The journal of the Royal College of Physicians of Edinburgh
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J R Coll Physicians Edinb · Sep 2017
Historical ArticleIn Carthage ruins: the illness of Sir Winston Churchill at Carthage, December 1943.
This paper reviews Churchill's illness in Carthage in December 1943. It was characterised by fever that lasted 6 days, left lower lobe pneumonia and two episodes of atrial fibrillation. ⋯ Sulphadiazine and digitalis leaf were prescribed and Churchill recovered. It is remarkable that, despite the severity of his illness, he continued to direct the affairs of State from his bed.
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Oral anticoagulation therapy has reduced the risk of ischaemic stroke and improved the outcomes for patients with atrial fibrillation considerably. The emergence of the non-vitamin K oral anticoagulants as alternatives to vitamin K antagonists has significantly changed the practice of stroke prevention in atrial fibrillation. ⋯ Individual approach is often mandatory due to heterogeneity of the risks and patient preferences. The purpose of this review is to summarise the current knowledge of the oral anticoagulation therapy in atrial fibrillation patients and guide physicians with the management of anticoagulants based on data from clinical trials and systematic reviews.
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Edinburgh has a wealth of medical collections, thanks not only to its role in the Enlightenment and the diaspora of graduates from the large medical school, but also to recent developments in medical heritage. Concentrating on the collections of the University of Edinburgh's Anatomy Department and Surgeons' Hall Museums at the Royal College of Surgeons of Edinburgh, this paper charts the complex and connected histories of the material culture of anatomy, pathology and surgery in the city. What roles did museums play, from their 18th century origins to their 21st century resurgence, and who used them?
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J R Coll Physicians Edinb · Sep 2016
Delivering comprehensive geriatric assessment in new settings: advice for frontline clinicians.
Over the decades, as the principles of comprehensive geriatric assessment have been established, there have been attempts to apply its principles to settings other than acute hospital medical wards or the general communitydwelling older population, for example, to other settings where older people with infirmity are found. The purpose of this paper is to describe and reflect upon the application of and evidence for comprehensive geriatric assessment in these new settings and give some advice to clinicians about how to optimise their contributions to these processes. I will state my advice having first discussed intermediate care, emergency surgery (hip fracture), elective surgery, dementia and delirium care, emergency care, cancer care, and the care of residents of care homes (mindful of the irony of calling the latter a new setting, given that geriatric medicine originated in long term care).