Clin Med
-
Revalidation for doctors in the UK began in December 2012. Doctors in training need to revalidate every 5 years after obtaining their licence to practice and also at the point of achieving their certificate of completion of training. ⋯ Postgraduate deans are the responsible officers for trainees and there are new processes in place, including responsibilities for educational supervisors and ARCP panels to ensure that postgraduate deans can fulfil their General Medical Council obligations. In this article, I give examples of how this might work in practice.
-
A 65-year-old Caucasian woman presented to the emergency department with rapidly worsening shortness of breath. On presentation she was tachycardic and tachypnoeic with reduced (85%) oxygen saturation. Cardiovascular examination revealed elevated jugular venous pressure with positive Kussmaul's sign, pulsus paradoxus and muffled heart sounds. ⋯ She subsequently underwent aortic root and aortic valve replacement surgery. Histology of the resected specimen showed inflammatory infiltrate with giant cell formation indicative of giant cell arteritis (GCA). This case highlights the need to consider GCA in the differential diagnosis of patients presenting with aortic aneurysm and pericardial effusion.
-
The kisspeptins are a group of recently discovered peptide hormones (collectively termed kisspeptin), which play a pivotal role in reproduction. Research investigating the actions of kisspeptin is helping to elucidate the regulatory mechanisms which govern fertility and may lead to the development of novel treatments for some reproductive disorders.
-
There is a 10% shortfall in the number of proximal colorectal cancer cases detected by the UK Bowel Cancer Screening Programme and the actual number of UK-registered proximal colorectal cancers. Sessile serrated adenomas/polyps (SSA/P) are common premalignant lesions in the proximal colon and are notoriously difficult to spot endoscopically. Missed or dismissed SSA/Ps might contribute to this UK proximal colon cancer detection disparity. ⋯ This is the result of increased endoscopist and pathologist awareness of these lesions and improved interdisciplinary communication. This is the result of increased endoscopist and pathologist awareness of these lesions, together with improved interdisciplinary communication, and we predict that this will lead to a comparable detection increase nationwide. Ongoing surveillance of an increasing number of these premalignant lesions could become a significant endoscopic resource requirement once UK guidelines on serrated lesion follow up are established.