Journal of the Royal College of Physicians of London
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J R Coll Physicians Lond · Jul 1992
Practice Guideline GuidelineGuidelines for good practice in and audit of the management of upper gastrointestinal haemorrhage. Report of a joint working group of the British Society of Gastroenterology, the Research Unit of the Royal College of Physicians of London and the Audit Unit of the Royal College of Surgeons of England.
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J R Coll Physicians Lond · Jul 1992
Diagonal earlobe creases and atheromatous disease: a postmortem study.
The association between the grade of earlobe creases and degree of atheromatous disease was investigated in 376 postmortem examinations. Each earlobe crease was individually graded from 0 to 3. ⋯ The risk of death from myocardial infarction was 2.50 in men with high-grade creases and 3.70 in women. The earlobe crease is an important sign of atheromatous disease and it may be useful to include it in the clinical examination of patients.
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J R Coll Physicians Lond · Jan 1992
What will happen to the quality of care with fewer junior doctors? A Delphi study of consultant physicians' views.
Hospital medical staffing: achieving a balance proposed a reduction in the number of junior doctors and an expansion in the number of consultant posts. This change was to be subject to the 'safety net'--that the number of staff should not fall below a minimum safe level for 24-hour emergency cover. However, no operational definition of 'safe' was offered. ⋯ This included such factors as the time spent by patients waiting in outpatient and A&E departments, and the time doctors spend talking to patients. Consultants were less concerned over the effect of reduced staff numbers on the technical efficiency of provision, and least of all on the effectiveness of care. This last point was seen to be a reflection of consultant physicians' confidence in the basic medical knowledge and skill of their junior staff.