British Medical Journal articles from December 2000

British Medical Journal archives from December 2000

Australian Net Gambling Ban Set To Take Effect.
December 23, 2000... CANBERRA, AUSTRALIA, 2000 DEC 21 (NB) -- By Adam Creed, Newsbytes. A twelve month ban targeting certain Australian Internet-based gambling operations will take effect on Friday, although the moratorium has a wide range of exemptions and there...

A pile of strangeness.(Editors' Choice)
December 23, 2000... Editor's choice "This anthology amassed itself like a cairn" write Seamus Heaney and Ted Hughes in the first line of their marvellous collection of poetry The Rattle Bag. It's the same with the Christmas BMJ. There is no master plan....

Hamster health care: time to stop running faster and redesign health care.(Editorial)
December 23, 2000... Time to stop running faster and redesign health care Across the globe doctors are miserable because they feel like hamsters on a treadmill. They must run faster just to stand still. In underdoctored Britain they must see ever more...

Hebdomadal rhythms of the heart.(mortality from heart attacks is greater on Monday than other days of the week)
December 23, 2000... Why do deaths peak at the start of the week? Because we don't like Mondays Dean Swift, in caustic vein, dubbed Monday the parson's holiday. But it certainly isn't a day of rest for the medical profession. The results of several recent...

African women with HIV: faith based answers might ease the social problems that lead to AIDS.(Editorial)
December 23, 2000... Faith based answers might ease the social problems that lead to AIDS The international AIDS conference held in Durban earlier this year made the world aware of the global HIV catastrophe and of the need to prevent vertical transmission...

Managing dysphonia caused by misuse and overuse: accurate diagnosis and treatment is essential when the working voice stops working.(Editorial)
December 23, 2000... Accurate diagnosis and treatment is essential when the working voice stops working Actors in the Royal Shakespeare Company are trained to use their voices with consummate skill to express any range of emotions in the most demanding of...

The NHS through American eyes.(UK National Health Service)(Editorial)
December 23, 2000... It has an enviable goal and constancy of purpose: build on it Criticism from without, demoralisation within, and ubiquitous scepticism besiege the National Health Service. The NHS Plan, released in the summer,[1] is the latest in a series...

Recipes for happiness.
December 23, 2000... "Happiness is when what you think, what you say, and what you do are in harmony" Mahatma Gandhi "To be busy is man's only happiness." Mark Twain "There is no happiness except in the realization that we have accomplished...

The Ghost of Christmas Past: health effects of poverty in London in 1896 and 1991.
December 23, 2000... Abstract Objectives To compare the extent to which late 20th century patterns of mortality in London are predicted by contemporary patterns of poverty and by late 19th century patterns of poverty. To test the hypothesis that the pattern...

Cardiovascular mortality in Dutch men during 1996 European football championship: longitudinal population study.
December 23, 2000... Abstract Objective To investigate whether an important football match increases stress to such an extent that it triggers acute myocardial infarction and stroke. Design Longitudinal study of mortality around 22 June 1996 (the day...

Streptokinase versus alteplase and other treatments for acute and delayed thrombolysis of blood stains in clothing.
December 23, 2000... Abstract Objective To assess the usefulness of heparin, alteplase, and streptokinase in removing blood stains. Design Randomised controlled trial. Setting Hospital laundry. Interventions Blood stains were allocated to...

Never too late ...
December 23, 2000... For many people in Britain, the winter of 1972-3 is remembered for the miners' strike, the "three-day week," power cuts, and reading by candlelight. For Dr Miles Markus, however, more serious matters were brewing. Working at the time in...

Manufacture and use of home made ophthalmoscopes: a 150th anniversary tribute to Helmholtz.
December 23, 2000... Abstract Objective To produce a simple, effective, and inexpensive training ophthalmoscope. Design Case study. Setting A coffee table in a sitting room and an eye clinic. Participants 10 friends and relatives, several...

Do animals bite more during a full moon? Retrospective observational analysis.
December 23, 2000... Abstract Objective To test the hypothesis that the incidence of animal bites increases at the time of a full moon. Design Retrospective observational analysis. Setting Accident and emergency department at a general hospital in...

Barking mad? Another lunatic hypothesis bites the dust.
December 23, 2000... Abstract Objective To assess whether dog bites requiring hospital admission occur more at the full moon. Design Review of dates of admission for dog bites to accident and emergency departments,June 1997 to June 1998, compared with...

