British medical bulletin
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British medical bulletin · Dec 2014
ReviewMemory difficulties are not always a sign of incipient dementia: a review of the possible causes of loss of memory efficiency.
Memory problems are a very common reason for presenting to primary care. There is a need for better treatments for dementia. Increased government and media interest may result in greater number seeking help for memory problems, which may not reduce the dementia gap but rather increase numbers seen who do not have dementia. This review highlights the issues around the diagnostic criteria and terminology used for people with memory complaints. ⋯ The accurate distinction of premorbid dementia syndromes from benign non-progressive memory problems. Studies of treatment options for people with benign non-progressive memory problems and longer-term follow-up to determine which patients develop chronic problems.
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British medical bulletin · Dec 2014
ReviewThe molecular genetics of hereditary and sporadic ovarian cancer: implications for the future.
Epithelial ovarian cancer (EOC) is a heterogeneous condition with poor survival outcomes. The genetics of hereditary and sporadic ovarian cancers will be covered and its implications to management and future research are discussed. ⋯ Given how heterogeneous 'ovarian' cancer is, trials into new drugs should report responses for the different histo-/geno-types rather than simply using staging. Although the effect of new drugs such as poly(ADP-ribose) polymerase inhibitors are being investigated in ovarian cancer, there is still a need to develop targeted therapies-especially to tackle mutations in PI3 K pathway, RAS pathway and TP53.
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British medical bulletin · Dec 2014
ReviewPlatelet-rich plasma injections for chronic plantar fasciopathy: a systematic review.
There is an increasing interest in platelet-rich plasma (PRP) injection as a treatment for chronic plantar fasciopathy (PF). We wished to evaluate the evidence for the use of PRP in PF/fasciitis. ⋯ Evidence for the use of PRP in PF shows promising results, and this therapy appears safe. However, the number of studies available is limited and randomized placebo-controlled studies are required. Characterizing the details of the intervention and standardizing the outcome scores would help to better document the responses and optimize the treatment.
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British medical bulletin · Dec 2014
ReviewCare of the dying: how do we replace the Liverpool Care Pathway?
Death is an inescapable certainty of life. Variability in care for dying persons, however, is present. The Liverpool Care Pathway (LCP) sought to guide care for the last days of life but was phased out after intense scrutiny. ⋯ Perceptions of relevant terminology; review of the definition of dying; improved recognition of the dying process and measuring the impact of communication skills training.
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Genomic science is developing rapidly, and engagement of public health professionals will be necessary to appraise new technologies and use them effectively. ⋯ Public health researchers should address how to accelerate the implementation of genomics for health benefit in developed and developing countries.