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Journal of the Royal College of Physicians of Edinburgh

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https://www.readbyqxmd.com/read/28569294/letters-to-the-editor
#1
P Myerscough
No abstract text is available yet for this article.
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569293/rhubarb-rheum-species-the-role-of-edinburgh-in-its-cultivation-and-development
#2
M R Lee, J Hutcheon, E Dukan, I Milne
Rhubarb was grown and used throughout China for thousands of years. It then found its way to St Petersburg where the Romanovs developed a flourishing trade in the plant to the rest of Europe. James Mounsey, a physician to the Tsar, brought back seeds from Russia to Scotland at considerable risk to himself. He passed some of the seeds to Alexander Dick and John Hope. Both these physicians then grew rhubarb at Prestonfield and the Botanic Garden (both in Edinburgh), respectively. Eventually rhubarb, in the form of Gregory's powder, became a common and popular medicine throughout the UK...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569292/from-the-house-with-the-green-shutters-to-our-lady-of-perpetual-succour-the-portrayal-of-alcohol-in-the-modern-scottish-novel
#3
A W Beveridge
In modern Scottish literature alcohol is a recurrent subject; this paper examines the different ways it is portrayed with particular emphasis on the novel. It has been seen as the resort of the weak-minded and the cause of personal degradation. It has been portrayed as a response to and a symptom of social disintegration. It has been depicted as leading to delirium and psychosis. On a positive note it has been hailed as a source of inspiration and as a means of celebration. It has helped some troubled characters find the road to redemption...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569291/misadventure-in-muirhouse-hiv-infection-a-modern-plague-and-persisting-public-health-problem
#4
R Robertson
This story is of particular interest and importance to Edinburgh and Scottish medicine. It describes the events in one general medical practice in Edinburgh, the Muirhouse Medical Group, and their impact and relationship to the AIDS pandemic. For many, the origin of HIV in the UK is now history. Since the introduction of HIV/AIDS into the intravenous illegal drug using community, much has changed but problems remain that should concern policy makers and clinicians. Reflections on the recent history of the HIV epidemic among drug users in the UK provide important insights into risks for current policy making and the potentially problematic direction that policy has taken...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569290/novel-combined-management-approaches-to-patients-with-diabetes-chronic-kidney-disease-and-cardiovascular-disease
#5
J Spaak
Most patients we care for today suffer from more than one chronic disease, and multimorbidity is a rapidly growing challenge. Concomitant cardiovascular disease, renal dysfunction and diabetes represent a large proportion of all patients in cardiology, nephrology and diabetology. These entities commonly overlap due to their negative effects on vascular function and an accelerated atherosclerosis progression. At the same time, a progressive subspecialisation has caused the cardiologist to treat 'only' the heart, nephrologists 'only' the kidneys and endocrinologists' 'only' diabetes...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569289/what-happens-to-the-heart-in-chronic-kidney-disease
#6
E Rutherford, P B Mark
Cardiovascular disease is common in patients with chronic kidney disease. The increased risk of cardiovascular disease seen in this population is attributable to both traditional and novel vascular risk factors. Risk of sudden cardiac or arrhythmogenic death is greatly exaggerated in chronic kidney disease, particularly in patients with end stage renal disease where the risk is roughly 20 times that of the general population. The reasons for this increased risk are not entirely understood and while atherosclerosis is accelerated in the presence of chronic kidney disease, premature myocardial infarction does not solely account for the excess risk...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569288/being-the-med-reg-an-exploration-of-junior-doctors-perceptions-of-the-medical-registrar-role
#7
J Fisher, M Garside, P Brock, V Gibson, K Hunt, Z Wyrko, A L Gordon
The role of the medical registrar is challenging and acknowledged as being a disincentive to a career in medicine for some junior doctors. We set out to build a broader understanding of the role through exploration of Foundation Doctors' and Core Medical Trainees' perceptions of the role. Data, gathered from focus groups, were analysed using a framework approach. Six key themes were identified, which were grouped under the headings 'perceptions of the medical registrar role' and 'transition into the role'. Our work builds on existing literature to inform a deeper understanding of how junior doctors perceive the medical registrar role...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569287/effect-of-a-national-focused-course-on-academic-medicine-for-uk-candidates-applying-for-a-clinical-academic-programme
#8
A Khajuria, K Cheng, J Levy
Background Academic medicine is crucial for healthcare advancement. However, recruitment of junior doctors into academia remains an area of concern globally. In the UK, a national integrated clinical academic pathway was developed to address these issues, with the Academic Foundation Programme as the 'first opportunity for research'. We aimed to evaluate whether a focused course on academic medicine could enhance knowledge, confidence and preparedness of candidates wishing to apply for an academic programme...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569284/acute-pulmonary-oedema-not-always-cardiogenic
#9
M Bonello, R Pullicino, A J Larner
