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Self-assessment/CPD answers 自我评价/ CPD答案
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-09-01 Epub Date: 2026-07-28 DOI: 10.1016/j.mpmed.2026.06.012
{"title":"Self-assessment/CPD answers","authors":"","doi":"10.1016/j.mpmed.2026.06.012","DOIUrl":"10.1016/j.mpmed.2026.06.012","url":null,"abstract":"","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 9","pages":"Pages 686-689"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917425","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
Cardiopulmonary resuscitation 心肺复苏术
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-09-01 Epub Date: 2026-07-29 DOI: 10.1016/j.mpmed.2026.06.007
Priya H. Gaglani, Vanessa Kandoole, Samantha Fitzsimmons
{"title":"Cardiopulmonary resuscitation","authors":"Priya H. Gaglani,&nbsp;Vanessa Kandoole,&nbsp;Samantha Fitzsimmons","doi":"10.1016/j.mpmed.2026.06.007","DOIUrl":"10.1016/j.mpmed.2026.06.007","url":null,"abstract":"<div><div>Performing cardiopulmonary resuscitation is a key competency for healthcare professionals. Training in immediate and advanced life support is a requirement for UK doctors; this is depicted in the Foundation training programme competencies and in the Internal Medicine Training curriculum. It requires being able to identify unwell patients, perform a structured assessment and treatment approach, master relevant procedural aspects and demonstrate non-technical skills including leading the resuscitation team. The Resuscitation Council UK has recently provided updated guidance on basic and advanced life support. These guidelines align with similar international guidelines, taking into account evidence from clinical trials of cardiac arrest management and national data on cardiac arrest outcomes in the community and in hospitals. The guidance includes considerations regarding individuals with suspected or confirmed coronavirus disease (COVID-19). The complex ethical aspects around escalation of care, advance care planning, ‘Do Not Attempt Cardiopulmonary Resuscitation’ decisions and communication with patients and their loved ones are also discussed. This chapter summarizes the current guidance on cardiopulmonary resuscitation.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 9","pages":"Pages 664-670"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924910","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
Regulatory, occupational and travel considerations in the cardiac patient 心脏病患者的法规、职业和旅行考虑
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-09-01 Epub Date: 2026-07-29 DOI: 10.1016/j.mpmed.2026.06.009
Paul M. Haydock, Kerolos W. Shaker
{"title":"Regulatory, occupational and travel considerations in the cardiac patient","authors":"Paul M. Haydock,&nbsp;Kerolos W. Shaker","doi":"10.1016/j.mpmed.2026.06.009","DOIUrl":"10.1016/j.mpmed.2026.06.009","url":null,"abstract":"<div><div>Evidence on the cardiovascular-related risk of incapacitation in high-risk situations or occupations is sparse. Recommendations regarding the need for cardiac assessment are consequently offered on the basis of expert consensus, according to what level of risk is regarded as acceptable to the profession or activity in question. This can complicate the process of recruitment or regulatory re-certification in the context of cardiovascular disorders as the level of tolerable risk of incapacitation related to cardiac pathology can differ according to the specific situation. This article provides an up-to-date overview on the impact of cardiac disease and regulation, with a particular focus on the UK Driver and Vehicle Licensing Agency and Civil Aviation Authority in the UK.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 9","pages":"Pages 671-675"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924912","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
Temporary pacing wire insertion 临时起搏导线插入
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.001
David Begley
{"title":"Temporary pacing wire insertion","authors":"David Begley","doi":"10.1016/j.mpmed.2026.05.001","DOIUrl":"10.1016/j.mpmed.2026.05.001","url":null,"abstract":"<div><div>Temporary pacing wire (TPW) insertion is a potentially life-saving procedure. A TPW is most commonly inserted as an emergency procedure but can be electively inserted to cover surgery. Access is via a venous sheath to the right ventricular apex, outflow tract or right atrium. Complications include those related to venous access, infection and perforation of the heart by the lead.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 616-617"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703812","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
Ventricular arrhythmias 室性心律失常
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.006
Jagan Muthurajah, John Silberbauer
{"title":"Ventricular arrhythmias","authors":"Jagan Muthurajah,&nbsp;John Silberbauer","doi":"10.1016/j.mpmed.2026.05.006","DOIUrl":"10.1016/j.mpmed.2026.05.006","url":null,"abstract":"<div><div>Ventricular arrhythmias represent a diverse spectrum of cardiac rhythm disorders, ranging from clinically silent premature ventricular contractions (PVCs) to life-threatening events such as ventricular tachycardia and ventricular fibrillation. These arrhythmias are a primary driver of morbidity and remain a leading cause of sudden cardiac death across a variety of structural and inherited cardiac conditions. Clinical presentation varies significantly, encompassing incidental findings on routine screening, symptomatic palpitations, syncope, haemodynamic collapse or sudden cardiac arrest. A structured clinical approach is mandatory for effective management, requiring a detailed history, 12-lead electrocardiogram interpretation, ambulatory monitoring and advanced imaging, most notably cardiac magnetic resonance imaging, which is essential for substrate characterization. Management strategies are multifaceted, involving the correction of reversible triggers, optimization of heart failure therapy, antiarrhythmic medications, implantable cardioverter–defibrillators and catheter ablation.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 587-592"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704093","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
Bradycardia 心动过缓
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.013
Alex Touze, John Paisey
{"title":"Bradycardia","authors":"Alex Touze,&nbsp;John Paisey","doi":"10.1016/j.mpmed.2026.05.013","DOIUrl":"10.1016/j.mpmed.2026.05.013","url":null,"abstract":"<div><div>Bradycardia is a reasonably common finding on clinical examination. Being able to identify the associated heart rhythm and considering this as part of the wider clinical context is key to guiding further investigations and management decisions with the patient. Knowing when no further investigation or management are required is equally as important. This article aims to outline the clinical considerations needed when encountering different bradyarrhythmias.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 593-597"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703964","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
