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Postgraduate Medical Journal

Lishan Chen, Hang Qian, Zhihuan Luo, Dongfeng Li, Hao Xu, Jishun Chen, Peigen He, Xintao Zhou, Tao Zhang, Jun Chen, Xinwen Min
BACKGROUND: Coronary artery disease (CAD) is the most frequent multifactorial disease worldwide and is characterised by endothelial injury, lipid deposition and coronary artery calcification. The purpose of this study was to determine the allelic and genotypic frequencies of two loci (rs2026458 and rs9349379) of phosphatase and actin regulator 1 (PHACTR1) to the risk of developing CAD in the Chinese Han population. METHODS: A case-control study was conducted including 332 patients with CAD and 119 controls...
February 18, 2019: Postgraduate Medical Journal
Samuel P Trethewey, Shantal Deepak, Samuel Saad, Ellen Hughes, George Tadros
BACKGROUND: Busy emergency departments (EDs) are not the optimum environment for assessment of patients in mental health crisis. The Psychiatric Decisions Unit (PDU) was developed by the Birmingham and Solihull Mental Health Foundation Trust as an enhanced assessment service to ensure patients in mental health crisis receive optimal care. AIMS: To evaluate the activities of the PDU and its impact on the frequency of ED presentations and inpatient admissions, and to explore patient satisfaction...
February 14, 2019: Postgraduate Medical Journal
Philip D Welsby
No abstract text is available yet for this article.
February 6, 2019: Postgraduate Medical Journal
Vishal Thakur, Amit Dalla, Sheetanshu Kumar, Muthu Sendhil Kumaran, Divya Aggarwal, Bishan Dass Radotra
No abstract text is available yet for this article.
February 6, 2019: Postgraduate Medical Journal
Animesh Das, Sucharita Anand
No abstract text is available yet for this article.
February 5, 2019: Postgraduate Medical Journal
Yufeng Jiang, Yafeng Zhou
No abstract text is available yet for this article.
February 1, 2019: Postgraduate Medical Journal
Ahmed Farouk Mohamed Elamin, Ciaran Grafton-Clarke, Kai Wen Chen, Toba Obafemi, Ahai Luvai, Ravish Katira, Gershan Davis
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a major development in the prevention of cardiovascular disease (CVD) and is one of the most significant discoveries since the development of statin therapy. Administration of two human monoclonal antibodies to PCSK9 (alirocumab and evolocumab) can significantly reduce low-density lipoprotein cholesterol (LDL-c) concentrations, thus improving lipid management. Accordingly, guidelines on the specific indications for alirocumab and evolocumab usage have been released...
February 1, 2019: Postgraduate Medical Journal
Yu Wang, Hui-Wen Zhang, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, Jian-Jun Li
BACKGROUND: Previous studies have revealed that plasma levels of free fatty acids (FFAs) are related to cardiovascular risk. However, whether FFAs could predict periprocedural myocardial injury (PMI) following percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) remains unclear. PURPOSE: This study aimed to investigate the relationship of FFAs to PMI in untreated patients with CAD who underwent PCI. METHODS: A total of 374 consecutive patients with CAD without lipid-lowering treatment on admission and with normal preprocedural cardiac troponin I (cTnI) levels who underwent PCI were prospectively enrolled...
January 30, 2019: Postgraduate Medical Journal
Abhilasha Garg, Pinaki Dutta, Nimisha Jain, Anil Bhansali
No abstract text is available yet for this article.
January 30, 2019: Postgraduate Medical Journal
Andrew James Beamish, Jessica Jane Foster, Harry Edwards, Torsten Olbers
For millennia, the smile has been recognised as a powerful communication device, offering benefits to both giver and receiver with few drawbacks. A sign of compassion, empathy and friendliness, smiling can benefit healthcare professionals and their patients, helping to build a relationship of trust. But beware the false smile, which is all too easily identified and may do more harm than good. In this review, we explore the literature surrounding smiling in healthcare and beyond, discussing the many reasons to be cheerful, from good health to a happy marriage, among aviators, table waiters, doctors, dentists and even dogs...
