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  • BMJ Publishing Group
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  • 1
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    Procalcitonin (2015)
    BMJ Publishing Group
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    Publication Date: 2015-08-20
    Description: Procalcitonin (PCT) is the 116 amino acid precursor of the hormone calcitonin, produced by the C cells of the thyroid. Its synthesis is upregulated in bacterial infection and downregulated by viral infection. Consequently, with the increasing development of antibiotic resistance, interest has focused on the ability of this marker to not only diagnose infection but to tailor antibiotic treatment and help reduce the development of antibiotic resistance. The value of PCT depends on the specific clinical situation and pretest probability of disease. This article discusses the role of PCT in these different situations, namely primary care, the emergency department and the intensive care unit. The true cost effectiveness of this test remains difficult to prove as evidence for the potential impact of using PCT on slowing the development of bacterial resistance remains largely circumstantial.
    Print ISSN: 0021-9746
    Electronic ISSN: 1472-4146
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
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    A difficult case of atopic eczema (2013)
    BMJ Publishing Group
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    Publication Date: 2013-10-15
    Description: A 56 year old retired administrator was referred to the dermatology department for a second opinion on the management of lifelong atopic dermatitis. She had been applying 1% hydrocortisone cream to...
    Keywords: Neurogastroenterology, Dermatology, Emergency medicine, Endocrinology, General practice, Case report, Immunology (including allergy), Drugs: CNS (not psychiatric), Childhood nutrition, Obesity (nutrition), Radiology, Asthma, Musculoskeletal syndromes, Osteoporosis, Sexual health, Clinical diagnostic tests, Radiology (diagnostics), Adrenal disorders, Calcium and bone, Drugs: endocrine system, Health education, Obesity (public health), Health promotion
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
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    Temple syndrome: improving the recognition of an underdiagnosed chromosome 14 imprinting disorder: an analysis of 51 published cases (2014)
    BMJ Publishing Group
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    Publication Date: 2014-07-18
    Description: Chromosome 14 harbours an imprinted locus at 14q32. Maternal uniparental disomy of chromosome 14, paternal deletions and loss of methylation at the intergenic differentially methylated region (IG-DMR) result in a human phenotype of low birth weight, hypotonia, early puberty and markedly short adult stature. The analysis of the world literature of 51 cases identifies the key features that will enhance diagnosis and potentially improve treatment. We found a median birth weight SD score (SDS) of –1.88 and median adult final height of –2.04 SDS. Hypotonia and motor delay were reported in 93% and 83% of cases, respectively. Early puberty was reported in 86% of cases with the mean age of menarche at 10 years and 2 months of age. Small hands and feet were reported frequently (87% and 96%, respectively). Premature birth was common (30%) and feeding difficulties frequently reported (n = 22). There was evidence of mildly reduced intellectual ability (measured IQ 75–95). Obesity was reported in 49% of cases, and three patients developed type 2 diabetes mellitus. Two patients were reported to have recurrent hypoglycaemia, and one of these patients was subsequently demonstrated to be growth hormone deficient and started replacement therapy. We propose the use of the name ‘Temple syndrome’ for this condition and suggest that improved diagnosis and long-term monitoring, especially of growth and cardiovascular risk factors, is required.
    Keywords: Molecular genetics, Obesity (nutrition), Reproductive medicine, Diabetes, Metabolic disorders
    Print ISSN: 0022-2593
    Electronic ISSN: 1468-6244
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 4
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    What is the role of coronary angioplasty and stenting in stable angina? (2016)
    BMJ Publishing Group
    Details
    Publication Date: 2016-02-06
    Description: What you need to knowFirst line treatment for stable CAD is optimum medical therapy to modify risk factors (for example, aspirin and statins) and relieve symptoms (for example, β blockers or calcium...
    Keywords: Urology, Epidemiologic studies, Practice pointer, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Stroke, Hypertension, Interventional cardiology, Ischaemic heart disease, Radiology, Drugs: musculoskeletal and joint diseases, Clinical diagnostic tests, Cardiothoracic surgery, Urological surgery, Vascular surgery, Internet, Sociology
    Topics: Medicine
    Published by BMJ Publishing Group
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