Abstract:
:Warfarin, a vitamin K antagonist, is the most widely used oral anticoagulant in the world. It is cheap and effective, but its use is limited in many patients by unpredictable levels of anticoagulation, which increases the risk of thromboembolic or haemorrhagic complications. It also requires regular blood monitoring and dose adjustment. New classes of drugs, non-vitamin K antagonist oral anticoagulants (NOACs), are now supported as alternatives to warfarin. Three NOACs are licensed: dabigatran, a direct thrombin inhibitor, and rivaroxaban and apixaban, antagonists of factor Xa. NOACs do not require routine blood monitoring or dose adjustment. They have a rapid onset and offset of action and fewer food and drug interactions. Current indications include treatment and prophylaxis of venous thromboembolism and prevention of cardioembolic disease in non-valvular atrial fibrillation. Effective antidotes are lacking and some caution must be used in severe renal impairment, but favourable trial evidence has led to their widespread adoption. Research is ongoing, and an increase in their use and indications is expected in the coming years.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Saraf K,Morris PD,Garg P,Sheridan P,Storey Rdoi
10.1136/postgradmedj-2014-132605subject
Has Abstractpub_date
2014-09-01 00:00:00pages
520-8issue
1067eissn
0032-5473issn
1469-0756pii
postgradmedj-2014-132605journal_volume
90pub_type
杂志文章,评审abstract::The Wolff-Parkinson-White syndrome can rarely present with pre-excited atrial fibrillation. In this condition the short refractory period of the accessory pathway can lead to rapid atrioventricular conduction. There is then a danger that at high heart rates the irregular broad complex tachycardia that results can dete...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.79.931.297
更新日期:2003-05-01 00:00:00
abstract::The term "natural childbirth" denotes an approach to childbirth characterised by a bias towards physical and mental hygiene in the management of pregnancy and labour. It emerged in Britain in the interwar period, partly as a response to the growing interventionism of mainstream obstetrics. Its appeal since then has re...
journal_title:Postgraduate medical journal
pub_type: 历史文章,杂志文章
doi:10.1136/pmj.79.929.168
更新日期:2003-03-01 00:00:00
abstract::A review of the role of presynaptic receptors in the modulation of neurotransmitter release indicates two types of presynaptic receptors. By means of presynaptic inhibitory autoreceptors a neurotransmitter can regulate its own release. In addition, presynaptic receptors are acted upon by other endogenous compounds, ei...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1981-01-01 00:00:00
abstract::The anticoagulant agents heparin and warfarin were introduced before the era of randomised clinical trials. As a result, the indications, dosages and monitoring techniques of these drugs have undergone re-evaluation in multiple clinical trials in the past years. Low molecular weight heparin has been developed, which h...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.859.283
更新日期:1997-05-01 00:00:00
abstract::The role of prostaglandins in inflammation is still disputed. Some workers have attempted to fit prostaglandins into a simple model, i.e. inflammatory leads to chemical mediator leads to vascular response. Recent work has shown that this approach may be misleading. An alternative model is proposed, involving the inter...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.625.660
更新日期:1977-11-01 00:00:00
abstract::The pharmacokinetics of a single oral dose of clomipramine were examined in a group of depressed patients, 8 female and 2 male with a mean age of 51 years (range 21-78). Their mean clomipramine half-life was 36 hours and mean plasma clomipramine clearance 73 litres per hour, with a wide range in each case. These resul...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::It has long been recognised that intensive efforts are needed to reform medical education in order to meet the future needs of populations worldwide. Pressure for changes to the organisation, content and delivery of both undergraduate and postgraduate medical education has greatly increased in the last two decades. Th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.837.397
更新日期:1995-07-01 00:00:00
abstract::Treatment of angina with a single drug often proves unsatisfactory because of dose-related unwanted effects or occasionally an adverse effect on the angina. A combination of a beta-blocking agent and a calcium antagonist drug might achieve satisfactory control of angina at acceptable doses of each drug. Widespread app...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1983-01-01 00:00:00
abstract::This purports to be the first recorded case of carcinoma of the pancreas presenting as a mechanical obstruction of the colon. The literature relating to some other rare modes of presentation is reviewed, and a comment made on the desirability of routine post-mortem studies. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.663.66
更新日期:1981-01-01 00:00:00
abstract::For millennia, the smile has been recognised as a powerful communication device, offering benefits to both giver and receiver with few drawbacks. A sign of compassion, empathy and friendliness, smiling can benefit healthcare professionals and their patients, helping to build a relationship of trust. But beware the fal...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2018-136286
更新日期:2019-02-01 00:00:00
abstract::We report four cases of Bartter's syndrome in two consecutive generations of an Irish family. Diagnoses were made on the basis of characteristic clinical features, blood and urine biochemistry with additional evidence from renal biopsy in one case. The aetiology, treatment and inheritance of the syndrome are discussed...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.816.791
更新日期:1993-10-01 00:00:00
abstract:AIM:To establish an updated clinical profile of adenocarcinoma of the lung. DESIGN:Retrospective review of clinical charts, chest radiography, and computed tomography of consecutive patients who attended Queen Mary Hospital in Hong Kong between June 1995 and December 1997. RESULTS:In the 115 patients studied, 13% wer...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.77.913.708
更新日期:2001-11-01 00:00:00
abstract::Gastric outlet obstruction by gall stone is a rare complication of a common disorder. Two cases are reported here. The investigations are conducted along the same lines as for pyloric stenosis. The diagnosis can be made with a barium meal or gastroscopy. Treatment is by surgical intervention after adequate resuscitati...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.744.909