Arabian nights--1001 tales of how pharmaceutical companies cater to the material needs of doctors: case report.
December 23, 2000... Abstract Objective To describe how pharmaceutical companies cater to the material needs of doctors. Design Case report of memoirs. Setting Facilities that have nothing to do with medicine, somewhere in the Arabian peninsula. ...

Non-invasive detection of hypoglycaemia using a novel, fully biocompatible and patient friendly alarm system.
December 23, 2000... Hypoglycaemia is a common complication of diabetes treatment with either insulin or sulphonylureas and is particularly common with intensified insulin regimens.[1] Episodes are often distressing and carry the risk of serious neurological and...

Saving Fred: what family practice means to medicine.
December 23, 2000... It is legend now, that Christmas Eve of 1985. I was just a rookie on the medical staff; Fred was 73 years old and not long retired when the ambulance came to fetch him for the classic signs of a myocardial infarction--chest pressure,...

Comparing apples and oranges: a randomised prospective study.
December 23, 2000... For many years the comparison of apples and oranges was thought to be impossible. Many authors use the analogy of the putative inability to compare apples and oranges as a means of scornfully reviewing the work of others. The tides of some...

How not to give a presentation.
December 23, 2000... The invitation arrives. You are invited to speak on the same programme as the Pope, Bill Clinton, and Madonna. Beside yourself with excitement, you forget that you've had these sort of invitations before--and that, for some strange reason,...

The Christmas present.
December 23, 2000... ZEN (Zambian enrolled nurse) Jason dried his hands and looked through the window. "Do you think it will rain today?" His colleague followed his gaze. "No, not today. Again not today. The rains are late." All along the Great Eastern Road...

Happy hedonists.
December 23, 2000... Recipes for happiness How do we define happiness? Have humans always sought happiness? Is it worth pursuing? Should happiness perhaps be classified as a psychiatric disorder? We asked a medical historian, a public health professor, a...

An elusive concept?(happiness)
December 23, 2000... "Happiness is a warm gun" wrote John Lennon many years ago, and millions of us still wish he hadn't, for it may have been the seed that was planted in Mark Chapman's disturbed mind to surface sometime later as an assassin's hand on the...

The obsessive pursuit of health and happiness.
December 23, 2000... Manic depression is part of my life, and as I have suffered both the agony of manic episodes and the despair of depressive ones, the thought of obtaining lasting happiness has a recurring appeal. Yet deep down I know this appeal to be false....

A new definition.
December 23, 2000... Gore Vidal told a wonderful joke on the radio recently about the former British prime minister Harold Macmillan and a social visit he paid with his wife to the then French president, Charles de Gaulle. At the end of a long and probably very...

Music to be born to, music to die to.
December 23, 2000... People say that birth and death are lonely events as you are the only one experiencing them at that very moment. But music can be a birth or death companion. We asked a range of contributors which music they would choose at either end of...

How to live forever: lessons of history.
December 23, 2000... Living forever is much in the news these days. Scarcely a week goes by without the papers, the television, and the internet holding out new and plausible hopes that the matter is now well in hand, a technical breakthrough away. Maybe you can...

Three lessons for a better cycling future.
December 23, 2000... Cyclists were the only group of road users in Britain whose death rate increased sharply during the 1990s,[1] yet cycling was in decline throughout the decade.[2] How could this happen, when attention on casualties was the most intense in the...

Civilisation and the colon: constipation as the "disease of diseases".
December 23, 2000... The publication in April 2000 of the results of a clinical trial that found high fibre cereals had no protective effect against colorectal adenomas stirred up considerable media attention and shook a cherished tenet of popular health...

Why are (male) surgeons still addressed as Mr?
December 23, 2000... Surgeons, or rather male surgeons, are always addressed as Mr in the United Kingdom and the Republic of Ireland, sometimes but not always in Australia and New Zealand, and rarely in Canada or the United States. This curious British tradition...

The discovery of aspirin: a reappraisal.
December 23, 2000... The discovery of aspirin is customarily said to have resulted from Felix Hoffmann's rheumatic father encouraging his son to produce a medicine devoid of the unpleasant effects of sodium salicylate. Hoffmann, a chemist in the pharmaceutical...

Serial homicide by doctors: Shipman in perspective.
December 23, 2000... The previous BMA chairman, among others, is on record as saying that Harold Shipman is unique, yet medicine has arguably thrown up more serial killers than all the other professions put together, with nursing a close second.[1-4] Dentistry...

O Happy day.
December 23, 2000... We chose Blake's colour printed engraving for the cover as an image of transcendent happiness. It was produced by someone who led "a life of the deepest obscurity and occasional suffering" but whose reputation is currently soaring.[1] The...

