The journal of the Royal College of Physicians of Edinburgh
-
J R Coll Physicians Edinb · Jan 2013
Biography Historical ArticleThe ancestors of Norman Bethune (1890-1939) traced back to the Bethunes of Skye, leading members of the MacBeth/Beaton medical dynasty.
Norman Bethune became famous through his work in the Spanish Civil War, his advocacy of socialised medicine in North America and his association with Mao Zedong's revolutionary movement in China. It has been suggested that he may have been descended from the Bethune or Beaton medical dynasty, who for generations served as physicians to kings of Scotland, the Lords of the Isles and to some of the larger Scottish clans. This paper traces his lineage back to the Isle of Skye. In the absence of old parish records as aids to tracing genealogy, other available evidence has confirmed that Bethune was indeed in the direct line of descent from the Bethunes or Beatons of Husabost, in Skye, one of the largest branches of this medical kindred, who were physicians to the MacLeods of Dunvegan.
-
J R Coll Physicians Edinb · Jan 2013
Comparative StudyViews of the chairs of Scottish health boards on engagement with quality management and comparisons with English trusts.
To describe the views of the chairs of Scottish health boards on the engagement of their boards with healthcare quality and to compare them with the views of the chairs of boards of English acute trusts. The focus of the Scottish Health Boards is on providing and commissioning care, while in England the acute trusts only provide care. ⋯ Although most chairs of Scottish boards view quality as a priority, they pay less attention to it than chairs in England, possibly due to their additional role in commissioning care.
-
J R Coll Physicians Edinb · Jan 2013
Social media: the way forward or a waste of time for physicians?
Social media is everywhere; its use has grown exponentially over recent years. The prevalence of these outlets for communication raises some interesting and potentially risky issues for physicians. On the one hand, some believe that physicians should have a strong social media presence and can benefit greatly from access to a global community of peers and leaders through blogs, online forums, Facebook, Twitter and other communication channels. ⋯ With an already time-pressured day, the priority should be patients, not tweets. Whatever your thoughts on the benefits and risks of social media, it is here to stay. Specific guidelines and guidance are needed to ensure that physicians who decide to join an online community reap the benefits of global communication, rather than regret it.
-
J R Coll Physicians Edinb · Jan 2013
A pilot survey of decisions by acute medicine staff after thunderclap headache.
Traditionally, neurologically pristine patients with a thunderclap headache are investigated with a non-contrast computed tomography (CT) brain scan, which if negative is followed by a lumbar puncture (LP) to exclude important secondary causes, particularly subarachnoid haemorrhage (SAH). However, misdiagnosis of such patients is still a cause of significant human and financial cost and a regular reason for medical litigation. This study explores the approach of emergency medicine and acute medicine clinicians to the investigation of a patient with thunderclap headache. ⋯ Most clinicians investigate neurologically intact patients with thunderclap headache following a CT/LP strategy, but deviations from recommended practice are common.
-
Psoriasis is a chronic, immune-mediated inflammatory skin disease affecting 1.3-2.2% of the UK population.1 Most commonly, psoriasis is characterised by well-demarcated, red plaques with adherent scale with a predilection for the scalp and extensor surfaces of the limbs. However, the effects of psoriasis go far beyond a patient's skin and may result in a degree of disability and impaired quality of life similar to that of other major medical conditions, such as cancer and heart disease. First-line therapies for most patients are topical treatments such as topical corticosteroids and vitamin D analogues. ⋯ Aside from the visible skin disease, psoriasis is also increasingly recognised to have important systemic manifestations. Psoriatic arthritis has long been established as an associated condition and, more recently, it has emerged that psoriasis is also associated with an increased risk of inflammatory bowel disease, cardiovascular disease and the metabolic syndrome. Both National Institute for Health and Care Excellence (NICE)2 and Scottish Intercollegiate Guidelines Network (SIGN)3 have recently published guidelines for the assessment and management of psoriasis which highlight the need for regular assessment in order to detect the development of arthritis and the presence of other co-morbidities such as obesity, diabetes, dyslipidaemia and hypertension.