Journal of the Royal College of Physicians of Edinburgh最新文献

{"title":"The continuum of liver injury with severity of dengue fever: A retrospective observational study.","authors":"Ritin Mohindra, Divyashree K, Madhur Kalyan, Ishani Bora, Roop Kishore Soni, Vikas Suri, Ashish Behera, Neha Saini, Vishal Sharma, Deepy Zohmangaihi","doi":"10.1177/14782715231216157","DOIUrl":"10.1177/14782715231216157","url":null,"abstract":"<p><strong>Background: </strong>Dengue is a major international health concern prevalent in tropical and sub-tropical countries. There are a paucity of studies on the relationship of hepatic complications with inflammatory parameters in dengue infection.</p><p><strong>Methods: </strong>Single-centre observational study was conducted at the tertiary care centre in North India. Patients (>12 years) diagnosed with dengue infection between August and November 2021 were enrolled in the study. The frequency of hepatic derangements and their associations with inflammatory severity was analysed.</p><p><strong>Results: </strong>Based on the clinical symptoms, 170 patients were classified into three categories, namely, dengue fever, warning dengue and severe dengue. Higher incidence of liver dysfunction was observed in severe dengue patients with median values of aspartate aminotransferase (AST) (3051 U/L, <i>p</i> < 0.001), alanine aminotransferase (ALT) (1792 U/L, <i>p</i> = 0.009), alkaline phosphatase (172 U/L, <i>p</i> = 0.001), T.Bil (34.2 µmol/L, <i>p</i> < 0.001), albumin (30 g/L, <0.001), and gamma-glutamyl transferase (152 U/L, <i>p</i> < 0.001) along with inflammatory marker C-reactive protein (CRP) (43 mg/dL, <i>p</i> < 0.001) highly deranged, in comparison to patients with/without warning signs. Median levels of CRP were found to be positively and significantly correlated with the median levels of AST and ALT (<i>p</i> < 0.05, <i>r</i> = 0.99) in all three categories of dengue patients. Liver injury was noted in 107 (63%) of the cohort, and mixed type of liver injury involving both hepatocellular and cholestatic patterns was observed as the most common type of injury (<i>n</i> = 50, 29.4%). Liver injury correlated with the severity of dengue illness as about 85% of severe dengue patients had significant liver injury (<i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>In dengue patients, the association of the liver injury with inflammatory severity suggests that the mechanism of liver injury may be related to inflammatory response apart from the hepatotropic nature of the virus.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"7-13"},"PeriodicalIF":1.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hoffmann's syndrome in subclinical hypothyroidism.","authors":"Kiran Hs, Shashank Cheemalapati, Venkatesh Cr","doi":"10.1177/14782715231218033","DOIUrl":"10.1177/14782715231218033","url":null,"abstract":"<p><p>Hypothyroidism is an endocrine disorder which occurs due to a deficiency of thyroid hormones. Hoffmann's syndrome is a rare complication of hypothyroidism - presenting as hypothyroid myopathy. We describe the case of a 20-year-old lactating female, known to have hypothyroidism (diagnosed during her pregnancy and having discontinued treatment following delivery), presenting with complaints of pain, swelling of bilateral calf muscles with cramps in bilateral lower limbs. Symptoms of muscle pseudohypertrophy with muscle stiffness are relatively rare in subclinical hypothyroidism and it is important to identify and diagnose this rare condition, and initiate appropriate treatment.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"26-28"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote and Rural Remedies exhibition.","authors":"","doi":"10.1177/14782715241242191","DOIUrl":"10.1177/14782715241242191","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":"54 1","pages":"113"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features in this issue.","authors":"Graeme P Currie","doi":"10.1177/14782715241244583","DOIUrl":"10.1177/14782715241244583","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":"54 1","pages":"3"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician-led thoracic ultrasound-guided biopsy; a district general hospital perspective.","authors":"M J Cafferkey, G A Martin","doi":"10.1177/14782715241231331","DOIUrl":"10.1177/14782715241231331","url":null,"abstract":"<p><strong>Background: </strong>Physician-led thoracic ultrasound (TUS)-guided biopsies provide a prompt route to tissue diagnosis in pleural and peripheral lung malignancies. This retrospective study reviews the diagnostic performance and safety of this approach in a UK District General Hospital.</p><p><strong>Methods: </strong>Time to biopsy, diagnostic yield and complication rate were analysed in a cohort of 49 patients undergoing ultrasound-guided tissue sampling between September 2019 and December 2022.</p><p><strong>Results: </strong>Fifty-one TUS-guided biopsies were attempted. Mean time from decision to biopsy was 5 days. The overall diagnostic yield was 82%. Complication rate was low; 3 minor adverse effects were reported which led to no change in routine care.</p><p><strong>Conclusion: </strong>This single centre retrospective study shows that physician-led TUS-guided biopsy provides a safe and timely method of obtaining a tissue diagnosis in thoracic malignancy. It offers an alternative to computer tomography (CT)-guided or thoracoscopic biopsies and should be considered in selected patients where local procedural expertise exists.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14-17"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling the 'Great imitator'!","authors":"Kaitlyn O'Brien, Sarmad Waqas","doi":"10.1177/14782715231219716","DOIUrl":"10.1177/14782715231219716","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"105"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vincent Marks DM, FRCPE, FRCP, FRCPath.","authors":"Anthony Seaton","doi":"10.1177/14782715231223049","DOIUrl":"10.1177/14782715231223049","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"109"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital at home: Opportunity knocks or opportunity costs?","authors":"Clare Bostock","doi":"10.1177/14782715241234082","DOIUrl":"10.1177/14782715241234082","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"94-97"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-induced chylothorax as a rare pleural complication in dasatinib therapy for chronic myeloid leukaemia.","authors":"Isaac Ks Ng, Mamta Ruparel, Esther Hl Chan, Kay Leong Khoo","doi":"10.1177/14782715241237577","DOIUrl":"10.1177/14782715241237577","url":null,"abstract":"<p><p>Chylothorax is a lymphatic chylous pleural effusion typically associated with traumatic (iatrogenic, non-iatrogenic) and non-traumatic (infections, malignancy, lymphatic disorders) aetiologies. Drug-induced chylothorax is uncommon and mostly reported in association with <i>BCR-ABL</i> tyrosine kinase inhibitor therapy.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"44-47"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing postural hypotension in a UK District General Hospital.","authors":"Dennis Poon, Babyshalini Muthukumar, Yik Lam Pang","doi":"10.1177/14782715241238785","DOIUrl":"10.1177/14782715241238785","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"106-107"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}