Assessment of the diagnostic value of NT-proBNP in heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a common concern in the medical field due to its prevalence in an ageing western population. HFpEF is associated with significant morbidity and mortality not dissimilar to heart failure (HF) with reduced ejection fraction. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and echocardiography are the guideline diagnostic indicators of HF and their use is being examined in this study, with the aim to consider NT-proBNP thresholds performance as a rule-out test.

Management of hypertensive emergencies and urgencies: narrative review.

Hypertensive emergencies are distinguished from hypertensive urgencies by the presence of clinical or laboratory target organ damage. The most common forms of target organ damage in developed countries are pulmonary oedema/heart failure, acute coronary syndrome, ischaemic and haemorrhagic stroke. In the absence of randomised trials, it is inevitable that guideline writers differ slightly regarding the speed and extent to which blood pressure should be lowered acutely.

Design and implementation of two medical escape rooms: An educational case study.

Background: Escape rooms (ERs) have become increasingly popular as an interactive educational experience, especially in medical education. We present an educational case study covering the design, implementation and evaluation of two medical ERs.

Approach: We created ERs for senior medical students from Glasgow University on rotation at Dumfries and Galloway Royal Infirmary.

Do we overtreat patients with presumed neutropenic sepsis?

Purpose: Many aspects of the management of neutropenic sepsis remain controversial. These include the choice of empiric antibiotic, the duration of antibiotic therapy and the possibility that very low-risk cases may be managed safely with oral rather than intravenous therapy.

Study Design: Retrospective cohort study conducted in a district general hospital serving a population of 148 000 in south west Scotland.

Unexplained chest pain in a patient with giant cell arteritis? Think aortic dissection.

Giant cell arteritis (GCA) is the commonest of the large-vessel vasculitides. Aortic inflammation in patients with GCA was first described over 80 years ago, but it has only been possible to study this systematically following the development of more sophisticated imaging techniques such as computed tomography angiography, magnetic resonance angiography and positron emission tomography. Both NICE and the European League Against Rheumatism (EULAR) recognise that aortic dissection may complicate GCA but stop short of recommending routine imaging.