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

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High-flow carotid cavernous fistula and 'white eye': A rare and easily misdiagnosed presentation - A case report and literature review. 高流量颈动脉海绵瘘和 "白眼"：罕见且易误诊的表现--病例报告和文献综述。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-04-18 DOI: 10.1177/14782715241246572
Francisco Caiza-Zambrano, Martín Gómez Lastra, Silvia Garbugino, Fabio Maximiliano Gonzalez, Julio Galarza Menoscal, Mauricio Benetti, Yemina Neme Segura, Luis Ariel Miquelini, Claudia Uribe-Roca, Manuel Fernández-Pardal, Luciana León-Cejas, Ricardo Reisin, Pablo Bonardo
{"title":"High-flow carotid cavernous fistula and 'white eye': A rare and easily misdiagnosed presentation - A case report and literature review.","authors":"Francisco Caiza-Zambrano, Martín Gómez Lastra, Silvia Garbugino, Fabio Maximiliano Gonzalez, Julio Galarza Menoscal, Mauricio Benetti, Yemina Neme Segura, Luis Ariel Miquelini, Claudia Uribe-Roca, Manuel Fernández-Pardal, Luciana León-Cejas, Ricardo Reisin, Pablo Bonardo","doi":"10.1177/14782715241246572","DOIUrl":"10.1177/14782715241246572","url":null,"abstract":"<p><p>The three classic symptoms of carotid cavernous fistula (CCF) are pulsating exophthalmos, bruit and conjunctival chemosis. Here, we present a clinical case of isolated abducens nerve palsy due to a high-flow CCF in an 84-year-old woman, without the typical congestive orbito-ocular features. It was a diagnostic challenge because, for patients older than 50 years with cardiovascular risk factors, ischaemic mononeuropathy is the most frequent aetiology. This case illustrates the least common type of CCF that can be easily misdiagnosed. Physicians should consider fistula as a possible diagnosis in a patient with isolated abducens nerve palsy even without the classic triad.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860728","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}
引用次数: 0
Guillain Barre syndrome mimicking brain death. 模仿脑死亡的格林巴利综合征
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-04-04 DOI: 10.1177/14782715241244839
Mukesh Kumar Sarna, Sarthak Shah, Puneet Rijhwani, Gourav Goyal, Anand Kumar Jain, Pallaavi Goel
{"title":"Guillain Barre syndrome mimicking brain death.","authors":"Mukesh Kumar Sarna, Sarthak Shah, Puneet Rijhwani, Gourav Goyal, Anand Kumar Jain, Pallaavi Goel","doi":"10.1177/14782715241244839","DOIUrl":"10.1177/14782715241244839","url":null,"abstract":"<p><p>A 49-year-old female patient presented at the hospital with a history of herpetic blisters, frequent episodes of vomiting and loose stools, bilateral upper and lower limb weakness, and diminishing sensorium. She was diagnosed with hyponatraemia and respiratory failure and later became unconscious with absent brainstem reflexes. The patient was initially treated for herpetic encephalitis, a chronic obstructive pulmonary disease with acute exacerbation, hyponatraemia and neuroparalytic snake bite. Further evaluation, however, identified the uncommon Guillain Barre syndrome presentation with overlap of Bickerstaff brainstem encephalitis. This is an uncommon disorder characterised by the involvement of higher mental functions, fixed dilated pupils, absent brainstem reflexes and quadriplegia that resembles a neuroparalytic snake bite and brain death. After receiving intravenous immunoglobulins for treatment, the patient completely recovered.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868420","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}
引用次数: 0
Intensive glucose control and the clinical paradox of transient progression of diabetic retinopathy: Prioritising the relevance of eye screening intervals. 强化血糖控制与糖尿病视网膜病变短暂进展的临床悖论：优先考虑眼科筛查间隔的相关性。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-05-15 DOI: 10.1177/14782715241254873
Sarita Jacob, George I Varughese
{"title":"Intensive glucose control and the clinical paradox of transient progression of diabetic retinopathy: Prioritising the relevance of eye screening intervals.","authors":"Sarita Jacob, George I Varughese","doi":"10.1177/14782715241254873","DOIUrl":"10.1177/14782715241254873","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922634","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}
引用次数: 0
Informed consent in clinical practice: Old problems, new challenges. 临床实践中的知情同意：老问题，新挑战。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-04-14 DOI: 10.1177/14782715241247087
Isaac Ks Ng
{"title":"Informed consent in clinical practice: Old problems, new challenges.","authors":"Isaac Ks Ng","doi":"10.1177/14782715241247087","DOIUrl":"10.1177/14782715241247087","url":null,"abstract":"<p><p>Informed consent is a fundamental tenet of patient-centred clinical practice as it upholds the ethical principle of patient autonomy and promotes shared decision-making. In the medicolegal realm, failure to meet the accepted standards of consent can be considered as medical negligence which has both legal and professional implications. In general, valid consent requires three core components: (1) the presence of mental capacity - characterised by the patient's ability to comprehend, retain information, weigh options and communicate the decision, (2) adequate information disclosure - based on the 'reasonable physician' or 'reasonable patient' standards and (3) voluntariness in decision-making. Nonetheless, in real-world clinical settings, informed consent is not always optimally achieved, due to various patient, contextual and systemic factors. In this article, I herein discuss three major challenges to informed consent in clinical practice: (1) patient literacy and sociocultural factors, (2) psychiatric illnesses and elderly patients with cognitive impairment and (3) artificial intelligence in clinical care, and sought to offer practical mitigating strategies to address these barriers.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857731","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}
引用次数: 0
