Clin Med
-
Please submit letters for the editor's consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine@rcplondon.ac.uk
-
Letters not directly related to articles published in Clinical Medicine and presenting unpublished original data should be submitted for publication in this section. Clinical and scientific letters should not exceed 500 words and may include one table and up to five references.
-
The Royal College of Physicians' Acute care toolkit 10 has recommended the use of the AMB score as an aid to determining patients suitable for ambulatory care. As this score has only been previously validated in one centre, the present study calculated the score of 200 patients referred to the medical take to see if it successfully identified patients who had a length of stay of less than 12 hours. In our test centre, the score was found to have a reduced sensitivity compared with the original centre (88 vs 96%) and a positive predictive value of 39%. Therefore in our hospital this was not a useful scoring system, and other trusts need to be aware that the AMB score may not be as effective as the original study suggested.
-
Historical Article
FitzPatrick Lecture: King George III and the porphyria myth - causes, consequences and re-evaluation of his mental illness with computer diagnostics.
Recent studies have shown that the claim that King George III suffered from acute porphyria is seriously at fault. This article explores some of the causes of this misdiagnosis and the consequences of the misleading claims, also reporting on the nature of the king's recurrent mental illness according to computer diagnostics. In addition, techniques of cognitive archaeology are used to investigate the nature of the king's final decade of mental illness, which resulted in the appointment of the Prince of Wales as Prince Regent. The results of this analysis confirm that the king suffered from bipolar disorder type I, with a final decade of dementia, due, in part, to the neurotoxicity of his recurrent episodes of acute mania.