Aim: The aim of the project was to assess critically, using Maxwell's six dimensions, the quality of the services provided by the two Rapid Access Chest Pain Clinics (RACPCs) in Central Lancashire.
Methods: Data on the actual use of the clinic was obtained from the two RACPCs. A record linkage exercise between the database of patients from the RACPC and HES/mortality data was performed. Expected use of the clinic was established from the performance of other RACPCs and from published angina incidence figures. Patient and general practitioner views were obtained by conducting questionnaire surveys.
Key Recommendations: (1) Clinic is providing a valuable service and should be continued. (2) A standardized database should be created which includes ethnicity and final diagnosis. (3) Alternative methods for rapid diagnosis and management of chest pain need to be provided for patients who are not suitable for the exercise electrocardiogram. (4) Referral criteria should be redrafted in order to remove the exclusion criteria for patients with chest pain of longer duration than 3 months. (5) Further resources need to be targeted at cardiology outpatients and revascularizations, as waiting times for patients with a positive test are felt to be too long.
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http://dx.doi.org/10.1111/j.1365-2753.2006.00696.x | DOI Listing |
Pain Rep
February 2025
Department of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Introduction: Management of pain associated with breast cancer surgeries is crucial in reducing incidence of postmastectomy pain syndrome. The pain distribution involves the anterior chest wall, axillary area and ipsilateral upper limb.
Objective: This study was designed to investigate the effect of bilevel erector spinae plane block (ESPB) with high thoracic block vs the conventional unilevel ESPB vs opioids in patients with cancer undergoing modified radical mastectomy regarding pain control and reducing pain in axilla.
Transl Cancer Res
December 2024
Department of Geriatric Respiratory Disease, Institute of Guangdong Provincial Geriatrics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Primary choriocarcinoma of the pulmonary artery is an exceedingly rare malignant neoplasm, which is often misdiagnosed due to its nonspecific clinical presentation. While this condition is characterized by the presence of trophoblastic cells, typically associated with gestational trophoblastic diseases, we encountered a case occurring in an extragenital location. The rarity of such tumors makes it challenging for clinicians to consider them in differential diagnosis, especially when the initial symptoms mimic more common conditions such as pulmonary thromboembolism (PTE).
View Article and Find Full Text PDFSisli Etfal Hastan Tip Bul
December 2024
Department of Cardiovascular Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye.
Pregnancy-related spontaneous coronary artery dissection (P-SCAD) is a life-threatening condition that occurs during or after pregnancy, is rare and can be overlooked. It is one of the most important causes of pregnancy-related acute myocardial infarction. A 25-year-old female patient was admitted with a complaint of chest pain in her 37th week of pregnancy.
View Article and Find Full Text PDFCureus
December 2024
Obstetrics and Gynecology, First Health Cluster, Dammam, SAU.
Mediastinal lymphangiomas are rare benign tumors arising from lymphatic system malformations, most commonly seen in pediatric populations. In adults, they are exceedingly rare and present diagnostic challenges due to nonspecific symptoms and imaging overlap with other mediastinal masses. Diagnosis is typically based on imaging, including CT and MRI, with histopathology confirming the diagnosis.
View Article and Find Full Text PDFNarra J
December 2024
Department of Dermatology Venereology and Aesthetic, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Varicella, caused by the varicella-zoster virus (VZV), is rarely reported in the elderly but often complicates with pneumonia. In this case report, we present a case of varicella pneumonia in the elderly. A 60-year-old man presented to the emergency room with vesicles filled with clear fluid that had appeared all over the body for the past four days.
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