A medical alphabet.
December 23, 2000... In the 1720s Jonathan Swift was challenged to the game of combining all the letters of the Greek alphabet with the word "guinea." He rose to the challenge, using excruciating puns, slang, and hidden words; for example: [Alpha]: half a...

Autopathography: the patient's tale.
December 23, 2000... The case history was invented by Hippocrates. Since then medical practice has been straitjacketed by its artificiality, to the detriment of the patient's own narrative. But patients have found ways of expressing themselves other than by...

Hostage.
December 23, 2000... Bang! Bang! Bang! It sounded like someone hitting a tea tray on a table, until I remembered that I was on the wrong side of the Atlantic for consultants to be served with tea and biscuits and screaming voices made me realise that the sounds...

Near drowning: self therapy in situ.
December 23, 2000... Post-traumatic stress disorder is a common problem, developing in 15-24% of people who are exposed to traumatic events.[1 2] General population surveys have suggested that 1 in 12 adults has experienced post-traumatic stress disorder, the...

Operations: spinal versus general anaesthetics--patient's view.
December 23, 2000... "Operations are fine, so long as you have the right attitude to them," a good friend told me. "Just treat them as a great adventure." And how should one maximise the adventure aspect of the operation? Stay awake while it is done. I do,...

Hear my song: auditory hallucinations with tramadol hydrochloride.
December 23, 2000... Tramadol hydrochloride is a weak opioid with effects on seratoninergic and adrenergic neurotransmission.[1] It is reported to have fewer opioid adverse effects than conventional opioid analgesia.[2] We report an unusual but important adverse...

The fragile male.
December 23, 2000... The human male is, on most measures, more vulnerable than the female. Part of the explanation is the biological fragility of the male fetus, which is little understood and not widely known. A typical attitude to boys is that they are, or must...

Job and his "doctors": bedside wisdom in the book of Job.
December 23, 2000... The book of Job has traditionally has been regarded as a philosophical or theological treatise on the nature of faith of a just man in an unjust world. Read by a modern clinician, the book becomes a treatise on adaptation to illness and loss,...

Three incidents.
December 23, 2000... It's a funny thing how one remembers seemingly minor incidents many years after their occurrence, often relating them to events of a similar type. This, I suppose, is what makes up the fabric of life. These stories took place about ten years...

Instinctive sleeping and resting postures: an anthropological and zoological approach to treatment of low back and joint pain.
December 23, 2000... If you are a medical professional and have been trained in a "civilised" country you probably know next to nothing about the primate Homo sapiens and how they survive in the wild. You probably do not know that nature has provided an automatic...

Tokelau on Naboo.
December 23, 2000... Tinea imbricata, a superficial fungal infection of man, has an ornate appearance composed of concentric circles and polycyclic or serpiginous scaly plaques (fig 1). The condition is common in several humid tropical regions, especially in...

Garages and hospitals, doctors and nurses.
December 23, 2000... When I take my car to the local garage, the owner, Boaz, greets me, listens to my complaints, and checks the car over. Then he calls in the shop foreman, Raffi, who examines it in more detail, calling in the mechanic or the electrician and...

Polydactyly reported by Raphael.
December 23, 2000... We were surprised to count six toes on the left leg of St Joseph in Raphael's famous painting of "The Marriage of the Virgin" (Milan, Pinacoteca di Brera), painted in 1504. This is probably not due to the carelessness of this painter, well...

Getting closer to patients and their families.(Editors Choice)
December 16, 2000... "The whole structure of medicine has been based on the assumption that physicians have the current information and patients do not. The bottom line is, the consumer will have virtually all the information the professionals have. This is...

Using injury data for violence prevention: government proposal is an important step towards safer communities.(Editorial)
December 16, 2000... Government proposal is an important step towards safer communities The UK government has indicated that its plans to tackle community violence will be based not just on information about offences but also on injury data derived from...

Self management in asthma care: professionals must rethink their role if they are to guide patients successfully.(Editorial)
December 16, 2000... Professionals must rethink their role if they are to guide patients successfully "Equipping people with asthma with the tools they need to manage their condition is as important as writing the correct prescription," according to the...

Screening for familial hypercholesterolaemia: effective, safe treatments and DNA testing make screening attractive.(Editorial)
December 16, 2000... Effective, safe treatments and DNA testing make screening attractive Familial hypercholesterolaemia is a common disorder of lipid metabolism associated with a high risk of early mortality from coronary artery disease.[1] It is so common...