Supraventricular tachycardia 室上性心动过速
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.014
Emma Kealaher, Dewi Thomas
{"title":"Supraventricular tachycardia","authors":"Emma Kealaher,&nbsp;Dewi Thomas","doi":"10.1016/j.mpmed.2026.05.014","DOIUrl":"10.1016/j.mpmed.2026.05.014","url":null,"abstract":"<div><div>Supraventricular tachycardia (SVT) is a common condition. Patients typically present with sudden-onset and rapid palpitations with heart rates frequently &gt;180 beats per minute. The term SVT is usually applied to atrioventricular nodal re-entrant tachycardia, atrioventricular reciprocating tachycardia and atrial tachycardia. This review article outlines the different types of SVT and the options for short- and long-term treatment of this condition.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 582-586"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703943","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
Cardiac channelopathies 心脏channelopathies
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-07-16 DOI: 10.1016/j.mpmed.2026.05.007
Simon Claridge, Arthur Yue, Anton Labeeb
{"title":"Cardiac channelopathies","authors":"Simon Claridge,&nbsp;Arthur Yue,&nbsp;Anton Labeeb","doi":"10.1016/j.mpmed.2026.05.007","DOIUrl":"10.1016/j.mpmed.2026.05.007","url":null,"abstract":"<div><div>Cardiac channelopathies are inherited cardiac disorders associated with potentially life-threatening ventricular arrhythmias. These are caused by genetic mutations of ion channels that alter the cardiac cell membrane potential and intracellular haemostasis. They include long QT syndrome (LQTS), Brugada syndrome and the much rarer catecholaminergic polymorphic ventricular tachycardia, idiopathic ventricular fibrillation, short QT syndrome and early repolarization syndrome. The presentation of these disorders varies widely from sudden cardiac death to incidental diagnosis on electrocardiography. Although these conditions are rare, diagnosis and subsequent familial screening can have significant results for the index patient and their family members. A clear understanding of the cardiac action potential helps to clarify the pathological mechanism of arrhythmogenesis that characterizes these conditions. Risk stratification of adverse outcomes from these conditions is complex and often imprecise. Both medical therapy and implantable cardioverter–defibrillators have a potential role in managing these patients. These conditions are rare and it is recommended that the complex management decisions be discussed in a multidisciplinary team environment wherever possible. Most of this review focuses on LQTS and Brugada syndrome as these are the most common forms of cardiac channelopathy.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 571-575"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703945","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
Chronic heart failure: epidemiology, investigation and management 慢性心力衰竭：流行病学、调查和管理
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.010
Daniela Noakes, Antonio Cannata
{"title":"Chronic heart failure: epidemiology, investigation and management","authors":"Daniela Noakes,&nbsp;Antonio Cannata","doi":"10.1016/j.mpmed.2026.05.010","DOIUrl":"10.1016/j.mpmed.2026.05.010","url":null,"abstract":"<div><div>Heart failure (HF) is a heterogenous clinical syndrome traditionally classified into three categories according to left ventricular ejection fraction (LVEF). It affects approximately 2% of the UK population, the prevalence increasing markedly with age. Despite improvements in medical therapy, HF remains associated with significant mortality. In individuals presenting with symptoms suggestive of HF, diagnosis relies on the measurement of natriuretic peptides and echocardiography. Management is guided by ejection fraction, with the strongest evidence base available for HF with reduced ejection fraction. Recommended treatment consists of the combination of four classes of medication: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers with or without neprilysin inhibition, β-adrenoceptor blockers, mineralocorticoid receptor antagonists and sodium–glucose co-transporter 2 inhibitors. Treatment with these ‘four pillars’ of medical therapy can extend life for up to 6 years. Despite this &lt;50% of patients are discharged from an HF admission in the UK on quadruple medical therapy. Device therapy can be appropriate in patients who are symptomatic despite optimized medical treatment; those with advanced HF should be considered for advanced therapies including heart transplantation or short-term mechanical circulatory support.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 542-547"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704032","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
Heart failure: classification and pathophysiology 心力衰竭：分类和病理生理学
Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.003
Ameer Rashed, Paul R. Kalra, Kaushik Guha
{"title":"Heart failure: classification and pathophysiology","authors":"Ameer Rashed,&nbsp;Paul R. Kalra,&nbsp;Kaushik Guha","doi":"10.1016/j.mpmed.2026.05.003","DOIUrl":"10.1016/j.mpmed.2026.05.003","url":null,"abstract":"<div><div>Heart failure (HF) is a syndrome consisting of symptoms (including breathlessness, fatigue and orthopnoea) that is often accompanied by clinical signs (including peripheral oedema, elevated venous pressure and respiratory findings) caused by a structural and/or functional abnormality of the heart. It is crucial that healthcare professionals consider a diagnosis of HF when a person presents with such symptoms or signs. In individuals in whom a diagnosis of HF is suspected, timely assessment by a specialist helps to confirm or refute the diagnosis. If HF is present, this assessment should classify the type and aetiology as identifying differing aetiologies can result in a more tailored therapeutic approach. HF can present with an insidious progression of symptoms, or acutely with a decompensation of the underlying chronic pathology or secondary to an acute event such as a myocardial infarction. Cardiac dysfunction activates a cascade of hormonal, neuronal, metabolic and inflammatory pathways that, without treatment, lead to progression of HF and other end-organ dysfunction.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 535-541"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704033","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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