Res Medica (E-Journal)
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The Cystic Fibrosis Gene
Get PDFIt’s now well over a year since the cystic fibrosis gene was cloned and there is still much to be done before its localisation can be translated into an improvement in health care for affected people. I’m not going to go into any details on how the gene was located, for this information (which is rather technical) see ref. 1. However to put it rather bluntly, despite the fact that the gene has been localised and sequenced has been sequenced, no-one really knows what it does. The cystic fibrosis gene has been named the CFTR gene (cystic fibrosis transmembrane conductance regulator). It is located on the long arm of chromosome 7 and is composed of 27 extrons which code for 1,400 amino-acid residues. There seem to be several different final products of the CFTR gene which result from the removal of exons from the first nucleotide binding fold. The functional significance of these products is not known
The Future
Get PDFA History article about the future seems a bit of an odd idea but we thought it might be \u27fun’! This article is the last of three speeches given at the start of the Society\u27s 250th Anniversary Appeal (about four years ago). At the time it was intended to publish a number of articles in a celebration copy of Res Medica. Sadly publication was hampered by financial constraints and Res Medica ‘slept on’ until our first issue last year which featured an historical account of the RMS. This article is about the personal predictions of the future of the RMS by Dr. Richard Newton. He was a senior president of the Society and is currently working as a psychiatrist at the Royal Edinburgh Hospital.How on earth does one talk about the future of the Royal Medical Society? During these celebrations, however, it is appropriate to wonder what the future might have in store for us and indeed to wonder whether we will still be here in another 250 years time.To picture the future one really needs to study the past and the present, and I am thankful that this has already been done by the two preceding speakers. It seems to me that the Royal Medical Society stands and has stood for two different things: at any time in the future these two parts of the Society will continue to be important. That is, its historical standpoint and present standpoint
Editorial
Get PDFThe key to becoming a good doctor is acquiring a solid foundation in the skills of listening to and examining patients. The importance of a thorough grounding in these skills had been recognized and prompted the current revision of the phase II course, the objective being to improve the introduction to clinical studies
Editorial
Get PDF“The Society dates from the year 1737, when ten medical students agreed to meet weekly in a tavern to hear one of their number read a dissertation on some medical subject. It is the oldest medical students’ society in Great Britain, and the only one to hold a Royal Charter (which was granted by King George III in 1779) The Society has a long and distinguished tradition, and its history is the history of the Edinburgh Medical School. Amongst its past members it boasts the names of Lister, Simpson the chloroform pioneer, Joseph Bell of Palsy fame, Charles Darwin, and Andrew Duncan. Today as in the past the Society’s business comprises the reading of dissertations by members, the arranging of talks given by men eminent in the contemporary medical world and the organising of symposia on subjects of current interest."Since the founding of the Royal Medical Society in 1737 it has always sought to broaden the educational horizons of its members. Res Medica was first published in 1957 to augment learning and provide a platform on which members ideas and work could be aired out with the walls of the Society’s hall. This edition of Res Medica represents its resurrection after a dormancy period of eight years and it is hoped that this tradition will be supported and maintained in future years. Over this eight year period we have witnessed numerous changes in the practice and teaching of medicine and the Royal Medical Society has remained in touch with these new ideas especially with its recent investment in a variety of computer aidedlearning facilities
News from the Society
Get PDFOn Monday 24th January 2005 the Royal Medical Society paid tribute to the celebrated bard Robert Burns. The supper, held in the Society’s rooms at Bristo Square, was attended by no less than 9 4 people - the largest number this event has seen in a long while! With new and long-standing members alike gathering for the annual event, we can safely say that Robert Burns has not been forgotten within this Society
Sleep problems in cancer: effective psychological interventions – a systematic review
