Clin Med
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This systematic review aims to estimate the prevalence of use of complementary and alternative medicine (CAM) by physicians in the UK. Five databases were searched for surveys monitoring the prevalence of use of CAM, which were published between 1 January 1995 and 7 December 2011. In total, 14 papers that reported 13 separate surveys met our inclusion criteria. ⋯ The three most commonly used methods of CAM were acupuncture, homeopathy and relaxation therapy. A sizable proportion of physicians in the UK seem to employ some type of CAM, yet many have not received any training in CAM. This raises issues related to medical ethics, professional competence and education of physicians.
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Randomized Controlled Trial
Glycated albumin is a potential diagnostic tool for diabetes mellitus.
Using a community-based population cross-sectional study, we investigated the validity of an enzymatic method for glycated albumin (GA) measurements and evaluated its utility as a diagnostic tool for diabetes mellitus (DM). In total, 1,211 participants from the city of Harbin, People's Republic of China, were enrolled in the study. A receiver operating characteristic (ROC) analysis for GA, fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) measurements in diagnosed and undiagnosed DM were compared, based on a definition of DM using 1999 WHO criteria. ⋯ Significant and positive correlations of fasting serum GA with FPG (r = 0.8097) and HbA1c (r = 0.8976) were found in participants enrolled in the study. ROC analysis for GA predicting undiagnosed DM with a cut-off point of 15.7% was similar to that of FPG and HbA1c. Therefore, our data indicate that GA is a potential tool for DM diagnosis.
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Atrial fibrillation (AF) is the most common arrhythmia worldwide, increasing in incidence with the aging population. Substantial morbidity and mortality accompany its diagnosis. ⋯ Novel anticoagulants and antiarrhythmics hold the promise of improved efficacy and safety. This review covers current therapy for AF, major advances in pharmacological management and future directions for therapy.
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Cardiac disease is the leading cause of maternal mortality in the UK. The major causes of cardiac deaths in pregnancy include cardiomyopathy, myocardial infarction, ischaemic heart disease and dissection of the thoracic aorta. With increasing numbers of migrant women in the UK, rheumatic heart disease in pregnancy has also re-emerged. ⋯ The care of pregnant women with heart disease thus requires a multidisciplinary approach, involving obstetricians, cardiologists and anaesthetists. This allows appropriate surveillance of maternal and fetal wellbeing, as well as planning and documentation of the management of elective and emergency delivery. This review discusses common cardiac conditions encountered in pregnancy and their antenatal and intrapartum management.