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Scottish Medical Journal

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https://www.readbyqxmd.com/read/29226770/an-unexpected-image-on-a-chest-radiograph
#1
Dogus Hemsinli, Hasan Mutlu, Gokalp Altun, Zerrin Pulathan, Ahmet C Ozdemir
Introduction Central venous catheterisation is an essential component of patient care in hospital. A forgotten complete guide-wire is a rare complication, although the reported incidence has increased rapidly over the last decade. Case report We report a 72-year-old man with a complete guide-wire inadvertently overlooked during catheter insertion. A central venous catheter had been inserted for total parental nutrition during treatment for pancreatitis. Five years later, the patient was readmitted with a painful lesion on his neck and the sensation of a sharp object under his skin...
November 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28836926/platypnoea-orthodeoxia-syndrome-in-the-elderly-a-difficult-to-make-diagnosis-of-intracardiac-right-to-left-shunt
#2
Enrico M Zardi, Silvia Spoto, Luciana Locorriere, Giulio Cacioli, Silvia Mazzaroppi, Bruno B Zobel, Germano Di Sciascio, Sebastiano Costantino
Introduction Platypnea-orthodeoxia syndrome is a combination of positional dyspnoea and hypoxemia; it is caused by several cardiac, pulmonary and hepatic diseases. Case presentation In this study, we describe a 77-year-old female affected by unexplained dizziness and hypoxia that exacerbated in upright position. After diagnosing platypnea-orthodeoxia syndrome and excluding all possible causes (liver cirrhosis, acute and chronic pulmonary diseases and arteriovenous malformations), the origin of the syndrome was individuated in the presence of a patent foramen ovale with right-to-left shunt...
August 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28587518/an-investigation-into-uk-medical-students-knowledge-of-lifestyle-factors-on-cancer
#3
S Luckman, C Xiao, E McLennan, A S Anderson, N Mutrie, S J Moug
Background and aim Lifestyle factor modification (alcohol, smoking, obesity, diet, physical activity) has the potential to reduce cancer incidence and cancer survival. This study assessed the knowledge of lifestyle factors and cancer in undergraduate medical students. Methods and results A total of 218 students (7 UK universities) completed an online survey of nine questions in three areas: knowledge (lifestyle factors and cancer); information sources; clinical practice (witnessed clinical counselling). Diet, alcohol, smoking and physical activity were recognised as lifestyle factors by 98% of responders, while only 69% reported weight...
August 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28679337/paper-chase
#4
Colin Geddes
No abstract text is available yet for this article.
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28679336/a-rare-cause-of-urosepsis-answers
#5
Jasenka Kraljević, Leo Grandić, Mario Duvnjak, Davor Librenjak, Zenon Pogorelić
No abstract text is available yet for this article.
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28679335/a-rare-cause-of-urosepsis-clinical-quiz
#6
Jasenka Kraljević, Leo Grandić, Mario Duvnjak, Davor Librenjak, Zenon Pogorelić
No abstract text is available yet for this article.
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28679334/syncope-in-a-patient-with-minimal-change-disease-without-nephrotic-range-proteinuria
#7
Wen-Fang Chiang, Jenq-Shyong Chan, Pauling Chu, Chia-Chao Wu
Introduction Pulmonary embolism is a potentially life-threatening complication of nephrotic syndrome. Syncope is rarely reported as an initial presentation of pulmonary embolism in nephrotic patients. Case presentation We describe a 35-year-old man who was taking steroids and diuretics for relapse of minimal change disease who presented after a syncopal event. The patient was hypotensive and had distended neck veins. The major laboratory findings were hypoalbuminemia with mild proteinuria. The findings on electrocardiography, chest radiography, and echocardiography and the elevated plasma D-dimer level raised suspicion of pulmonary embolism...
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28670981/keep-an-eye-out-a-rare-case-of-acute-onset-charles-bonnet-syndrome-after-stanford-type-a-aortic-dissection-repair-surgery
#8
Fabian Cook, Scott Dougherty, Robert Moreton, Maziar Khorsandi
Charles Bonnet Syndrome describes the triad of complex visual hallucinations secondary to ophthalmic pathology in psychologically normal people. We present a rare case of acute-onset Charles Bonnet Syndrome following cardiac surgery that resulted in profound loss of visual acuity in both eyes with characteristic visual hallucinations that were initially mistaken for delirium. Computed tomography of the brain revealed bilateral occipital infarcts, providing the substrate for Charles Bonnet Syndrome. A high index of suspicion should be maintained in cognitively intact patients with visual loss who are also experiencing visual hallucinations to ensure prompt diagnosis and management of this often overlooked condition...
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28490287/cheiro-oral-syndrome
#9
Mamoun Saeed, Abdelrahman Abbker, Paul Brenan, Tarig Mohammed Abkur
We describe a 64-year-old man who presented to the emergency department with a two-day history of left perioral and hand numbness. Examination revealed impaired sensation of the left corner of the mouth and ipsilateral fingers. Neuroimaging showed an acute right thalamic lacunar infarct consistent with the diagnosis of cheiro-oral syndrome. In this report, we discuss the importance of recognising this syndrome and instituting appropriate management to prevent further cerebrovascular events.
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28228054/this-message-is-sent-with-high-self-importance
#10
(no author information available yet)
No abstract text is available yet for this article.
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28186466/mental-hospital-life-in-the-50s
#11
Leslie Bartlet
The recollections of a retired psychiatrist concerning his time as a house doctor in a 1952 Scottish mental hospital. These pertain to early days of the National Health Service. He describes the routines and practices of those times, and he refers to some of his reactions to his experiences.
