CMJ | 24 Jul 2013 | News

Mental health in pregnancy remains a significant issue, with 7-13% [1] of women experiencing depressive symptoms during pregnancy. ‘Confidential Enquiries into Maternal Deaths in the United Kingdom’ [2] have highlighted suicide in pregnancy and during the first postnatal year as a leading cause of maternal death. SSRIs are known to cross the placental barrier, however the safety of these drugs in pregnancy is not well understood [3].

CMJ | 1 Jul 2013 | News

As medical students, we should all know about the legal regulations surrounding key aspects of medicine, The Welsh Government published the Draft Human Transplantation Act in June 2012 [1]. It proposes that Welsh residents give presumed consent for organ donation unless they ‘opt out’ of the system.

In order to be passed, the draft bill must first be introduced into the assembly, go through all 4 stages of scrutiny and then be presented for Royal Assent. Ministers aim for the law to be in place by 2015.

CMJ | 19 Jun 2013 | News

Chronic obstructive pulmonary disease (COPD) is a common respiratory condition with a high level of resource utilisation through hospital admissions, specialist visits and chronicity of disease [1]. The WHO defines an exacerbation as an acute increase in symptoms beyond the normal daily variation, especially with an increase in cardinal symptoms of cough, sputum production and dyspnoea [2]. Current international guidelines advocate glucocorticoid use in acute exacerbations, with a 10-14 day course of oral prednisolone commonly utilised [3].

CMJ | 9 Jun 2013 | News

The Cambridge Medicine Journal are proud to announce the 2013 Case Report and Medical Imaging Competition, open to all UK medical students. We are on the hunt for the best clinical case reports and picture articles for publication in one of Cambridge's leading medical journals.

CMJ | 11 Jan 2013 | News

Coronary artery disease (CAD) affects millions worldwide. In North America, nearly 700,000 people are diagnosed with multi-vessel CAD and require immediate revascularisation and of these, 200,000 are diabetic. Coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) are the two main modalities of revascularisation. The previous BARI, CARDia, TAXUS and SYNTAX randomised clinical trials offered conclusive evidence favouring CABG over PCI as the preferred method of revascularisation (1).

CMJ | 17 Dec 2012 | News

Friday 23rd November saw the First Wales Medical Undergraduate Conference take place at the Michael Griffiths Building, University Hospital of Wales. Jointly organised by Cardiff University and Meducation - a community of over 23,000 medical students and doctors, who by sharing their knowledge, ideas and experiences, endeavour to facilitate learning medicine.

CMJ | 10 Dec 2012 | News

A study published in the British Journal of Pharmacology [1] has found that curcumin, commonly found in curries, is effective at improving cardiac function and may have potential in treating patients who have had a heart attack.

CMJ | 3 Dec 2012 | News

A study was recently carried out across general practices in Belgium [1]. It aimed to evaluate the added value of gut feeling to diagnosing serious infections when clinical impression suggested otherwise. Out of 3369 clinically non-severe cases, six were eventually diagnosed with serious infections. In two of the six cases (33%) the clinicians had initially had a bad gut feeling. In the 3363 cases that were eventually diagnosed with non-serious illnesses, there were 44 (1.3%) false alarms from intuitive feelings.

CMJ | 27 Nov 2012 | News

High density lipoprotein (HDL), or ‘good cholesterol’, is an apoprotein containing-lipid particle that plays a vital role in reverse cholesterol transport by removing cholesterol deposits from both intravascular and extravascular tissues and transporting it back to the liver for excretion or re-utilization(1, 2). In conventional medical wisdom, elevated levels of high-density lipoproteins (HDL) translate into lower risk of atherosclerosis and ischaemic heart disease.

CMJ | 15 Nov 2012 | News

Highly active antiretroviral therapy (HAART) has been shown to decrease morbidity and mortality from HIV infection, with a combination of these potent pharmacological agents being most effective and least likely to confer resistance [1]. The general therapeutic goals are to prolong and improve life, reduce viral load and promote immune reconstitution whilst minimising side effects [2]. Despite the revolutions HAART has provided, immune reconstitution is not complete or sustained in many patients, with opportunistic infection and death still relatively high [3].

CMJ | 14 Nov 2012 | News

Three pathological subtypes of Alzheimer’s disease (AD) are currently thought to exist, supported by distinct histological and clinical presentations. These are: typical AD, hippocampal-sparing AD and limbic-predominant AD [1]. The clinical presentations are accounted for by the loss of function of specific brain regions caused by generalised neurotoxicity.

CMJ | 1 Nov 2012 | News

Nondystrophic myotonias are a group of rare skeletal muscle ion channel disorders, with prevalence of one in a million [1] causing stiffness and, depending on the channelopathy, pain, weakness and fatigue [2]. Despite significant effects on quality of life and function, there is insufficient data to recommend a safe and effective treatment. In recent times, mexiletine, a class 1b antiarrhythmic drug with high affinity for muscle sodium channels has been found to reduce stiffness, although effectiveness is largely unknown [2, 3].