Get PDFIntroduction: Sleep problems are one of the most prevalent complications cancer patients experience. These have been shown to produce harmful effects such as reduced immunity and mood disturbances. While pharmacological agents for sleep problems may be used, psychological therapies should be considered where possible.Aim: The aim of this review is to evaluate the effectiveness of different psychological interventions for sleep problems in cancer patients.Methods: A systematic review was conducted. Databases searched included PsychINFO, Embase, MEDLINE, and Web of Science for papers published during the period from January 2003 to December 2013. Combinations of the following terms were used: “sleep disturbance”, “sleep problems”, “insomnia”, “cognitive behavioural therapy”, “CBT”, “non-pharmacological”, “sleep hygiene”, “psychological intervention”, “psychological treatment”, and “cancer”.Results: 22 papers were selected for analysis. The main finding from this systematic review was that cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR) is the most promising psychological intervention for the treatment of insomnia in cancer patients. Other psychological treatments such as sleep education and multimodal programmes also demonstrate good potential for use in oncology.Conclusions: Further randomized controlled trials comparing the effectiveness of CBT and MBSR in different types of cancer are required to determine their relative benefits and costs
An Audit of the Management of ABPA in CF patients at Alder Hey Children’s Hospital
Get PDFBackground: Allergic bronchopulmonary aspergillosis (ABPA) is a persistent problem for many cystic fibrosis (CF) patients. It is a challenging condition to diagnose and manage.Aim: The CF team at Alder Hey Children’s Hospital aimed to assess how consistently and effectively they were managing the condition. A diagnosis and management monitoring tool was used to systematically draw data for auditing.Methods: Out of 87 patients under the care of the CF team, 20 had previously been diagnosed with ABPA. 60% had 4 out of the 4 minimal diagnostic criteria. 75% grew cultures positive for A. fumigatus at some point since their diagnosis of ABPA. All patients had received prednisolone therapy at some point since diagnosis, with 7 patients receiving the maximum starting dose of 40 mg and 1.29 mg/kg for those below maximum dose. 14 patients were prescribed antifungal therapy. 5 patients had levels ordered when they started the therapy, 5 had levels ordered between 45 and 1149 days after prescription, and 3 have had no levels ordered to date. A second audit was performed one year later to complete the audit cycle.Results: This cohort of patients had a much higher prevalence of ABPA than the general CF population.Discussion: Research into the relationship between ABPA exacerbation and concurrent infections or antibiotic therapy could help identify risk factors for developing an exacerbation. There should be discussions about how to improve the consistency in initial dosing of prednisolone, considering guidelines.Conclusion: There should be more itraconazole levels taken to ensure safety and effectiveness of antifungal therapy
Editorial
Get PDFHippieville is where it’s at, or words to that effect. The recent efflorescence of “ the scene” has brought its own problems, not the least medical; this could be all too graphically seen in the H aight-Ashbury district of San Franciscothis summer where a lemming migration ofdisenchanted American youth far outstripped the city’s hygiene and health provisions. A philosophy of not so much a programme more a way of life does not lend itself easily toadequate sanitation, to efficient screeningagainst infectious diseases, to immunisation programmes for the young and to regular and orthodox nutrition; nor did the defiance of many of the hippies and the irritation of the authorities help matters. Sepsis, upper respiratory ailments, scrum hepatitis (from needle injections of drugs) and venereal disease were rife. The collateral dangers from exuberant use of narcotics and dubious pharmacological cocktails further complicated the picture
"James MacKenzie: Research in General Practice
Get PDFBorn the son of a Highland farmer in 1853, near Scone in Perthshire, James MacKenzie was destined to become a leader among medical men. He utilised the opportunities of a general practitioner to study the early symptoms of disease and the bearing of the disease on thepatient’s future life.In defining how this came about, three main factors seem to emerge as especially significant in his early years. As an apprentice to a Perth chemist, he found that his “ natural bent lay in a practical rather than an academic direction”. In his preclinical years at Edinburgh University,he experienced some difficulty in passing examinations, for they were contrived for the purpose of testing memory rather than the power ofreasoning — MacKenzie had difficulty in remembering isolated facts, but if facts were “ related in some consecutive manner, they could not only be remembered, but their bearing on one-another fully appreciated”