Emerging arboviral encephalitis: newsworthy in the West but much more common in the East.(Editorial)
December 16, 2000... Newsworthy in the West but much more common in the East The recent outbreaks of West Nile encephalitis in New York and Israel are drawing the western world's attention to the potential threat of arthropod-borne virus (arbovirus)...

Research misconduct: Britain's failure to act.(Editorial)
December 16, 2000... Act or risk losing public confidence in research More than a year ago the good and the great of British medicine assembled in Edinburgh and agreed that the time had come to act decisively on research misconduct.[1-3] Unfortunately,...

Managing chronic disease--round 2.(call for papers)(Editorial)
December 16, 2000... The 26 February 2000 issue of the BMJ was devoted to management of chronic disease. With grant support from the Robert Wood Johnson Foundation we will publish two more theme issues on this topic, one in October 2001 and another in 2002. In...

Plans for tackling research fraud may not go far enough.(News)
December 16, 2000... Caroline White London The UK government is considering giving its support to a national body to tackle misconduct in biomedical research. But members of the Committee on Publication Ethics (COPE), which was set up three years ago by...

University must tell patients that they were research "guinea pigs".(News)
December 16, 2000... Deborah Josefson New York Federal regulators have ordered officials at the University of Missouri at Columbia Medical Center to inform 78 patients who underwent heart surgery there that they were unwitting research subjects. The US...

In brief.(News)
December 16, 2000... Emergency contraception to go over the counter: From January, pharmacists in the United Kingdom will be able to dispense levonorgestrel (Levonelle-2), the emergency contraceptive pill, to women aged over 16 who have not got a prescription....

Public's satisfaction with the NHS declines.(UK National Health Service)(News)
December 16, 2000... The public's satisfaction with the NHS, usually surprisingly buoyant even in the face of cuts and shortages, has plunged in the past two years, a new Mori poll conducted on 2000 adults for the BMA says. The number of people satisfied with the...

Gut cells engineered to produce insulin.(News)
December 16, 2000... Engineering non-pancreatic cells to produce insulin in response to a glucose load may one day be a successful approach in the treatment of diabetes. Canadian scientists have now shown that cells other than [Beta] pancreatic cells can be...

Trusts must use, not just collect, clinical data.(News)
December 16, 2000... Zosia Kmietowicz London The first clinical governance reviews to come out of the Commission for Health Improvement (CHI) have shed valuable light on what to expect from an investigation by the government's clinical services watchdog. ...

Early x ray for low back pain confers little benefit.(News)
December 16, 2000... Routine early x ray examination for low back pain is expensive and confers little benefit, a new report from the Health Technology Assessment programme said last week. The report describes and analyses the first randomised controlled...

Sanctions against Iraq "double" child mortality.(News)
December 16, 2000... Roger Dobson Abergavenny Child health specialists have called for an urgent review of the sanctions against Iraq and warned that the blockade has resulted in a doubling of the death rates among children aged under 5 years. Mortality...

Patients will consult doctors through a TV screen in 2020.(News)
December 16, 2000... Patients might have their own "health biography" held in an encrypted form on the internet by the year 2020, a new report from the healthcare panel of the Foresight programme says. The programme, which was set up by the UK Department of...

Unicef calls for children to head the health agenda.(News)
December 16, 2000... Susan Mayor London The poverty and neglect still suffered by millions of children in the world is a "waste of human potential," warned an assessment of the wellbeing of children published this week by Unicef (the United National...

Calcium antagonists not best therapy for hypertension.(News)
December 16, 2000... David Spurgeon Quebec A meta-analysis of trials involving 27743 people has shown that calcium antagonists are inferior to other types of antihypertensive drugs as first line agents in reducing the risks of several major complications of...

Doctor who revealed patient details cleared by GMC.(General Medical Council)(News)
December 16, 2000... A consultant neurologist in Scotland who discussed a teenage patient with suspected Creutzfeldt-Jakob disease (CJD) in a television interview and revealed enough for a Sunday newspaper to identify her and splash her name on its front page was...

Guide to ethics of treating children published.(News)
December 16, 2000... A guide to help doctors treating children to avoid pitfalls such as those highlighted by inquiries into children's heart surgery at Bristol, organ retention at Alder Hey hospital in Liverpool, and research on babies at North Staffordshire...

Cloned chickens to help fight cancer.(News)
December 16, 2000... Bryan Christie Edinburgh The scientists who created Dolly the sheep are planning to clone a hen that can lay "golden" eggs that are rich in proteins to fight human cancer. They have announced a project aimed at breeding flocks of...

