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Clinical Medicine: Journal of the Royal College of Physicians of London

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https://www.readbyqxmd.com/read/27927837/response
#1
Joel Abbott
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927836/assessment-for-benign-paroxysmal-positioning-vertigo-in-medical-patients-admitted-with-falls-in-a-district-general-hospital
#2
Andrew M Chancellor
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927835/service-contribution-and-cost-effectiveness-of-specialist-registrars-in-nhs-trusts-a-survey-and-costing-analysis
#3
Andrew Rl Medford
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927834/the-independent-validation-of-the-foundation-programme-application-process-a-closer-look
#4
Fiona Patterson, Kim Walker
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927833/uk-medical-education-database-an-issue-of-assumed-consent
#5
Rebecca Best, Jason Leo Walsh, Benjamin Howell Lole Harris, David Wilson
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927832/central-lines-and-the-general-medical-registrar-time-for-a-change-in-the-curriculum
#6
Catherine Mary Napier, Anna Louise Mitchell
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927831/image-of-the-month-aortic-coarctation-assessed-by-contemporary-multimodality-cardiac-imaging
#7
Bartosz Olechowski, Samantha Fitzsimmons, Sue Thomas, Trevor Richens, Peter O'Kane
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927830/lesson-of-the-month-2-oncology-obstetrics-and-orthopaedics-an-unusual-partnership
#8
Claire Fuller, Catherine Bale, Jill Bishop, Paul Cool
Breast cancer diagnosed during pregnancy is a relatively uncommon event. This challenging situation presents clinicians with difficult decisions, often requiring a multidisciplinary approach at a time of heightened anxiety for the patient and their family. This paper describes the case of a young woman with metastatic breast cancer diagnosed in early pregnancy, and outlines how this complex clinical situation was managed.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927829/lesson-of-the-month-1-lobar-pulmonary-consolidation-in-an-immunocompromised-host
#9
Daniel J Reynolds, Carl A Andersen, Sumedh S Hoskote, Hee Eun Lee, Aditya Raghunathan, Sanjay Kalra, Andrew H Limper
A 19-year-old male with a history of idiopathic panuveitis, currently taking methotrexate and infliximab, presented to our institution with 6 weeks of cough, dyspnoea and fevers. He had failed outpatient antimicrobial therapy. Computerised tomography (CT) of the chest revealed the presence of a lobar pneumonia and he was treated with broad spectrum antibiotics, which did not improve his symptoms. Bronchoalveolar lavage was performed with a transbronchial lung biopsy because of the diagnostic uncertainty of the patient's presentation...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927828/cme-immunology-and-allergy-108458-self-assessment-questionnaire
#10
Sarah Johnston, Tahseen A Chowdhury
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927827/introduction-to-drug-allergy-and-whom-to-refer-for-specialist-assessment
#11
Bogusia Kasternow, Mohammed Yousuf Karim
Drug allergy is defined as an adverse drug reaction with an established immunological mechanism. The National Institute for Health and Care Excellence published clinical guidelines on drug allergy in 2014 and quality standards in 2015. The intention of this article is to highlight indications for referral to specialists for management of drug allergy. Accurate diagnosis of drug allergy is critical of course for patient safety, but also for better use of the drugs that we have available and to reduce unnecessary avoidance of drugs...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927826/an-update-on-allergen-immunotherapy
#12
S Hasan Arshad
Allergen-specific immunotherapy (AIT) has been used to treat allergic diseases for over a century. It is the only treatment that addresses immune dysfunction underlying allergic responses rather than simply treating symptoms or suppressing inflammation. Its safety and efficacy in allergic rhinitis, asthma and insect allergy has been documented in a number of systematic reviews but its cost effectiveness is less clear. AIT reduces symptoms and requirement for medication, while improving quality of life. Further, the effect continues for years after discontinuation of treatment...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927825/an-update-on-mast-cell-disorders
#13
Hannah Cookson, Clive Grattan