A patient presented with fulminant pulmonary oedema and required acute intubation and ventilation. There was no history of a prior cardiac disorder. As he was weaned from sedation, following stabilisation of his pulmonary status, neurological signs suggestive of brainstem dysfunction became apparent. Investigations showed infarcts in the posterior cerebral circulation secondary to a vertebral artery dissection. Neurogenic pulmonary oedema needs to be considered in any patient with fulminant pulmonary oedema without overt evidence or history of cardiac disease...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569283/isolated-mediastinal-lymphadenopathy-performance-of-ebus-tbna-in-clinical-practice
#10
P P Velu, P A Reid, W A Wallace, K M Skwarski
Background Isolated mediastinal lymphadenopathy is an increasingly common finding as a result of the increasing use of cross-sectional thoracic imaging. We investigated the performance of endobronchial ultrasoundguided transbronchial needle-aspiration (EBUS-TBNA) in establishing a pathological diagnosis in patients with isolated mediastinal lymphadenopathy. Methods We retrospectively analysed all consecutive EBUS-TBNA examinations performed over a 4-year period at a single tertiary referral centre. Final diagnoses were made using pathology reports, correlated with clinical features and the results of any other investigations...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569282/do-not-attempt-cardiopulmonary-resuscitation-decisions-joint-guidance
#11
R Campbell
Since its introduction in the 1960s as a treatment to restart the heart after sudden cardiac arrest from a heart attack, attempts at cardiopulmonary resuscitation have become more common in other clinical situations. Cardiopulmonary resuscitation can be a lifesaving treatment, with the likelihood of recovery varying greatly depending on individual circumstances; however, overall, the proportion of people who survive following cardiopulmonary resuscitation is relatively low. Anticipatory decisions were recognised as being the best way of ensuring that cardiopulmonary resuscitation was not attempted against individuals' wishes...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569281/a-qualitative-study-of-determinants-of-patient-behaviour-leading-to-an-infection-related-hospital-admission
#12
A P Tonna, A E Weidmann, R B Laing, I Tonna, G M Macartney, V Paudyal, D Stewart
Objectives To describe and understand the determinants of patients' behaviours surrounding admission to hospital for an acute infective episode Method Patients admitted to the infection or acute medicine admission units of a major Scottish teaching hospital and commenced on antibiotic therapy after admission were included. Semi-structured face-to-face interviews were conducted using a pre-piloted interview schedule guide that focused on gathering information about patient behaviours and experiences prior to admission to hospital with an acute infection...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569280/respiratory-dysfunction-in-parkinson-s-disease
#13
D Forsyth, K M Torsney
Respiratory dysfunction has been associated with Parkinson's disease since it was first described in 1817. The respiratory symptoms observed in Parkinson's disease patients vary greatly. Most patients remain asymptomatic, whereas others present with acute shortness of breath and even stridor. In August 2016, an electronic literature search was conducted using PubMed and Google Scholar. Results were screened and studies reporting on respiratory dysfunction associated with Parkinson's disease were included. Respiratory dysfunction is due to a combination of factors including restrictive changes, upper airway obstruction, abnormal ventilatory drive and response to medications...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569279/safety-and-efficacy-of-self-expandable-metal-stents-for-obstructive-proximal-and-distal-large-bowel-cancer
#14
V Mitra, M Hu, D Majumdar, V Krishnan, B Chaudhury, J Hancock, D Dwarakanath
Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction)...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569278/governance-and-oversight-of-researcher-access-to-electronic-health-data-the-role-of-the-independent-scientific-advisory-committee-for-mhra-database-research-2006-2015
#15
P Waller, J A Cassell, M H Saunders, R Stevens
In order to promote understanding of UK governance and assurance relating to electronic health records research, we present and discuss the role of the Independent Scientific Advisory Committee (ISAC) for MHRA database research in evaluating protocols proposing the use of the Clinical Practice Research Datalink. We describe the development of the Committee's activities between 2006 and 2015, alongside growth in data linkage and wider national electronic health records programmes, including the application and assessment processes, and our approach to undertaking this work...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569277/clinical-stroke-prevention-in-atrial-fibrillation
#16
C Voukalis, E Shantsila, G Y Lip
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...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569276/the-case-for-using-an-evolutionary-professional-protocol-for-improving-care-act-local-think-global
#17
D Pontin, M Temple
No abstract text is available yet for this article.
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569275/a-critique-of-the-national-clinical-strategy-for-scotland
#18
D Pontin, M Temple
No abstract text is available yet for this article.
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569274/the-state-of-medical-training-refocusing-our-narrative
#19
C Ryan, E Ward, M Jones
No abstract text is available yet for this article.
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28569273/turning-predator-into-prey-the-problem-of-predatory-journals
#20
M D Witham, H Runcie
No abstract text is available yet for this article.
March 2017: Journal of the Royal College of Physicians of Edinburgh
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