QJM : monthly journal of the Association of Physicians
-
Serum sodium has been shown to predict mortality in heart and liver failure. ⋯ The serum sodium is a powerful initial marker of likely mortality in unselected general medical patients. The increased death rate in hyponatraemic patients is independent of other clinical variables, whereas mortality in the hypernatraemic group is primarily a factor of illness severity.
-
This study was designed to assess the effectiveness of a series of journal clubs held for anesthesiology residents in promoting their awareness of research methods and statistical analysis, as well as their skills in critical thinking and appraisal. ⋯ Journal clubs can enable residents to develop the knowledge, expertise and enthusiasm needed to undertake research plans and can also enhance their ability in critical thinking and scientific reading.
-
The aim of this study was to describe the clinical effects of promethazine in overdose and explore the relationship between delirium and possible predictor variables. ⋯ The main feature of promethazine toxicity is delirium, the probability of which can be predicted from the dose ingested. The administration of charcoal and the presence of co-ingestants appears to reduce the probability of delirium in a predictable manner.
-
We report a rare case of pyomyositis of the iliacus muscle in a 29-year-old woman. After 2 weeks of adequate treatment, secondary septic sacroiliitis occurred, a complication that had not been described previously. Pyomyositis of the iliacus muscle must be considered in the differential diagnosis of acute pain in the hip region.
-
Multicenter Study
Thrombolytic therapy for acute stroke in the United Kingdom: experience from the safe implementation of thrombolysis in stroke (SITS) register.
To describe the United Kingdom (UK) experience with thrombolytic therapy with intravenous alteplase (rt-PA) for stroke, as captured by the Implementation of Thrombolysis in Stroke (SITS) project. ⋯ Thrombolytic therapy for stroke has been implemented successfully at a small number of UK stroke centres, with patchy provision throughout the country. The low frequency of treatment out with office hours suggests deficient infrastructure to support delivery. UK patients tended to be more severely affected at baseline and to be treated later. Outcomes are comparable to those seen at the non-UK SITS centres.