget Healy, Laird Cameron, Mark Weatherall, Richard Beasley
BACKGROUND: Evidence from randomised controlled trials shows that low-molecular-weight heparin is effective in reducing the risk of venous thromboembolism (VTE) in the clinical setting of temporary lower limb immobilisation. Despite this, international guidelines are non-committal in advocating the use of anticoagulation in this clinical scenario. We determined the risk of VTE associated with lower limb immobilisation and the proportion of VTE events associated with lower limb immobilisation by undertaking a secondary analysis of two case-control studies that had used a similar methodology...
October 26, 2016: Postgraduate Medical Journal
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