Clin Med
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The National Institute for Health and Clinical Excellence (NICE) guidelines for the management of atrial fibrillation were published in June 2006. It was anticipated that they would potentially lead to increased demand for echocardiography (ECHO), increased access to secondary care services (for example for cardioversion), and require additional resources for monitoring anticoagulation. A primary care survey was therefore initiated in South Devon, in advance of publication of the guidelines as a snapshot of existing practice, to determine any additional resources and education required to meet the new standards. The main aim was to determine what proportion of patients were managed exclusively in primary care, how frequently patients were investigated by ECHO and whether anticoagulation was being appropriately targeted at patients at high risk of thromboembolic events.
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Historical Article
A history of the gardens of the Royal College of Physicians of London.
The Royal College of Physicians of London (RCP) was founded in the City of London in 1518 and at that time many of the royal, religious and lay residences had gardens. The gardens were used, among other things, to grow fruit trees, herbs for the kitchen and for strewing on the floor, and for leisure, with lawns, bowling and flowers. So it would have been natural for the RCP Fellows to wish to have a garden of their own. ⋯ The fourth home in Pall Mall East in 1815 was landlocked. Therefore when the fifth (and current) home in Regent's Park was opened in 1964 it was splendid to have a large garden, carefully designed, planted and recorded. In 2004 a wonderful transformation took place when the College created a modern physic garden showing the development of medicinal plants through the ages and in many parts of the world.