British medical bulletin
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Dystonia is a clinically heterogeneous group of hyperkinetic movement disorders. Recent advances have provided a better understanding of these conditions with significant clinical impact. ⋯ Growing understanding of the disease mechanisms involved will allow the development of targeted and disease-modifying therapies in the future.
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British medical bulletin · Sep 2017
ReviewAnticoagulation after coronary stenting: a systemic review.
Anticoagulant therapy is mainly used to prevent patients from suffering coronary and systemic thromboembolism after stenting. Many studies have been done to formulate an optimized regimen of a post-PCI or long-time anticoagulant therapy. Recent advances in the selection and duration of anticoagulant agents will be conducive to the management of patients who are considered to need anticoagulant therapy after stenting. ⋯ The safety and efficacy of bivalirudin, a direct thrombin inhibitor, need to be further investigated by more large-scale randomized clinical trials.Based on the widespread use of ticagrelor and prasugrel for patients who need long-time oral anticoagulant therapy, further study is needed to find an optimal strategy that balances the risk of bleeding and ischemic events after coronary stenting.
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Effective data sharing does not occur in the UK despite being essential for the delivery of high-quality genomic services to patients across clinical specialities and to optimize advances in genomic medicine. ⋯ Mechanisms to improve public trust.
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British medical bulletin · Sep 2017
Think adult-think child! Why should staff caring for dying adults ask what the death means for children in the family?
Bereaved children and young people in the UK are 'hidden mourners'. ⋯ 'Think adult-think child' means that all staff caring for dying adults should take responsibility for asking what the death means for the children in the family, with schools, primary care and faith organizations having protocols and expertise available to support grieving children; recent catastrophes expose need for agencies to have management plans that focus on vulnerable children and young people.