Updates

New explanation of how to calculate the QRS axis on a 12 lead ECG in the Electrocardiography section.

New section outlining the association between p wave dispersion and the progression to chronic Afib in the Atrial fibrillation section.

A new section and table relating to the use of the Delta gap in metabolic acidosis has been added to the Metabolic acidosis section.

A more detailed table of developmental milestones for children has been added as a new page link from “Developmental milestones” in the Assessment of Children section.

A table outlining the difference in the nature of contractions between true and false labour has been added to the Labour section.

Information about the immature platelet fraction and how it can help differentiate causes of thrombocytopenia has been added to the Thrombocytopenia section.

Updates information regarding the Geneva method of risk stratification based on clinical features and catheter embolectomy in the Management of PE section

Updated information about ST/S ratio and discordant ST elevation and depression and how it may add to the accuracy of the Sgarbossa criteria.

Updated Vertigo section, with information on how to differentiate BPV and vestibular neuronitis.

Updated information regarding the association between hypo and hyperkalaemia and AMI in the Management of ACS section.

Updated information about the procedure of abdominal paracentesis and the analysis of ascitic fluid.

Updated details in the Bowel Obstruction section mostly regarding the radiological features of each of them

Updated information regarding variations in metabolism of codeine in the Opioid Toxicity section of the Toxicology chapter.

Updated section on “Coronary Artery Disease’ following recent release of the 3rd universal definition of an MI in Circulation.

Updated sections with new evidence from an RCT of IABP published recently in Journal of Intensive Care Medicine that did not show any overall mortality benefit from IABP. Patients < 50 years of age did have better outcomes however the power of the study was inadequate to indicate if this is a real difference.

Updated information that suggests inhaled corticosteroids in prepubertal children with asthma causes (rather than just an association) a slight reduction in overall growth.

A section on Factorial designs of randomised trials has been added to the ‘Study methods’    section of the Research Skills chapter.

Ascertainment bias has been added to the  ‘Analysis of the Medical literature’ section of the Research Skills chapter.

Indications, tips on how to read head CTs and related CNS anatomy images have been included as new pages in the ‘Neurological assessment’ section of the Neurology Chapter.

Updated information regarding bronchiolitis diagnosis and management.