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Scottish Medical Journal

José Pedro L Nunes
Large-scale randomised controlled trials, carried out in the context of secondary cardiovascular prevention, have shown that statins are superior to placebo: these drugs were shown to decrease cardiovascular events and total mortality. A further set of clinical trials compared high intensity to low/standard intensity LDL cholesterol lowering in the same setting (using either statins or a statin/ezetimibe association). In this case, a decrease in LDL cholesterol and a concomitant significant reduction in cardiovascular events were seen with intensive therapy, however with no change in total mortality...
November 26, 2016: Scottish Medical Journal
H Sapsford, A G Sutherland
INTRODUCTION: Recent work suggests that reconstruction of the ruptured anterior cruciate ligament within 12 months of injury results in better outcomes. We present a complete audit cycle examining the effect of establishment of an Acute Knee Clinic on time to surgery. METHODS: Records of 20 anterior cruciate ligament reconstructions undertaken by the senior author between June 2003 and May 2004 were examined to identify the time to surgery. The Acute Knee Clinic was established in December 2004...
September 21, 2016: Scottish Medical Journal
Prasad Palani Velu, Susan E Fernandes, Ian F Laurenson, Donald D Noble
A 65-year-old man presented with a six-month history of lethargy, weight loss and dry cough. He had a background of mild chronic obstructive pulmonary disease. Chest radiograph showed new right upper lobe cavitary opacification. Sputum cultures were acid-fast bacilli smear positive and yielded Mycobacterium marinum - a non-tuberculous mycobacterium (NTM) often found in aquatic environments and rarely associated with respiratory disease. The suspected source was silent aspiration of contaminated water, likely due to his initiating the siphon of his fish-tank by mouth...
November 2016: Scottish Medical Journal
Lara DA Zegers, Richard Hc Zegers
BACKGROUND AND AIMS: One of the characteristics in Laurel and Hardy films is a lot of physical violence. The present study examines the occurrence of eye trauma in Laurel and Hardy movies and discusses the impact they could have been had if the films were set in reality. METHODS AND RESULTS: All 92 movies starring Laurel and Hardy as a pair in leading roles were watched together by the authors and were scored for any eye trauma. Eighty-eight eye traumas happened, of which 48% were directed at Hardy...
November 2016: Scottish Medical Journal
John Larkin
No abstract text is available yet for this article.
November 2016: Scottish Medical Journal
A Lazaridis, M E Drosou, A Fontalis, E Prousali, S E Hadwe, O Giouleme, K Petidis
INTRODUCTION: Celiac disease is an autoimmune disease of the small intestine which occurs in genetically predisposed people of all ages. A large clinical spectrum of manifestations accompanies the onset of the disease with diarrhoea, flatulence and weight loss being the most common. However, findings like osteoporosis, iron deficiency, anaemia and hypocalcaemia could also insinuate the existence of the disease. CASE PRESENTATION: We report the case of a 55-year-old man with numbness and tingling of the upper extremities due to hypocalcaemia that proved to be an uncommon case of celiac disease...
November 2016: Scottish Medical Journal
David Fitzpatrick, Patrick O'Meara, Andrew Cunningham
This short report describes the case of a young adult male who had smoked a synthetic cannabinoid legal high product called 'Exodus Damnation'. The patient's presentation was atypical from that described in the literature, with hypotension and hypoxaemia. Of note was the rapid recovery after pre-hospital intervention with high-flow oxygen therapy and intravenous fluids. The patient refused on-going care, despite repeated advice to attend the Emergency Department. The distinct lack of specialist support and referral to drug treatment for this patient population, with whom ambulance services are coming into contact with increasing frequency, is reported...
November 2016: Scottish Medical Journal
Agapios Gkentzis, Grenville Oades
BACKGROUND AND AIMS: Small renal masses are commonly diagnosed incidentally. The majority are malignant and require intervention. The gold standard treatment is partial nephrectomy unless the patient has significant co-morbidities when surveillance or ablative therapies are utilised. The latter are relatively novel and their long-term efficacy and safety remain generally poorly understood. We performed a literature review to establish the current evidence on the oncological outcome of thermal ablative techniques in small renal masses treatment...
November 2016: Scottish Medical Journal
Thavenesh K Ramachandren, Renée Ma Petrilli
INTRODUCTION: SJS and TEN are two rare self-limited but serious cutaneous drug reactions with significant morbidity and mortality. There are many drugs associated with the condition. We report a case of early TEN syndrome post Carbamazepine use, review the current literature and discuss the management challenges. CASE REPORT: A 51-year-old female was admitted to hospital for investigation and management of complex partial seizures secondary to a meningioma. She was commenced on 100mg BD of Carbamazepine for seizure control and discharged home...