Dr George Jamieson Ross McHardy BM, BCh, FRCPE, FRCP. 乔治-贾米森-罗斯-麦克哈迪博士（Dr. George Jamieson Ross McHardy BM, BCh, FRCPE, FRCP）。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-05-30 DOI: 10.1177/14782715241259058
Anthony Seaton
{"title":"Dr George Jamieson Ross McHardy BM, BCh, FRCPE, FRCP.","authors":"Anthony Seaton","doi":"10.1177/14782715241259058","DOIUrl":"10.1177/14782715241259058","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176466","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}
引用次数: 0
Severe bradycardia at acute medical take - Think about myxoedema coma. 急诊时出现严重心动过缓 - 考虑肌性水肿昏迷。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-04-10 DOI: 10.1177/14782715241244840
Aye Chan Maung, Henrietta Brain, Chitrabhanu Ballav, Sarbpreet Sihota
{"title":"Severe bradycardia at acute medical take - Think about myxoedema coma.","authors":"Aye Chan Maung, Henrietta Brain, Chitrabhanu Ballav, Sarbpreet Sihota","doi":"10.1177/14782715241244840","DOIUrl":"10.1177/14782715241244840","url":null,"abstract":"<p><p>We report two cases of myxoedema coma that presented to the acute medical take with severe bradycardia. These patients were initially misdiagnosed as bradyarrhythmia of primary cardiac origin. They were then diverted to the cardiology service at another district general hospital (DGH) for admissions. Both cases were subsequently diagnosed with myxoedema coma having screened thyroid function tests on arrival at the cardiology unit. Despite being treated for myxoedema coma, both patients unfortunately succumbed to the disease and later died in the hospital. These cases highlight that clinical suspicion and recognition of myxoedema coma remain significant challenges in a developed world despite readily available and highly sensitive thyroid hormone assays.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869269","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}
引用次数: 0
Medical students highlight the importance of medical education, kindness, compassion and belief when learning about patients with myalgic encephalomyelitis/chronic fatigue syndrome. 医科学生在了解肌痛性脑脊髓炎/慢性疲劳综合征患者时，强调了医学教育、仁慈、同情和信念的重要性。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-05-27 DOI: 10.1177/14782715241255977
Nina Louise Muirhead
{"title":"Medical students highlight the importance of medical education, kindness, compassion and belief when learning about patients with myalgic encephalomyelitis/chronic fatigue syndrome.","authors":"Nina Louise Muirhead","doi":"10.1177/14782715241255977","DOIUrl":"10.1177/14782715241255977","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155625","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}
引用次数: 0
Cost and non-cost factors associated with delays in receiving medical care in adults with atherosclerotic cardiovascular disease. 与患有动脉粥样硬化性心血管疾病的成人延误就医相关的成本和非成本因素。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-05-28 DOI: 10.1177/14782715241256693
Reed Mszar, Kobina Hagan, Shubham Lahan, Tarang Parekh
{"title":"Cost and non-cost factors associated with delays in receiving medical care in adults with atherosclerotic cardiovascular disease.","authors":"Reed Mszar, Kobina Hagan, Shubham Lahan, Tarang Parekh","doi":"10.1177/14782715241256693","DOIUrl":"10.1177/14782715241256693","url":null,"abstract":"<p><strong>Background: </strong>The study aims to compare cost and non-cost factors associated with delays in receiving medical care in adults with atherosclerotic cardiovascular disease (ASCVD).</p><p><strong>Methods: </strong>Using 2014-2018 data from the Centers for Disease Control and Prevention (CDC) Behaviour Risk Factor Surveillance System (BRFSS) survey (<i>N</i> = 508,203), multivariate logistic regression models were developed to compute the adjusted odds ratio of reasons for delays in medical care in adults with ASCVD.</p><p><strong>Results: </strong>Our study population of 61,227 adults with ASCVD (9.1%) had higher odds of any medical care delay (aOR 1.50, 95% CI 1.43-1.57), delay due to cost (aOR 1.55, 95% CI 1.45-1.65), long clinic wait times (aOR 1.21, 95% CI 1.04-1.39) and lack of transportation (aOR 1.64, 95% CI 1.47-1.84) than those without ASCVD.</p><p><strong>Conclusion: </strong>Novel public health and health policy approaches are urgently needed to reduce the cost- and non-cost-related barriers that adults with ASCVD encounter when accessing healthcare services.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157745","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}
引用次数: 0
Was thalidomide a placebo hypnotic? 沙利度胺是安慰剂催眠药吗？
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 Epub Date: 2024-05-28 DOI: 10.1177/14782715241258503
Stewart Justman
{"title":"Was thalidomide a placebo hypnotic?","authors":"Stewart Justman","doi":"10.1177/14782715241258503","DOIUrl":"10.1177/14782715241258503","url":null,"abstract":"<p><p>Six decades ago the world learned that thalidomide, a seemingly non-toxic sedative and hypnotic, caused severe birth defects including the flipper-like deformity of the arms known as phocomelia. When thalidomide was tested against placebo by the trialist Louis Lasagna in 1960 (while the drug was banned from the U.S. marketplace), he found the 100-mg dosage equivalent to placebo, as well as greatly inferior to the 200-mg dosage, in producing sleep. Even as these findings were made known, a 100-mg dose of thalidomide was in general use as a sleep aid for pregnant women. It appears that unbeknownst to themselves, an untold number of pregnant women around the world who were prescribed thalidomide incurred the risks of a teratogen in return for the benefits of a sugar pill.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162749","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}
引用次数: 0
Features in this issue. 本期专题
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-06-01 DOI: 10.1177/14782715241263730
{"title":"Features in this issue.","authors":"","doi":"10.1177/14782715241263730","DOIUrl":"https://doi.org/10.1177/14782715241263730","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761616","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}
引用次数: 0
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