Disorders of mast cell activation can be classified as primary (mastocytosis), secondary (reactive) or idiopathic. This article discusses how to recognise and approach the diagnosis of patients suspected to have symptoms of abnormal mast cell activation. Given the highly varied and often complex symptomatology of such patients, we advocate applying a logical step-wise approach to investigating these patients to ensure the correct diagnosis is made. Treatments of mast cell activation disorders are discussed, dividing them into those that ameliorate the effects of mast cell mediators and those that act to stabilise the mast cell...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927824/immunoglobulin-therapy
#14
Sarah Louise Johnston, Rob Hollingsworth
Immunoglobulin is an expensive blood product of potentially limited supply used in a wide variety of medical conditions, across a number of specialties. Historically, immunoglobulin has been associated with transmission of blood borne infection (eg hepatitis C). Immunoglobulin use needs to be carefully considered, appropriately prescribed and recorded. The Department of Health, in conjunction with relevant stakeholders, has established a demand management programme to secure immunoglobulin supplies for patients most in need of treatment and to limit use for indications where evidence is lacking...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927823/secondary-antibody-deficiency-causes-and-approach-to-diagnosis
#15
Sapna Srivastava, Philip Wood
Antibody deficiencies can occur in the context of primary disorders due to inherited genetic defects; however, secondary immune disorders are far more prevalent and can be caused by various diseases and their treatment, certain medications and surgical procedures. Immunoglobulin replacement therapy has been shown to be effective in reducing infections, morbidity and mortality in primary antibody deficiencies but secondary antibody deficiencies are in general poorly defined and there are no guidelines for the management of patients with this condition...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927822/clinical-implications-of-the-global-multidrug-resistant-tuberculosis-epidemic
#16
Kartik Kumar, Ibrahim Abubakar
Multidrug-resistant tuberculosis (MDR TB) is a significant threat to global health estimated to account for nearly half a million new cases and over 200,000 deaths in 2013. The number of MDR TB cases in the UK has risen over the last 15 years, with ever more complex clinical cases and associated challenging public health and societal implications. In this review, we provide an overview of the epidemiology of MDR TB globally and in the UK, outline the clinical management of MDR TB and summarise recent advances in diagnostics and prospects for new treatment...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927821/harveian-oration-2016-some-observations-on-the-causes-and-consequences-of-obesity
#17
Stephen O'Rahilly
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927820/headache-in-an-hiv-positive-patient-diagnostic-challenges-and-approach-to-treatment%C3%A2
#18
Andrew Creamer, Stefanos Ioannidis, Thomas Wilhelm, Tabitha Mahangu, Marc Lipman
Headaches are a common complaint in HIV positive patients attending emergency services. A thorough understanding of the differential diagnoses, initial investigations and empirical management of this presentation is essential for the assessing physician. We discuss a case of a patient with known advanced HIV infection presenting with headache to the emergency department. Given the range of possible diagnoses, broad-spectrum antimicrobial therapy was initially commenced. This was stopped when magnetic resonance imaging confirmed a diagnosis of venous sinus thrombosis...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927819/managing-complex-long-term-conditions-and-multimorbidity
#19
Archana Dhere
No abstract text is available yet for this article.
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927818/interdisciplinary-management-of-hip-fracture
#20
Cameron Swift, Saoussen Ftouh, Patrick Langford, Timothy S Chesser, Antony Johanssen
Hip fracture is a prevalent age-associated occurrence incorporating both medical and surgical need and a major challenge to public health and NHS resources. Effective management requires coordinated collaboration across specialties, professions and services. This concise guideline focuses on interdisciplinary aspects of hip fracture management abstracted from National Institute for Health and Care Excellence (NICE) clinical guideline (CG124), including the concept and implementation of the Hip Fracture Programme, detection and management of comorbidity and delirium, optimal analgesia, timing of surgery, multidisciplinary mobilisation, rehabilitation and hospital discharge...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
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