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From the Editor

Welcome to the second issue of 2016, which contains two papers on the important topic of atrial fibrillation (AF) and stroke. Paroxysmal AF is an important cause of stroke. Tran et al. show there are variations in practice between stroke physicians and cardiologists, with the former accepting shorter runs of AF as diagnostic of paroxysmal AF. Then there is the issue of treatment. Most patients with AF should be offered anticoagulation. Until recently, warfarin has been the only available agent but is a ‘tricky’ drug for the patient and the physician, not least because of the need for monitoring of its anticoagulant effect and dose adjustment. As a consequence, anticoagulation is not as widely used as the evidence suggests it ought to be. Over the last few years, several new oral anticoagulants have become available and Bashir et al. offer practical advice on the use of these agents for stroke prevention in patients with AF.

Zika continues to attract much attention and Ellul et al. provide a critical review of the recently reported association between Zika and Guillain-Barré syndrome.

We have one of our popular Current Controversies, with Jeffrey and Downie arguing that empathy can – or cannot – be taught.

Last year, we publicised the launch of the digital edition of the medical consultation letters of Dr William Cullen; a very 21st century event. In his own day (the 18th century), Cullen was an ‘early adopter’ of technology. In this issue, Shuttleton tells the fascinating story of Cullen’s use of James Watt’s copying machine.

Martyn Bracewell


Volume 46 issue 2


S Dunn, M Jones, T Woodcock, F Cullen, D Bell, J Reed

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J Hardy, A Jeyabalan, N Bhatt, ARL Medford

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History & Medical Humanities