The School of Medicine is the medical school of the University of Leeds, in the city of Leeds, West Yorkshire, England. The School of Medicine was founded in 1831.The School of Medicine now forms part of the University's Faculty of Medicine and Health. The School is composed of institutes located at multiple sites in West Yorkshire including the Worsley Building, LIGHT, St James's Campus, and Chapel Allerton Hospital. The School of Medicine is primarily linked with two major hospitals for clinical teaching: the Leeds General Infirmary and St James's University Hospital, both run by the Leeds Teaching Hospitals NHS Trust, alongside smaller district NHS Trusts.
The Hippocratic Oath, written by the father of medicine, Hippocrates in 430 BCE has been sworn for millennia across the world by new doctors. Its nine articles outline how a doctor must treat their patients effectively, abiding by the core ethical principles that underscore Good Medical Practice today, including a focus on beneficence and non-maleficence. Today, the Gods of Olympus are no longer routinely worshipped, and we benefit from vast medical and technological advances, so the question arises whether the principles of Hippocratic medicine are still relevant? On the island of Kos, Hippocrates' birthplace, there continues the tradition of an annual 'oath swearing' ceremony for students that have completed medical school both from Greece and across the world. Whilst this event can be used to celebrate the achievements of the new doctors in training, is there still a need for them to retrace the routes of the profession? This article aims to explore the core principles of the Oath and Hippocratic medicine and determine their relevance in today's modern society.
Imaging is instrumental in diagnosing and directing the management of atherosclerosis. In 1958 the first diagnostic coronary angiography (CA) was performed, and since then further development has led to new methods such as coronary CT angiography (CTA), optical coherence tomography (OCT), positron tomography (PET), and intravascular ultrasound (IVUS). Currently, CA remains powerful for visualizing coronary arteries; however, recent studies show the benefits of using other non-invasive techniques. This review identifies optimum imaging techniques for diagnosing and monitoring plaque stability. This becomes even direr now, given the rapidly rising incidence of atherosclerosis in society today. Many acute coronary events, including acute myocardial infarctions and sudden deaths, are attributable to plaque rupture. Although fatal, these events can be preventable. We discuss the factors affecting plaque integrity, such as increased inflammation, medications like statins, and increased lipid content. Some of these precipitating factors are identifiable through imaging. However, we also highlight significant complications arising in some modalities; in CA this can include ventricular arrhythmia and even death. Extending this, we elucidated from the literature that risk can also vary based on the location of arteries and their plaques. Promisingly, there are less invasive methods being trialled for assessing plaque stability, such as Cardiac Magnetic Resonance Imaging (CMR), which is already in use for other cardiac diseases like cardiomyopathies. Therefore, future research focusing on using imaging modalities in conjunction may be sensible, to bridge between the effectiveness of modalities, at the expense of increased complications, and vice versa.
Abstract Aim A Whipple procedure with vasculature resection is performed in selected patients when indicated. The oncological outcomes were reviewed and compared with patients who underwent a standard Whipple procedure. Method As part of a wider literature review, survival outcomes following a standard Whipple procedure were compared with patients who underwent either arterial or venous resection. Anatomical dissection of cadavers was also conducted to highlight the concomitant anatomy. Results When venous resection was performed there was a lower 5-year survival compared to the standard Whipple procedure. However, this difference became non-significant once subgroup analysis was performed on studies which used neo-adjuvant therapy. Effective performance of arterial resection demonstrated greater median survival over palliative care. Though, when compared to those who underwent a standard Whipple procedure the median survival, 1-year and 3-year survival was lower. Conclusions When neo-adjuvant therapy is used, the oncological outcomes of those who underwent a venous resection Whipple procedure were similar to those who underwent a standard Whipple procedure. Clinicians should be aware of the possible benefits this provides in increasing survival. The Whipple procedure with arterial resection is a possible treatment as it demonstrated greater oncological outcomes over palliative care. However, these patients need to be carefully selected by the surgeon.