November 2016: Scottish Medical Journal
Suha Akpinar, Güliz Yilmaz
Non-ischemic, high-flow priapism is defined as the state of painless and permanent erection of the penis which generally develops by perineal trauma. Selective transarterial embolisation is one of the treatment options. We present an 18-year-old men who had complaints of painless and permanent erection after a blunt perineal trauma. Colour Doppler ultrasound revealed a pseudoaneurysm and fistula at the left cavernosal artery. Hence autologous blood clot injection was performed to embolise the pseudoaneurysm...
November 2016: Scottish Medical Journal
Rosemary Haddock, Christopher Deighan, Peter C Thomson
BACKGROUND AND AIMS: Higher mortality rates have been reported for patients admitted at a weekend compared to a weekday. Our aim was to assess in-patient mortality patterns by day of the week, in a tertiary renal unit. METHOD AND RESULTS: Mortality related to day of admission and day of death was analysed over a two-year period at Glasgow Western Infirmary renal unit. Typical caseload was also assessed over two random four-week periods. As a proportion of admissions, 30-day mortality was 46/540 (8...
November 2016: Scottish Medical Journal
Felicity Arthur, Robert Carachi
BACKGROUND AND AIMS: The cardinal features of bilious vomiting and abdominal distension assist in the diagnosis of malrotation and volvulus, an often fatal condition in the neonate. When these symptoms are absent, however, diagnosis becomes trickier. In the older child, these classic symptoms are less likely to occur, or occur at a later stage, meaning these children suffer from a delay in diagnosis and consequently do poorer. There is a need, therefore, to identify the common presenting features in these older children in order to facilitate earlier diagnosis and improve outcomes...
August 30, 2016: Scottish Medical Journal
E McIlveen, A Jackson, J Bowie, C Stirling, A Downie, D Kingsmore
INTRODUCTION: Acute renal transplant emboli can be disastrous and result in loss of the renal transplant. This case was successfully treated with thrombolysis. CASE PRESENTATION: A 66-year-old female underwent a right-sided deceased heart-beating donor renal transplant. She had excellent transplant function but presented acutely three years later with pain in the transplanted kidney, an acute rise in serum creatinine and new onset atrial fibrillation. Bedside ultrasound scan demonstrated absent transplant perfusion...
August 19, 2016: Scottish Medical Journal
Duncan Light, Kasra Razi, Liam Horgan
INTRODUCTION: Obturator hernias are a rare groin hernia. They are most commonly found incidentally during laparoscopic inguinal hernia repair. We investigated our experience with obturator hernias in the elective and emergency setting. METHODS: Cases of obturator hernia were identified from a hospital database and reviewed retrospectively over the last 10 years. There were no exclusions. There were a number of surgeons involved with an interest in groin hernia surgery...
August 8, 2016: Scottish Medical Journal
(no author information available yet)
No abstract text is available yet for this article.
August 2016: Scottish Medical Journal
John Larkin
No abstract text is available yet for this article.
August 2016: Scottish Medical Journal
Hadi A Oun, Andrew J Price, Jamie P Traynor
BACKGROUND AND AIMS: Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. METHODS AND RESULTS: From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period...
June 22, 2016: Scottish Medical Journal
Kieran Montgomery, Imran Khan, Kathleen Thomson, David Wynne
BACKGROUND AND AIMS: The World Health Organisation (WHO) surgical checklist acts as a safety check before surgery. The three components are: sign in, surgical pause and sign out. This study aims to assess and improve the surgical pause at a tertiary paediatric surgical unit. METHODS AND RESULTS: Theatre nurses used as a standardised tool to record how the pause was carried out. All other theatre staff were blinded. Presentation of these data at departmental meetings allowed creation of a checklist poster which was placed in every theatre...
June 9, 2016: Scottish Medical Journal
Con Lafferty, Linda Smith, Alison Coull, Jim Shanley
BACKGROUND AND AIMS: New psychoactive substances are causing increasing harm across the UK but the use of new psychoactive substance by injecting has become a significant problem within Lothian since the beginning of 2014. Data indicate a rapid rise in the number of existing drug injectors, particularly heroin injectors, moving to new psychoactive substance injecting. This paper reports the experiences within Lothian of a sudden increase in injecting of ethylphenidate over one year. A temporary class drug order was placed on ethylphenidate on 10 April 2015, and as yet the effects of this are unknown...
May 12, 2016: Scottish Medical Journal
Jennifer Cleland, Jacqueline Burr, Peter Johnston
BACKGROUND AND AIMS: The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. METHODS: Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances...
May 10, 2016: Scottish Medical Journal
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