The journal of the Royal College of Physicians of Edinburgh
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Acute kidney injury (AKI) represents a medical emergency associated with poor clinical outcomes. The international guideline group Kidney Disease: Improving Global Outcomes (KDIGO) has defined AKI according to rises in serum creatinine and/or reductions in urine output. Any patient who meets the criteria for AKI should be reviewed to ascertain the cause of AKI and the severity of the injury should be staged. ⋯ The optimal choice of intravenous fluid therapy remains controversial. There is currently renewed interest in more specific therapies for AKI secondary to hypoperfusion and/or sepsis, which have been previously unsuccessful. A number of therapeutic strategies are presently being explored in clinical trials.
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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.
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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.