Recently added articles from Clinical Medicine:
From the Editor
Jun 01, 2008; Allan, Robert ... Cost effectiveness or quality of care? The 1960s hospital in the West Midlands renowned for success in the Royal College of Physicians (RCP) membership exam had a clinical laboratory housed in little more than a prefabricated hut away from the main site and largely obscured by trees. The ...
What do physicians think about physician assisted suicide and voluntary euthanasia?
Jun 01, 2008; Saunders, John ... Background In considering the second version of the Assisted Dying for the Terminally Ill Bill, the Royal College of Physicians (RCP) opted for a position of 'neutrality',1 changing its earlier opposition to physician assisted suicide (PAS) and voluntary euthanasia (VE).2 'Neutrality' ...
Do doctors have a future? Key messages from the medical professionalism roadshows
Jun 01, 2008; Shepherd, Susan ... Background In December 2005, the Royal College of Physicians (RCP) published a seminal report on medical professionalism. 1 The report was the product of a multiprofessional group, chaired by Baroness Cumberlege. The group worked intensively for just over a year adopting a variety of ...
The role of specialist physicians in the commissioning of clinical services
Jun 01, 2008; Winocour, Peter H ... The NHS in England has adapted to the concept of the purchaser-provider split. Over the last 25 years this has undergone several reincarnations, the latest of which is practice-based commissioning (PBC).1 After general practitioner (GP) fundholding was abolished, this alternative model, ...
National review of deaths among HIV-infected adults
Jun 01, 2008; Lucas, S B; Curtis, H; Johnson, M A ... ABSTRACT - This review describes patterns of mortality among adults infected with HIV in the UK and assesses the contributions of late diagnosis of HIV infection and non-HIV-related disease to such mortality. In total, 387 adults with HIV who died between 1 October 2004 and 30 September 2005 ...
What is the place of thrombolysis in acute stroke? A review of the literature and a current perspective
Jun 01, 2008; Jenkins, Peter O; Turner, Martin R; Jenkins, Paul F ... ABSTRACT - The global burden of stroke, the undisputed success of intravenous thrombolysis in the management of myocardial infarction and subsequent evidence from animal models of cerebral infarction have all fuelled intense interest in the potential role for thrombolytic agents in the acute ...
Primary percutaneous coronary intervention for acute ST elevation myocardial infarction - first year's experience of a tertiary referral centre in the UK
Jun 01, 2008; Dorsch, M F; Blackman, D J; Greenwood, J P; Blaxill, J M; Priestley, C; Hunter, S; Jani, M; McLenachan, J M ... ABSTRACT - This study evaluated the first year's experience of a large interventional centre in the UK after a primary percutaneous coronary intervention (PCI) programme that runs 24 hours a day and seven days a week was started. Workload, patient outcome, length of stay, and effect on the ...
Diagnosis and management of patients with heart failure in England
Jun 01, 2008; Murphy, Jeremy J; Chakraborty, Reena Roy; Fuat, Ahmet; Davies, Michael K; Cleland, John G F ... ABSTRACT - The objective of this postal survey was to assess the services currently accessed by primary care trusts (PCTs) for patients with chronic heart failure. Of the 303 PCTs in England, 225 (74%) responded to the questionnaire. Natriuretic peptides were used by 61 (26%) PCTs, whereas ...
Pathogenesis of HIV: non-specific immune hyperactivity and its implications for vaccines
Jun 01, 2008; Cadogan, Martin; Dalgleish, Angus G ... ABSTRACT - More than a decade ago, the pathogenesis of AIDS was reviewed in this journal, using the subtitle 'classical and alternative views', when evidence was accumulating that HIV could not cause AIDS simply through direct cytopathic mechanisms alone. Generalised immune activation after ...
The New Zealand national junior doctors' strike: implications for the provision of acute hospital medical services
Jun 01, 2008; Robinson, Geoffrey; McCann, Kieran; Freeman, Peter; Beasley, Richard ... ABSTRACT - The New Zealand junior doctors' strike provided an opportunity to consider strategies that might be employed to overcome the international shortage of junior doctors. This article reports the experience of the emergency department (ED) and internal medicine (IM) services at Wellington ...
The concept, delivery and future of medical ambulatory care
Jun 01, 2008; Strang, George ... ABSTRACT - Bed shortages, efficient modern diagnostic services and increasing risks associated with hospital admission, require review of conventional medical practice. Patients referred as emergencies who are walking, talking sense, eating and drinking and have normal sphincter function can ...
The new EU health strategy: a step forward or another example of 'bureaucracy total control'?*
Jun 01, 2008; Merkel, Bernard ... ABSTRACT - This article sets out the background to and the aims of the European Union (EU) health strategy published by the European Commission in October 2007. It explains the rationale for EU action in health, including the need to ensure effective cooperation in protection of health, and ...
International medical graduates: lessons from the past and hopes for the future
Jun 01, 2008; Trewby, Peter ... ABSTRACT - The high levels of unemployment among international medical graduates (IMGs) in the UK and the skewed career structure of the NHS may stem from the 1930 withdrawal of General Medical Council recognition for Indian degrees forcing Indian colleges to align more closely with Western ...
Respiratory problems on the acute take: pleural disease and acute dyspnoea
Jun 01, 2008; Stevenson, Nicola J; Simpson, Jon ... ABSTRACT - Respiratory disease contributes significantly to the workload of the acute medical take. This article, aimed at all physicians, reviews the evidence base for common respiratory conditions presenting as an acute emergency. There is particular emphasis on pleural disease and respiratory ...
Paediatric gastroenterology 1966-2000
Jun 01, 2008; Walker-Smith, John ... ABSTRACT - Between 1966 and 2000 the pattern of gastroenterological disease in children in developed communities changed. Clinically severe infective gastroenteritis has declined in incidence. Infection of children with the conventional serotypes of Escherichia coli dramatically declined. During ...
Oral rehydration therapy: applied physiology
Jun 01, 2008; Elliott, Elizabeth ... A 2007 poll hailed oral rehydration therapy (ORT) as one of the 15 most important medical milestones of our time.1 Oral rehydration therapy is 'the administration of fluid by mouth to prevent and correct the dehydration that is a consequence of diarrhoea'. 2 As John Walker-Smith states, its ...
Inflammatory bowel disease in children
Jun 01, 2008; Heuschkel, Robert ... The incidence of inflammatory bowel disease (IBD), particularly Crohn's disease (CD), in children appears to be increasing. About 20% of patients with IBD present before the age of 19, and thus a significant burden of this illness falls on adolescents and young adults. Paediatricians and ...
Pathogenesis of gastrointestinal infection
Jun 01, 2008; Phillips, Alan ... I came to paediatric gastroenterology in the 1970s as a zoologist with an interest in structure and function. I was appointed as an electron microscopist at Queen Elizabeth Hospital for Children (QEHC) in London where it had been decided that an academic approach, rather than technical support, ...
Working with schools in deprived areas to raise aspirations for medicine and other healthcare science careers
Jun 01, 2008; Pearce, Sarah J ... ABSTRACT - Educational attainment is inversely related to socio-economic status. The achievement gap widens as children progress through the system. Take up of science options is particularly poor and difficulties are compounded by lack of relevant science-based work experience in deprived ...
Do musicians have different brains?
Jun 01, 2008; Stewart, Lauren ... ABSTRACT - The search for anatomical correlates of special skills dates from the end of the 19th century, when post-mortem brains of gifted individuals, including musicians, were examined for clues as to origins of their prized abilities. Modern neuroimaging techniques provide the chance to ...