January 30, 2019: Postgraduate Medical Journal
Lijie Ren, Chao Li, Weiping Li, Yixuan Zeng, Shisheng Ye, Zhichao Li, Hongye Feng, Zhihao Lei, Jingjing Cai, Shiyu Hu, Yi Sui, Qiang Liu, Bernard M Y Cheung
China has the largest stroke population and at-risk population in the world. However, it has a lower thrombolytic therapy rate and longer onset-to-needle time/door-to-needle time for patients who had an acute stroke compared with developed countries, which might be due to redundant procedures or inefficient systems. Things are changing due to some new initiatives. Two years ago, a new emergency system in China, Stroke Emergency Map, was first launched as a regional emergency system in Shenzhen, the bustling metropolis just north of Hong Kong...
January 29, 2019: Postgraduate Medical Journal
John Rhys Condon
Paget's disease of bone is characterised by overactive osteoclasts that resorb bone at a higher rate than normal. Osteoblasts attempt to repair the damage by laying down new bone which in turn is resorbed leaving a chaotic pattern of lytic and dense sclerotic bone behind. Deformed bone enlarges, becomes vascularised, bends and fractures. No bone is exempt but the skull, pelvis, vertebrae and long bones are commonly affected. Pressure from pagetic bone impinges on the auditory, facial, optic, trigeminal nerves and the spinal cord, risking paraplegia or quadriplegia...
January 25, 2019: Postgraduate Medical Journal
Krishna C Keri, Samuel Blumenthal, Varsha Kulkarni, Laurence Beck, Tepsiri Chongkrairatanakul
Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in non-diabetic Caucasian adults over 40 years of age. It has an estimated incidence of 8-10 cases per 1 million. Fifty per cent of patients diagnosed with primary MN continue to have nephrotic syndrome and 30% of patients may progress to end-stage renal disease over 10 years. Although it was recognised as a distinct clinic-pathological entity in 1940s by immunofluorescence and electron microscopy, the pathogenesis and treatment have become more apparent only in the last decade...
January 25, 2019: Postgraduate Medical Journal
Stamatios Petousis, George Karamitros, Chrysoula Margioula-Siarkou, Panagiotis Christidis, Apostolos Mamopoulos, Apostolos Athanasiadis, Themistoklis Dagklis
No abstract text is available yet for this article.
January 23, 2019: Postgraduate Medical Journal
John Launer
No abstract text is available yet for this article.
January 23, 2019: Postgraduate Medical Journal
Arifeen Sylvanna Rahman, Siyu Shi, Pamela Katherine Meza, Justin Lee Jia, David Svec, Lisa Shieh
BACKGROUND: Decreasing delays for hospitalised patients results in improved hospital efficiency, increased quality of care and decreased healthcare expenditures. Delays in subspecialty consultations and procedures can cause increased length of stay due to reasons outside of necessary medical care. OBJECTIVE: To quantify, describe and record reasons for delays in consultations and procedures for patients on the general medicine wards. METHODOLOGY: We conducted weekly audits of all admitted patients on five Internal Medicine teams over 8 weeks...
January 23, 2019: Postgraduate Medical Journal
Ina Dubin, Yair Glick, Amichai Schattner
No abstract text is available yet for this article.
January 23, 2019: Postgraduate Medical Journal
Annum Faisal, Kayla Andres, Jubran Afzal Khan Rind, Aparna Das, David Alter, Jeevarathna Subramanian, Tracy J Koehler, Jessica Parker, Nathan Bernicchi
INTRODUCTION: The Choosing Wisely guidelines advise against ordering routine blood tests for hospitalised patients unless they change management. Unnecessary testing can lead to adverse effects (eg, iatrogenic anaemia, poor sleep quality, risk for infections and increased cost of care). METHODS: An 8-week quality initiative aimed at reducing unnecessary blood tests was implemented in three internal medicine resident inpatient services. The initiative included a 30 min educational session, reminders prior to rotation and midrotation and posters in work areas that displayed lab pricing and urged judicious testing...
January 22, 2019: Postgraduate Medical Journal
Qi-Feng Deng, Hui-Yun Gu, Wu-Ya Peng, Qiong Zhang, Zheng-Dong Huang, Chao Zhang, Yun-Xiang Yu
STUDY DESIGN: Systematic review with meta-analysis. OBJECTIVES: To evaluate the effects of enhanced recovery after surgery (ERAS) on the postoperative recovery of patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: The PubMed, Embase, Cochrane and ISI Web of Science databases were searched to identify literature including randomised controlled trials (RCTs), cohort studies and case-control studies through 2 May 2018...
January 21, 2019: Postgraduate Medical Journal
George Kimpton, Barnaby Hole
No abstract text is available yet for this article.
January 21, 2019: Postgraduate Medical Journal
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