Patient dies of alternative cancer remedy.(News)
December 16, 2000... Scott Gottlieb New York A patient with cancer died of kidney and liver failure after refusing conventional treatment and taking an alternative medicine known as hydrazine sulfate, researchers have reported. According to the report,...

US doctors consider access to health care for all.(News)
December 16, 2000... Deborah Josefson New York Doctors in the United States could be required to support access to health care for everyone, if proposals currently before the American Medical Association (AMA) are passed next June. The association's...

Untying the strings.(News)
December 16, 2000... This week Clare Short, secretary for international development, launched the UK government's second white paper on globalisation and poverty. Tessa Richards talked to her about her priorities for action Clare Short is passionate that...

Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials.
December 16, 2000... Abstract Objectives To obtain reliable estimates of the effects of neuraxial blockade with epidural or spinal anaesthesia on postoperative morbidity and mortality. Design Systematic review of all trials with randomisation to...

Outcome of case finding among relatives of patients with known heterozygous familial hypercholesterolaemia.
December 16, 2000... Abstract Objectives To assess the feasibility of detecting new cases of heterozygous familial hypercholesterolaemia by using a nurse led genetic register. Design Case finding among relatives of patients with familial...

The Old Man.
December 16, 2000... You think my sons I should be more content, Rest on my honoured name, grow old with grace? You do not understand how I resent The narrow confines of life's too brief space. There are so many mountains yet to climb, And winding river valleys...

Relation between private health insurance and high rates of caesarean section in Chile: qualitative and quantitative study.
December 16, 2000... Abstract Objectives To explore the circumstances and factors that explain the association between private health insurance cover and a high rate of caesarean sections in Chile. Design Qualitative analysis of audiotaped in-depth...

Presence of relatives during testing for brain stem death: questionnaire study.
December 16, 2000... In brain stem death, where the body remains warm and pink and has a pulse and a chest that rises and falls, relatives may have difficulty accepting that the patient has died. It has been suggested that if relatives witness tests for brain...

Choosing a collaborator.
December 16, 2000... The project looked promising. We planned to determine, using a rat model, whether chemotherapy-induced damage to an endocrine gland could be modified by endocrine manipulation induced before and during chemotherapy. We had an excellent...

Qualitative study of views of health professionals and patients on guided self management plans for asthma.
December 16, 2000... Abstract Objectives To explore the views held by general practitioners, practice nurses, and patients about the role of guided self management plans in asthma care. Design Qualitative study using nine focus groups that each met on...

Always double check.
December 16, 2000... The staff in the accident and emergency department had asked for a medical opinion on the first patient of the evening. Recently arrived from west Africa, the unfortunate young man was straggling to describe his numerous symptoms to his...

Quality of web based information on treatment of depression: cross sectional survey.(Information in Practice)
December 16, 2000... Abstract Objectives To evaluate quality of web based information on treatment of depression, to identify potential indicators of content quality, and to establish if accountability criteria are indicators of quality. Design Cross...

Menopausal symptoms.(Extracts from 'Clinical Evidence')
December 16, 2000... Interventions Beneficial: Oestrogens Tibolone Likely to be beneficial: Progestogens Clonidine Unknown effectiveness: Phyto-oestrogens Testosterone Antidepressants Background Definition...

Corrections and clarifications.(Correction Notice)
December 16, 2000... Use of lipid lowering drugs for primary prevention of coronary heart disease: meta-analysis of randomised trials A confusion between US and British abbreviations for drug doses led to an error in this paper by Michael Pignone and...

Much ado about a monument.(One Hundred Years Ago)
December 16, 2000... A monument which it is proposed to erect to Tarnier, the distinguished obstetrician, is giving rise to a good deal of heart-burning in certain sections in the medical world of France. The design approved by the Committee shows in relief...

Doctors should advise adolescents to abstain from sex.(For and Against)(Education and Debate)
December 16, 2000... Against a background of high rates of teenage pregnancy and an increasing prevalence of sexually transmitted infections, the sexual conduct of young people is vigorously debated. Many teenagers later say that they had sexual intercourse "too...

An integrated national pharmaceutical policy for the United Kingdom?(Education and Debate)
December 16, 2000... The UK government wishes to have "joined up" policies to integrate areas such as health and social care. Although many of these policies impinge on pharmaceuticals (box below), there is no coherent, integrated, national pharmaceutical policy....