Abstract:
BACKGROUND:Transient ischaemic attacks (TIAs) carry a significant early risk of stroke. New national guidelines state patients should be seen within 7 days of the incident, with higher-risk patients being seen within 24 h. Meeting these targets across the NHS poses a significant challenge. A novel approach to TIA assessment has been developed using a nurse-led rapid-access anterior circulation TIA clinic. METHODS:This was a prospective evaluation of all patients attending the FAST-TIA clinic between November 2003 and December 2006. Diagnostic yield of neurovascular events among patients seen through the TIA service and median time from referral to assessment and from event to assessment were measured. RESULTS:282 patients were eligible for investigation, and seen through the clinic over a period of 38 months. A vascular event was diagnosed in 242 (86%). TIA was diagnosed in 133 (55%), minor ischaemic stroke in 77 (32%), haemorrhagic stroke in three (1%), and an ocular event in 29 (12%). Median time from referral to assessment was 3 days (interquartile range (IQR) 1-7), and from event to assessment it was 7 days (IQR 3-18). 34% of patients were seen within 24 h of referral. CONCLUSIONS:This model has a high diagnostic rate of 86% vascular events, significantly higher than current national averages of approximately 55%. Current national guidelines for early assessment of patients (published subsequent to this study) are achievable using this service. The FAST-TIA model is an easily reproducible and pragmatic method of improving the diagnostic yield of TIA services, while keeping within national targets.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Banerjee S,Natarajan I,Biram R,Sutton K,Ekeng G,Ames D,Chataway Jdoi
10.1136/pgmj.2009.083162subject
Has Abstractpub_date
2009-12-01 00:00:00pages
637-42issue
1010eissn
0032-5473issn
1469-0756pii
85/1010/637journal_volume
85pub_type
杂志文章abstract::Five per cent of patients with germ cell tumours of the testis will develop a further tumour in the contralateral testis. Standard treatment in such cases is a second orchidectomy, resulting in infertility, hormone replacement, and psychological morbidity. In this case report we explore the role of testis conservation...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.886.481
更新日期:1999-08-01 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
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更新日期:1980-03-01 00:00:00
abstract::A study was undertaken to determine the effects of long-term insulin therapy on the development and regression of lipid perturbations and experimental cholesterol atherosclerosis in rabbits: (1) Insulin administration for 15 days significantly reduced plasma lipid levels and free fatty acids in rabbits fed a high-chol...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.628.80
更新日期:1978-02-01 00:00:00
abstract::The selective COX-2 inhibitors (coxibs) were originally developed to minimise the adverse effects of conventional non-steroidal anti-inflammatory drugs (NSAIDs) while maintaining the same analgesic and anti-inflammatory properties. Many large studies confirmed the improved gastric side effect profile of coxibs compare...
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abstract::Ulcerative colitis is not commonly associated with recognizable pulmonary disease and only four sporadic cases of sarcoidosis in association with ulcerative colitis have been previously reported. However, in a series of 680 patients with ulcerative colitis, pulmonary or extra-pulmonary sarcoidosis has at some stage be...
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pub_type: 杂志文章
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abstract::Splenic peliosis was identified at necropsy in a 62-year-old woman receiving continuous ambulatory peritoneal dialysis for end-stage renal failure, and erythropoietin therapy for uraemia and anaemia. The immediate cause of death was arrhythmia related to ischaemic heart disease, following an episode of intramuscular h...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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abstract::Hypertension is the most common chronic disease in the West Indies, and is a major health problem today being among the 10 most common causes of death in the English-speaking territories of the region. Most patients have essential hypertension. Renal failure, stroke, and cardiac failure are the most common complicatio...
journal_title:Postgraduate medical journal
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pub_type: 杂志文章,评审
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::Congenital heart disease is now more prevalent than acquired in pregnancy in the developed world. In pregnancy the fall in systemic vascular resistance and increase in blood volume and cardiac output can cause functional deterioration in certain conditions. A minimally symptomatic woman with good ventricular function,...
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.63.744.907
更新日期:1987-10-01 00:00:00
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更新日期:1998-06-01 00:00:00
abstract::Muscarinic receptors are present on several different cells in lung and are predominantly involved in bronchoconstriction and mucus secretion. Muscarinic receptor activation leads to breakdown of phosphoinositides in airway smooth muscle cell membranes, which leads to intracellular calcium release and contraction. Mus...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
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abstract::A case of intrahepatic cholestatic jaundice following warfarin therapy is described. The patient made a complete recovery on withdrawal on the drug. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
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abstract::Rhabdomyolysis is a rare but potentially fatal complication of hyperosmolar states. We report a case of severe hyperosmolar non-ketotic diabetic coma causing rhabdomyolysis in a young man. Despite very high levels of creatine kinase there was no detectable myoglobinuria. Creatine kinase estimation should be a standard...
journal_title:Postgraduate medical journal
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doi:10.1136/pgmj.70.819.44
更新日期:1994-01-01 00:00:00
abstract::Posterior leukoencephalopathy syndrome is a newly recognised brain disorder that predominantly affects the cerebral white matter. Oedematous lesions particularly involve the posterior parietal and occipital lobes, and may spread to basal ganglia, brain stem, and cerebellum. This rapidly evolving neurological condition...
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abstract::Eight patients with steroid-sensitive nephrotic syndrome which frequently relapsed despite cyclophosphamide treatment were given cyclosporin A (7.5 mg/kg/day to 10 mg/kg/day) for 8 to 12 weeks. Six had minimal change glomerulonephritis and two had focal segmental glomerulonephritis. Cyclosporin A was given to 5 patien...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:1987-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:1990-03-01 00:00:00
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abstract::This study examines clinical features of late onset anorexia nervosa. This involved the scrutiny of a large database of patients with anorexia nervosa comprising data gathered at standardized initial assessments over the period 1960-1990. Patients with a late onset were compared to other selected patient samples. The ...
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abstract::The gross and microscopic features of an unusual case of neurocutaneous melanosis are described. This is an example of the rare association between a primary central nervous system malignant melanoma and a giant congenital melanocytic naevus of 'bathing trunk' distribution. ...
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abstract::Prostate cancer is receiving ever more publicity with the result that more men are having their prostate specific antigen checked and a greater proportion of men are diagnosed with potentially curable localised disease. Advances in the therapeutic modalities including radical surgery, external beam radiotherapy, and b...
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journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-01-01 00:00:00