British medical bulletin
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The time around a patient's death is often filled with sadness, but good medical and nursing care can provide comfort to patients and their carers at this critical time. For many, a 'pain-free' death is a priority although there are other aspects to providing good care at the end of life. Honest, open discussion with patients and carers about their wishes is an essential prerequisite to individualized care. ⋯ Research into care of the dying will continue to be challenging. Priorities include; whether the use of tools such as the LCP improve the care patients receive, and the development of routine outcome measures including validated reports from patients and proxies.
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British medical bulletin · Jan 2008
ReviewSocial cognition in schizophrenia: a review of face processing.
People with schizophrenia have difficulties in interpreting social information. Much social information is gathered from faces, and face processing represents a well-characterized model to study the basis of social deficits in schizophrenia. ⋯ Research is required to understand more about both the basis of social deficits in schizophrenia and their potential remediation.
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Atrial fibrillation (AF) is the most common, sustained rhythm disturbance. The prevalence of AF is increasing as people live longer. Common conditions such as hypertension and ischaemic heart disease play an important role in the development of AF. The presence of AF is associated with increased morbidity and mortality from stroke and heart failure, particularly in patients with structural heart disease. ⋯ Novel antiarrhythmic agents, including atrial specific agents with improved efficacy and safety profile, are currently under development. New antithrombotic agents with efficacy similar to warfarin which do not require regular INR testing appear to be promising, but there are lack of data about their long-term safety. There is increasing evidence that inflammation and fibrosis may play a major role in the initiation and maintenance of AF. Statins by means of their pleotropic effects and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers by preventing atrial remodelling may prove useful in preventing the development of AF. However, there is insufficient evidence to expand the use of these agents to a wider patient population at risk of AF. It needs to be seen if strategies towards primary and secondary prevention with treatment of underlying heart disease and modification of risk factors have a larger effect than specific interventions in preventing the burden of AF in the general population.
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Parkinson's disease (PD) is one of the most common neurodegenerative disorders. Sources of data Literature search using Medline with keywords Parkinson's disease supplemented with previously published papers known to the author. ⋯ Although there is no cure, there are several management options for the early treatment of PD. As the disease progresses, further treatment options are available; however, the management of late-stage motor complications and non-motor symptoms remains particularly challenging and will benefit from further clinical research.
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British medical bulletin · Jan 2008
ReviewIntermittent pneumatic compression in fracture and soft-tissue injuries healing.
Current methods of fracture care use various adjuncts to try and decrease time to fracture union, improve fracture union rates and enhance functional recovery. Intermittent pneumatic compression (IPC), one such modality, is used in the management of both fractures and soft-tissue injuries. ⋯ IPC appears to be an effective modality to enhance fracture and soft-tissue healing. However, the number of subjects in human studies is small, and adequately powered randomized controlled trials in humans are required to produce stronger clinically relevant evidence.