更新日期:1987-10-01 00:00:00
abstract::A woman aged 35 years from the Philippines presented with epigastric discomfort associated with an epigastric mass. On examination the liver was markedly enlarged. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.762.233
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Right ventricular (RV) fractional area change and tricuspid annular plane systolic excursion (TAPSE) are recognised methods for assessing RV function. However, the way in which these variables are affected by varying degrees of pulmonary hypertension (PH) has not been well characterised. METHODS:RV end-syst...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2007.059642
更新日期:2008-01-01 00:00:00
abstract::Aspirin was first synthesised 100 years ago and its preparation and marketing is generally reckoned to have been the foundation of the pharmaceutical industry. For most of the time since then it has been used for the relief of pain and fever. The modern phase of aspirin use commenced with the reporting in 1974 of a ra...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.876.587
更新日期:1998-10-01 00:00:00
abstract::Unstable and unpredictable disease control in diabetes or asthma, with frequent hospitalisations, is frequently referred to as 'brittle'. We describe two cases of Addison's disease with recurrent hospitalisations in hypo-adrenal crises. Both patients had significant psychosocial disruption, and failure to take hydroco...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.76.893.166
更新日期:2000-03-01 00:00:00
abstract::The incidence, aetiology and possible inheritance of duodenal diverticula remain controversial. These aspects are discussed through the presentation of a family, in which duodenal diverticula occurred in a man and his two sons. To the best of our knowledge, this is the first such family documented in the medical liter...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.705.489
更新日期:1984-07-01 00:00:00
abstract::This article reviews the unique pharmacological properties of methadone and outlines its appropriate clinical application, with focus upon its use in the treatment of chronic pain. Although methadone is most widely known for its use in the treatment of opioid dependence, methadone also provides effective analgesia. Pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.022988
更新日期:2004-11-01 00:00:00
abstract::Localized fibrous mesothelioma of the pleura is an uncommon neoplasm. Very rarely (there have been three previous cases) it may occur as an isolated mediastinal tumour. Such a tumour was present for at least 3 years in a 47 year old man, causing shortness of breath and superior vena cava syndrome. A mass weighing over...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.768.788
更新日期:1989-10-01 00:00:00
abstract:PURPOSE:To determine the association between professors' self-perception of mentoring skills and their academic performance. DESIGN:Two hundred and fifteen professors from Imperial College London, the first Academic Health Science Centre (AHSC) in the UK, were surveyed. The instrument adopted was the Mentorship Skills...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133542
更新日期:2016-10-01 00:00:00
abstract::A patient is described who developed acute pericarditis during a severe first attack of Crohn's disease. The opportunity was taken to measure levels of circulating immune complexes, both during the acute phase of the illness and during convalescence; no significant change in these levels from normal values was found. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.708.682
更新日期:1984-10-01 00:00:00
abstract::A case of myxoedema coma is reported where the administration of chlorpromazine resulted in a prolonged dystonic reaction. A similar challenge with a butyrophenone when the patient was on thyroxine caused a similar but much abbreviated response. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.653.192
更新日期:1980-03-01 00:00:00
abstract::Children in India constitute a very high risk group from mortality and morbidity due to lack of specialised healthcare. Remote care of paediatric patients by offsite specialists using telemedicine technology is a highly potential solution for coping up with the shortage of specialists in Indian subcontinent. We at a t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2009.082735
更新日期:2010-12-01 00:00:00
abstract::The morphological features of endomyocardial fibrosis and Löffler's endocarditis are described. Sixteen cases of the chronic stage of Löffler's endocarditis were compared with pathological material of thirty-two patients with endomyocardial fibrosis. No morphological differences were noted. It is suggested that endomy...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.623.538
更新日期:1977-09-01 00:00:00
abstract::Recent studies of stress mechanisms in hypertension have focussed on the cardiovascular and neuroendocrine reactions to challenging or threatening psychosocial stimuli. Fixed hypertension may develop in some animal models following chronic exposure to psychosocial conflict. Acute experiments in humans show that marked...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.729.697
更新日期:1986-07-01 00:00:00
abstract::Eosinophilic gastroenteritis is a condition characterised by eosinophilic infiltration of the gastrointestinal tract. Biliary obstruction is an unusual presentation. A case where the initial investigations were consistent with carcinoma of the head of pancreas but the resection specimen showed no malignancy is present...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.922.498
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%-15% of cases. Any part of the nervou...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134475
更新日期:2017-07-01 00:00:00
abstract::This review examines the appropriate timing of intervention in acute pancreatitis. In gallstone pancreatitis, it is now clear that cholecystectomy during the primary admission carries no greater risk of complications than delayed cholecystectomy and enables earlier recovery to normal activity. This course of action pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.69.813.509
更新日期:1993-07-01 00:00:00
abstract::The differing aspects of fibrocystic disease are presented. The various histological components making up the breast account for the variegated presentation of symptoms and findings. Pain, tenderness and nodularity represent the greatest problem with the former two prompting the patient to seek relief. The latter symp...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1979-01-01 00:00:00