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28173740/emergency-department-redirection-to-primary-care-a-prospective-evaluation-of-practice
#12
James A Bentley, Shobhan Thakore, William Morrison, Weijie Wang
Background and aim Non-urgent Emergency Department presentations contribute to overcrowding, which can adversely affect patient care. Redirecting patients to a more appropriate service is an option to help address this. We conducted a prospective evaluation of a major Scottish hospital's Emergency Department redirection policy to assess its safety. Methods and results Over two months, 620 patients triggered senior assessment for redirection with 444 (72%) redirected to primary care. Information on presentation was collected with subsequent management and outcome of redirection provided by the patient's general practitioner...
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28152662/posterior-reversible-encephalopathy-syndrome-as-a-complication-of-henoch-sch%C3%A3-nlein-purpura-in-a-seven-year-old-girl
#13
Daiane Dos Santos, Felipe Welter Langer, Tatiane Dos Santos, Giordano Rafael Tronco Alves, Marisa Feiten, Walter Teixeira de Paula Neto
Introduction Henoch-Schönlein purpura is a multisystem small vessel vasculitis. Neurologic manifestations are uncommon. Posterior reversible encephalopathy syndrome is a rare complication of Henoch-Schönlein purpura with typical clinical and neuroimaging findings that occurs most commonly in the setting of severe hypertension and renal injury. Case presentation A seven-year-old girl was admitted to our institution presenting with clinical and laboratory findings suggestive of Henoch-Schönlein purpura. Glucocorticoid therapy was initiated, but five days following her admission, she developed altered consciousness, seizures, arterial hypertension, and cortical blindness...
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28110629/clippers-and-the-need-for-long-term-immunosuppression
#14
Tarig M Abkur, Hugh Kearney, Michael J Hennessy
Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) is a rare chronic inflammatory disorder of the central nervous system. Herein, we describe the case of a 62-year-old female who presented with right sided facial tingling, gait ataxia and diplopia. Neuroimaging revealed pontine curvilinear enhancing lesions with extension into cerebellar peduncles, characteristic of CLIPPERS. This report discusses the differential diagnosis and the importance of prolonged immunomodulatory treatment for this rare neuro-inflammatory disorder...
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28110628/sublingual-glyceryl-trinitrate-during-colonoscopy-and-terminal-ileal-intubation-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Patsy-Anne Hill, Sofoklis Panteleimonitis, Graham McKay, Carol Watson, Andre Prach, Angus Macdonald
Background and aims Sublingual glyceryl trinitrate has been used as an aid to cannulate the Sphincter of Oddi during endoscopic retrograde cholangiopancreatography. Its role in terminal ileal intubation during colonoscopy is unknown. This study examines the role of sublingual glyceryl trinitrate in terminal ileal intubation during colonoscopy. Methods A triple-blind randomized controlled trial comparing sublingual glyceryl trinitrate (800 µg) vs. placebo (saline) in relation to terminal ileal intubation during colonoscopy was performed...
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28084899/limited-role-of-hla-dq2-8-genotyping-in-diagnosing-coeliac-disease
#16
Siba P Paul, Matthew Hoghton, Bhupinder Sandhu
The European guidelines for diagnosing coeliac disease in children were revised in 2012. These recommend that in symptomatic children, a diagnosis of coeliac disease can be made without small-bowel biopsies provided their anti-tissue transglutaminase (anti-tTG) titre is >10 times of upper-limit-of-normal (>10×ULN) and anti-endomysial antibody is positive. In order to firm up the diagnosis in these children with very high anti-tTG titre, HLA-DQ2/DQ8 should be checked and be positive. Approximately 25-40% of white Caucasian population has HLA-DQ2/DQ8 haplotype...
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/27889702/statins-and-the-cholesterol-mortality-paradox
#17
REVIEW
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...
February 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/29214906/lingua-patientis-new-words-for-patient-communication-and-history-taking
#18
Donald F Weaver
The English language sometimes fails in its ability to describe the severity or complexity of medical symptoms and complaints. In frustration, patients (or families) occasionally create new words to convey the subtleties of their medical history. Although medicine has created a comprehensive technical lexicon for physicians, we have failed to develop a corresponding patient-centric vocabulary (lingua patientis) that provides more accurate symptom description. The social networking of lingua patientis words might enhance history taking and afford improved appreciation of disease impact on individual patients...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/29192564/rare-case-of-atypical-parkinsonism-why-family-history-is-important
#19
Naveed Malek, Ravi Jampana, Donald G Grosset
We discuss the clinical presentation and assessment of a middle aged previously fit and well man who presented with two episodes of syncope to the cardiologists followed by the development of a rapidly progressive parkinsonian syndrome a couple of years later, which was not responsive to standard dopaminergic replacement therapies. Magnetic resonance imaging scan of the brain was normal and a DAT SPECT scan showed reduced dopamine uptake in the basal ganglia. On further enquiry, a family history of a similar presentation in his first cousin was elicited and that cousin had tested positive for a mutation in the PRNP gene...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/29169299/the-changing-case-mix-of-hip-fractures-in-scotland-evidence-from-the-scottish-hip-fracture-audit
#20
Stephen D Hannah, K B Ferguson, R Smith, J Hutchison, G Holt
Until discontinued in 2008, the Scottish Hip Fracture Audit collected and reported on data relating to the quality of care of hip fracture patients in Scotland. In 2013, the audit was recommenced under the umbrella of the MSK Audit group, which audits high volume orthopaedic pathways across Scotland. Our aim is to report on the changes in the demographics of hip fracture patients in Scotland between 2003 and 2013. There was an increase in the proportion of male patients from 2003 to 2013 (22.4% to 29.5%; p < 0...
January 1, 2017: Scottish Medical Journal
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