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Last Build Date: Sat, 25 Feb 2017 17:32:30 GMT

 



Pisa syndrome

Fri, 24 Feb 2017 15:36:33 GMT

categorise

← Older revision Revision as of 15:36, 24 February 2017
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The classic description of the neuroleptic induced syndrome is by [[Karl Ekbom]] et al. in [[1972]][http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=4115928  Ekbom K, Lindholm H, Ljungberg L. New dystonic syndrome associated with butyrophenone therapy. Zeitschrift für Neurologie. 1972; 202(2):94-103.].
The classic description of the neuroleptic induced syndrome is by [[Karl Ekbom]] et al. in [[1972]][http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=4115928  Ekbom K, Lindholm H, Ljungberg L. New dystonic syndrome associated with butyrophenone therapy. Zeitschrift für Neurologie. 1972; 202(2):94-103.].
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[[Category:Neurology]][[Category:Movement disorders]]
+
[[Category:Neurology]][[Category:Movement disorders]][[Category:Parkinsonism]]
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Camptocormia

Fri, 24 Feb 2017 15:33:32 GMT

categorise

← Older revision Revision as of 15:33, 24 February 2017
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[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Orthopaedic surgery]]
[[Category:Orthopaedic surgery]]
 +
[[Category:parkinsonism]]
{{refsec}}
{{refsec}}



Long QT syndrome

Fri, 24 Feb 2017 08:57:52 GMT

update ← Older revision Revision as of 08:57, 24 February 2017 (3 intermediate revisions not shown)Line 6: Line 6: ==Causes== ==Causes== ===Congenital=== ===Congenital===  +A congenital syndrome of QT prolongation was first described in 1957[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=13435203  JERVELL A, LANGE-NIELSEN F. Congenital deaf-mutism, functional heart disease with prolongation of the Q-T interval and sudden death. American heart journal. 1957 Jul; 54(1):59-68.](Print) ([http://dx.doi.org/10.1016/0002-8703(57)90079-0 Link to article] – subscription may be required.). *Mutation in the KQT-like voltage-gated potassium channel-1 gene ([[KCNQ1]]) causing *Mutation in the KQT-like voltage-gated potassium channel-1 gene ([[KCNQ1]]) causing **Long QT syndrome 1 (LQT1) -Autosomal dominant, female predominance with transmission distortion **Long QT syndrome 1 (LQT1) -Autosomal dominant, female predominance with transmission distortion Line 75: Line 76: }} }} -This may be significant with many drugs with greatest risk due to complex genetics including HERG (KCNH2) modulator proteins.For example the potassium channel regulator ALG10 (KCR1) gene on 12p11.1 unmutated may protect against drug induced arrhythmias [[Pubmed:14525949|Kupershmidt S, Yang IC, Hayashi K, Wei J, Chanthaphaychith S, Petersen CI, et al. The IKr drug response is modulated by KCR1 in transfected cardiac and noncardiac cell lines. The FASEB journal : official publication of the Federation of American Societies for Experimental Biology 2003;17:2263-5.]] ([http://dx.doi.org/10.1096/fj.02-1057fje Direct link] – subscription may be required.). The problem was first recognised with [[Quinidine]] in the 1920s but remains an important one still today with drugs such as [[sotalol]] which have a relatively high risk being over prescribed for benign arrhythmias like [[atrial fibrillation]]. Indeed plenty of drugs have been withdrawn from the market that cause much less QT prolongation problems than many anti-arrhythmic agents, either in terms of QT prolongation eg [[terfenidine]] at therapeutic levels only increases the QT interval by 6 msec (compared with say 50msec for a drug like sotalol), but the problems were exaggerated by its markedly decreased metabolism with [[cytochrome CYP3A]] inhibition.[[pubmed:14999113|Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350(10):1013-22.]] subscription may be required to this [http://content.nejm.org/cgi/content/full/350/10/1013?searchid=1083340227933_6029  link]+===Significance===  +Drug-induced long QT syndrome (diLQTS) may be significant with many drugs, with greatest risk of sudden death due to complex genetics including HERG (KCNH2) modulator proteins. For example the potassium channel regulator ALG10 (KCR1) gene on 12p11.1 unmutated may protect against drug induced arrhythmias [[Pubmed:14525949|Kupershmidt S, Yang IC, Hayashi K, Wei J, Chanthaphaychith S, Petersen CI, et al. The IKr drug response is modulated by KCR1 in transfected cardiac and noncardiac cell lines. The FASEB journal : official publication of the Federation of American Societies for Experimental Biology 2003;17:2263-5.]] ([http://dx.doi.org/10.1096/fj.02-1057fje Direct link] – subscription may be required.). The problem was first recognised with [[quinidine]] in the 1920s but remains an important one still today with drugs such as [[sotalol]] which have a relatively high risk being over prescribed for benign arrhythmias like [[atrial fibrillation]]. Indeed plenty of drugs have been withdrawn from the market that cause much less QT prolongation problems than many anti-arrhythmic agents, either in terms of Q[...]