CMJ | 29 Oct 2012 | News

Upper Respiratory Tract Infections (URTIs) are a leading cause of sickness and loss of productivity amongst adults and school-aged children [1]. Vitamin D has been shown to play a role in a variety of respiratory diseases, including asthma, COPD, malignancy and infectious diseases – although the mechanism for these is largely unclear [2].

CMJ | 9 Oct 2012 | News

The Department of Health (DH) announced recently that pregnant women at 28-38 weeks gestation would be offered vaccination against pertussis, also known as whooping cough [1]. Pertussis might be something that we would only associate with developing countries, but maybe it is no longer so rare in the UK.

CMJ | 2 Oct 2012 | News

Multiple sclerosis (MS) is a debilitating disease of the central nervous system (CNS) due to demyelination of the brain and spinal cord. It manifests as a multitude of symptoms including optic neuritis, sensory deficits and motor weakness. Most cases of MS present with a relapsing-remitting course and patients often deteriorate in health and bodily functions as their disease progresses. Current treatment of MS includes parenteral agents such as beta-interferon and glatiramer acetate.

CMJ | 9 Sep 2012 | News

As the spread of HIV infection is fast reaching epidemic proportions in many parts of the world. Pre-exposure prophylaxis has emerged as a new approach towards HIV prevention for people at risk of HIV infection.

CMJ | 9 Sep 2012 | News

Airway diseases such as asthma and chronic obstructive pulmonary disorder (COPD) are characterised by airway hyper-responsiveness (AHR), respiratory cough, and dyspnoea. Transient receptor potential vanilloid 1 (TRPV1) is highly expressed by sensory neurons and vagal afferents innervating the airways, and is thought to contribute to the features of airway diseases. Since TRPV1-sensitive nerves may play a role in AHR and bronchoconstriction, there has been much interest in pharmacological therapy which targets TRPV1, in order to treat various respiratory diseases.

CMJ | 6 Aug 2012 | News

Aplastic anaemia refers to a haematological condition in which there is absolute deficiency in red cells, white cells and platelets within the peripheral blood. This occurs due to defects with the production of haematopoietic stem cells. Currently, the methods of treatment available include immunotherapy and allogeneic bone marrow transplantation [1].

CMJ | 2 Aug 2012 | News

A recent paper by Curtis et al. aimed to validate a recently developed multi-biomarker disease activity (MBDA) test (Vectra™ DA, Crescendo Bioscience) relative to clinical rheumatoid arthritis (RA) activity in patients from InFoRM, BRASS and Leiden Early Arthritis Clinic cohorts [1]. 12 biomarkers used to compute the composite MBDA score included IL-6 and TNF-RI (cytokine signalling), VCAM-1 (leukocyte recruitment), EGF, VEGF-A, MMP-1, MMP-3, YKL-40, leptin and resistin (angiogenesis, cartilage and bone remodelling), as well as CRP and SAA (acute phase response).

CMJ | 1 Aug 2012 | News

The 65-75 age group represents the fastest growing population beginning renal dialysis, although rates decline after 75 [1]. Previous studies report that elderly patients are less likely to progress to end-stage renal disease before death [2]. However, many previous studies have defined renal failure as requiring dialysis, which is not necessarily reflective of true rates of failure given that patients may choose not to initiate dialysis.

CMJ | 24 Jul 2012 | News

The fast-growing field of tissue engineering provides an interesting application of stem-cell technology to the generation of biological tissues. In recent years, we have begun to see the emergence of these techniques in a clinical context for tissue transplantation. In 2008, there was widespread interest as a patient with end-stage bronchomalacia received the first bioengineered trachea transplant (1). In this groundbreaking procedure, a donor trachea was decellularised to create a structural scaffold, seeded with the patient’s stem cells and then transplanted back into the patient.

CMJ | 10 Jul 2012 | News

Diabetes is a major health burden, with the number of diabetics projected to increase from 366 to 552 million people worldwide by the year 2030 (1). Diabetes is a major risk factor for cardiovascular disease, and leads to complications such as ulceration of the feet (see image). Pre-diabetes is a high risk state for the development of diabetes. It is estimated that every year 5-10% of the people with pre-diabetes will reach the criteria for a diagnosis of diabetes. The American Diabetes Association classifies prediabetes as having a fasting plasma glucose of between 5.6 and 6.9mmol/l.

CMJ | 4 Jul 2012 | News

International sepsis guidelines recommend that empirical combination antibiotic therapy be used for the treatment of gram-negative infections (1). This is to increase the chance that the organism will be sensitive to at least one therapy, to prevent superinfection and to encourage more effective bacterial clearance (2). However, the efficacy of this approach has not been clinically proven for patients with severe sepsis – a subpopulation with altered pharmacokinetics. This study compares the effects of combination vs. monotherapy for patients with severe sepsis (3).

CMJ | 3 Jul 2012 | News

Psoriasis is a common, disfiguring, immune-mediated inflammatory skin disease affecting 2% of the population in the United Kingdom. It not only manifests as characteristic scaling skin rashes and plaques on the skin, but is also associated with pruritus, pain, arthropathy and a three-fold increase in mortality from cardiovascular disease. Due to the chronic, incurable nature of the disease and its severe impact on the quality of life, anxiety and depression also affects up to 25% of patients with psoriasis (1).