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Mary Armitage

Publications and source records attributed to Mary Armitage.

8 recordsLinked to original sources
PubMed2003

Recent concerns surrounding HRT.

Millions of women are treated with hormone replacement therapy (HRT) for relief of menopausal symptoms, including vasomotor flushes and sweats for which oestrogen is uniquely and highly effective. Others may continue longer-term treatment in the hope that HRT will help to prevent chronic disease. The preservation of bone mass with continuing oestrogen therapy and reduction of subsequent risk of fracture is well established. Observational studies of the metabolic and vascular effects of oestrogens have suggested a potential benefit in reducing the risk of vascular disease, but recently published randomized controlled trials demonstrate no evidence of benefit in women with established vascular disease or in apparently healthy women. The increased risks of breast cancer and thromboembolic disease have been confirmed in these trials, with evidence of increased risk of stroke. Observational data suggest there may be a small increased risk of ovarian cancer associated with longer-term use of HRT. The premature termination of one arm of the Women's Health Initiative randomized controlled trial caused concern among patients, doctors and pharmaceutical companies. There are difficulties in extrapolating the results from trials using a specific HRT product to advise women on the wide range of other hormone products, doses, combinations and routes of administration. However, in the absence of evidence that other products are safer, the data suggest that for many women the risks associated with long-term use of HRT outweigh the benefits. There are nonhormonal strategies for the prevention and treatment of osteoporosis. HRT is not, and has never been, licensed in the UK for the prevention or treatment of vascular disease, and the data suggesting potential benefit should now be regarded as biased. The absolute incidence of an adverse event is low, and the risk in an individual woman in a single year is very small, but the risks are cumulative over time with long-term use. The risk-benefit balance of each woman needs regular reappraisal with continued use.

Alzheimer Disease↗
PubMedDate not supplied

A consultant physician in acute medicine: the Bournemouth Model for managing increasing numbers of medical emergency admissions.

Consultant-led medical admission units have been developed as one method of managing the increasing number of acute medical emergencies. The need to document such innovations and to evaluate and analyse the role of an acute care physician in meeting the problems of acute care has been emphasised. We therefore report our experience of an acute admissions unit led by a consultant physician in acute medicine in a district general hospital.

Admitting Department, Hospital↗
PubMedDate not supplied

Supporting revalidation: methods and evidence.

The aim of revalidation is to reassure the public that doctors are up to date and fit to practise. The Royal College of Physicians has developed various programmes of work, both ongoing and under development, in support of revalidation. The purpose of this work is to provide guidance for doctors about the standards of practice expected and the types of evidence required for revalidation. A range of methods and tools are outlined that could be used by doctors to demonstrate their commitment to evaluating and reflecting on the way they practise medicine. These methods include ways of assessing both professional standards and clinical competence. Although the conclusions of the Chief Medical Officer in terms of the absolute requirements for revalidation are still unknown, the College is committed to supporting its Members and Fellows to prepare for revalidation through setting educational, professional and clinical standards in medicine.

Clinical Competence↗