Ganfyd:Current events

Sat, 18 Feb 2017 18:26:55 GMT

year

← Older revision Revision as of 18:26, 18 February 2017
(One intermediate revision not shown)
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== [[2017]] ==
== [[2017]] ==
-
===January===
+
===February 2017===
 +
*Further evidence that [[austerity]] may have an impact on public health in England and Wales is published to some controversy as the official view is that [[influenza]] effects have not been controlled for. 
 +
===January 2017===
*The English [[NHS]] has a worse [[Winter crisis]] than has been the case for many years. This was predicted and is believed by many to be related more to chronic under-resourcing of health and social care sector rather than poor whole systems design and [[NHS]] management.
*The English [[NHS]] has a worse [[Winter crisis]] than has been the case for many years. This was predicted and is believed by many to be related more to chronic under-resourcing of health and social care sector rather than poor whole systems design and [[NHS]] management.



Austerity

Sat, 18 Feb 2017 18:18:17 GMT

political ← Older revision Revision as of 18:18, 18 February 2017 Line 1: Line 1: {{SubjectBox}} {{SubjectBox}} -[[Austerity]] is not necessarily bad for health as [[prosperity]] can lead to unhealthy lifestyles. While such may partially explain why not all [[economic recessions]] lead to increased population mortality[https://www.ncbi.nlm.nih.gov/pubmed/27730407 Avendano M1, Moustgaard H, Martikainen P. Are some populations resilient to recessions? Economic fluctuations and mortality during a period of economic decline and recovery in Finland. Eur J Epidemiol. 2016 Oct 11][https://www.ncbi.nlm.nih.gov/pubmed/27745879 Regidor E, Vallejo F, Granados JA, Viciana-Fernández FJ, de la Fuente L, Barrio G. Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people. Lancet. 2016 Oct 13. pii: S0140-6736(16)30446-9. doi: 10.1016/S0140-6736(16)30446-9.], [[austerity]] affecting social networks appears to be more predictive of mortality[https://www.ncbi.nlm.nih.gov/pubmed/15177842 Ghobarah HA1, Huth P, Russett B. The post-war public health effects of civil conflict. Soc Sci Med. 2004 Aug;59(4):869-84.][https://www.ncbi.nlm.nih.gov/pubmed/9508159 Notzon FC1, Komarov YM, Ermakov SP, Sempos CT, Marks JS, Sempos EV. Causes of declining life expectancy in Russia. JAMA. 1998 Mar 11;279(10):793-800.] [https://www.ncbi.nlm.nih.gov/pubmed/26980412 Loopstra R, McKee M, Katikireddi SV, Taylor-Robinson D, Barr B, Stuckler D. Austerity and old-age mortality in England: a longitudinal cross-local area analysis, 2007-2013. J R Soc Med. 2016 Mar;109(3):109-16. doi: 10.1177/0141076816632215.].+[[Austerity]] is not necessarily bad for health as [[prosperity]] can lead to unhealthy lifestyles. While such may partially explain why not all [[economic recessions]] lead to increased population mortality[https://www.ncbi.nlm.nih.gov/pubmed/27730407 Avendano M1, Moustgaard H, Martikainen P. Are some populations resilient to recessions? Economic fluctuations and mortality during a period of economic decline and recovery in Finland. Eur J Epidemiol. 2016 Oct 11][https://www.ncbi.nlm.nih.gov/pubmed/27745879 Regidor E, Vallejo F, Granados JA, Viciana-Fernández FJ, de la Fuente L, Barrio G. Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people. Lancet. 2016 Oct 13. pii: S0140-6736(16)30446-9. doi: 10.1016/S0140-6736(16)30446-9.], [[austerity]] affecting social networks appears to be more predictive of mortality[https://www.ncbi.nlm.nih.gov/pubmed/15177842 Ghobarah HA1, Huth P, Russett B. The post-war public health effects of civil conflict. Soc Sci Med. 2004 Aug;59(4):869-84.][https://www.ncbi.nlm.nih.gov/pubmed/9508159 Notzon FC1, Komarov YM, Ermakov SP, Sempos CT, Marks JS, Sempos EV. Causes of declining life expectancy in Russia. JAMA. 1998 Mar 11;279(10):793-800.] [https://www.ncbi.nlm.nih.gov/pubmed/26980412 Loopstra R, McKee M, Katikireddi SV, Taylor-Robinson D, Barr B, Stuckler D. Austerity and old-age mortality in England: a longitudinal cross-local area analysis, 2007-2013. J R Soc Med. 2016 Mar;109(3):109-16. doi: 10.1177/0141076816632215.]. In England and Wales data analysed until July 2015 have been postulated to be consistent with change in government policy with regard to social and health funding due to austerity impacting particularly on the elderly and mentally infirm and not necessarily the strain of [[influenza]] circulating in winter 2015[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=28199896  Green M, Dorling D, Minton J. The Geography of a r[...]



Weekend morbidity and mortality experiments

Sat, 18 Feb 2017 17:11:56 GMT

update ← Older revision Revision as of 17:11, 18 February 2017 Line 1: Line 1: [[Image:Mortality-after-MI.png|thumb|left|Differental mortality for four year cohorts of acute myocardial infarction in New Jersey, showing deteriorating survival in the 1999-2002 cohort compared to the previous 8 years and differential survival for every 4 year period in favour of weekday admissions rather than weekend (prefix WE) admissions[[pubmed:17360988|Kostis WJ, Demissie K, Marcella SW, Shao YH, Wilson AC, Moreyra AE; Myocardial Infarction Data Acquisition System (MIDAS 10) Study Group. Weekend versus weekday admission and mortality from myocardial infarction. N Engl J Med. 2007;356(11):1099-109.]] ]] [[Image:Mortality-after-MI.png|thumb|left|Differental mortality for four year cohorts of acute myocardial infarction in New Jersey, showing deteriorating survival in the 1999-2002 cohort compared to the previous 8 years and differential survival for every 4 year period in favour of weekday admissions rather than weekend (prefix WE) admissions[[pubmed:17360988|Kostis WJ, Demissie K, Marcella SW, Shao YH, Wilson AC, Moreyra AE; Myocardial Infarction Data Acquisition System (MIDAS 10) Study Group. Weekend versus weekday admission and mortality from myocardial infarction. N Engl J Med. 2007;356(11):1099-109.]] ]] -*For religious, social and political reasons we have the concept of the working week and weekends. Cultures make varying provision for emergency health care at weekends but usually limit access to certain healthcare resources at weekends. This has been associated with differential mortality in patients  with common medical illnesses depending upon what day they are admitted to hospital creating the 'weekend effect' on mortality.[[pubmed:11547721|Bell CM, Redelmeier DA. Mortality among patients admitted to hospitals on weekends as compared with weekdays.N Engl J Med. 2001;345(9):663-8. Erratum in:N Engl J Med 2001;345(21):1580.]] [[pubmed:17347472|Saposnik G, Baibergenova A, Bayer N, Hachinski V. Weekends: A Dangerous Time for Having a Stroke? Stroke. 2007 Mar 8;]][[pubmed:16864005|Barba R, Losa JE, Velasco M, Guijarro C, Garcia de Casasola G, Zapatero A. Mortality among adult patients admitted to the hospital on weekends. Eur J Intern Med. 2006 Aug;17(5):322-324. ]][[Pubmed:16443639|Foss NB, Kehlet H. Short-term mortality in hip fracture patients admitted during weekends and holidays. British journal of anaesthesia 2006;96:450-4.]] ([http://dx.doi.org/10.1093/bja/ael012 Direct link] – subscription may be required.)[http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=20110288  Aylin P, Yunus A, Bottle A, Majeed A, Bell D. Weekend mortality for emergency admissions. A large, multicentre study. Quality & safety in health care. 2010 Jun; 19(3):213-7.]([http://dx.doi.org/10.1136/qshc.2008.028639 Link to article] – subscription may be required.)[http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=23716356  Aylin P, Alexandrescu R, Jen MH, Mayer EK, Bottle A. Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics. BMJ (Clinical research ed.). 2013; 346:f2424.](Epub) [http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=22307037  Freemantle N, Richardson M, Wood J, Ray D, Khosla S, Shahian D, Roche WR, Stephens I, Keogh B, Pagano D. Weekend hospitalization and additional risk of[...]