British Medical Journal articles from February 1999

British Medical Journal archives from February 1999

Government sets up inquiry into ventilation trial.
February 27, 1999... An inquiry has begun into research conducted at the North Staffordshire Hospital after parents alleged that they were misled into consenting to experimental treatment for their premature babies. A new type of ventilator was tested between...

GMC advises doctors on seeking consent.
February 27, 1999... The UK General Medical Council (GMC) has issued advice for doctors on seeking patients' consent. The new guidance, prepared by the GMC's standards committee, discusses the ethical issues that doctors should consider before, during, and...

Sacked editor takes new post.
February 27, 1999... Dr George Lundberg, who was fired after 17 years as editor of JAMA (the journal of the American Medical Association), has been named editor in chief of Medscape, a leading internet site. He told the BMJ he is considering "creation of a...

Newborns prescribed drugs only tested in adults.
February 27, 1999... Many of the drugs used to treat neonates and children have been tested only in adults, forcing doctors and pharmacists to calculate the appropriate, safe doses themselves, new research shows. Ninety per cent of patients in a neonatal...

Scientists try new strategy to eradicate dengue fever.
February 27, 1999... A new programme, sponsored by the governments of the United Kingdom and Australia, has been successful in reducing the risk of dengue fever in parts of Vietnam. The Australian Foundation for the Peoples of Asia and the Pacific, an aid...

New guidelines for mild hypertension published.
February 27, 1999... Revised guidelines on treating patients with mild hypertension have been drawn up by the World Health Organisation and the International Society of Hypertension. The main recommendations of the guidelines, which update those issued in...

Primary care trusts will have wide powers.
February 27, 1999... Primary care trusts, which will be set up in England under the Health Bill now going through parliament, will have wide ranging powers. Whereas primary care groups are committees of health authorities, primary care trusts will be free...

Quebec faces severe pressure on casualty departments.
February 27, 1999... Quebec's provincial government is injecting $C20m (48m [pounds sterling]; $77m) into its hospitals as a short term measure to help solve the worst emergency room overcrowding crisis in recent memory. That's $C5m more than the health and...

Price of some drugs in Hungary to rise 30% for patients.
February 27, 1999... Patients taking prescription drugs in Hungary are facing a double blow: domestic manufacturers are raising their prices by 10%, and the government is cutting its subsidies to consumers. Certain medicines will be put out of reach of...

Abuse of OTC drugs rising in South Asia.
February 27, 1999... Pharmaceutical preparations available without prescriptions (over the counter drugs) have emerged as drugs of serious misuse across India, Bangladesh, and Nepal, a report released last week in New Delhi warned. The report from the United...

New malaria vaccine shows promise.
February 27, 1999... An experimental malaria vaccine designed to protect the host from each stage of the parasite's life cycle has shown promise in animal trials (Proceedings of the National Academy of Sciences 1999;96:1615-20). Researchers from the US...

Staphylococcus resistant to vancomycin emerges.
February 27, 1999... Researchers have reported the first three cases in the United States of infections caused by Staphylococcus aureus bacteria resistant to vancomycin, an antibiotic often reserved to fight these infections when no other agent is effective. ...

Scottish white paper aims to tackle health divide.
February 27, 1999... A sustained attack on inequality, social exclusion, and poverty is promised in a government white paper on public health in Scotland which identifies these factors as the root causes of much of the country's ill health. Although there...

"Unprecedented" row delays second phase of BSE inquiry.
February 27, 1999... Witnesses at the inquiry into bovine spongiform encephalopathy claim procedures are unfair. Will the Bristol inquiry adopt the same methods, and will witnesses again cry foul? Sparks have been flying behind the scenes at the inquiry into...

Risk of testicular cancer in subfertile men: case-control study.
February 27, 1999... Abstract Objective To evaluate the association between subfertility in men and the subsequent risk of testicular cancer. Design Population based case-control study. Setting The Danish population. Participants Cases were...

Corrections.(To "Recent Advances: Neurosurgery" in January 2, 1999 issue, pp 35-8.)(To "Obituary - Dr. Leslie Ely ("Peter") Lucas" in January 16, 1999 issue, p 198.)(To "Smoking cessation: evidence based recommendations for the healthcare system" in January 16, 1999 issue, pp 182-5.)
February 27, 1999... Recent advances: Neurosurgery In this article by Michael Powell (2 January, pp 35-8) reference 11 was incorrect and should have read: Powell MP, Torrens MJ, Thompson JLG, Horgan JG. Isodense colloid cysts of the third ventricle. A...

Analysis of Chinese herbal creams prescribed for dermatological conditions.
February 27, 1999... Abstract Objective To determine whether Chinese herbal creams used for the treatment of dermatological conditions contain steroids. Design 11 herbal creams obtained from patients attending general and paediatric dermatology...

Increased risk of irritable bowel syndrome after bacterial gastroenteritis: cohort study.
February 27, 1999... Evidence exists of an increased risk of irritable bowel syndrome after an episode of bacterial gastroenteritis.[1 2] In one study, 12 out of 38 patients presented with bowel dysfunction 1 year after salmonella gastroenteritis.[1] In another...

Cross sectional study of social variation in use of an out of hours patient transport service.
February 27, 1999... Out of hours primary care has undergone radical reorganisation in recent years, with increasing numbers of general practitioner cooperatives operating from primary care emergency centres.[1] A major issue continues to be equity of access,...

Trend analysis of socioeconomic differentials in deaths from injury in childhood in Scotland, 1981-95.
February 27, 1999... Injuries are a leading cause of death and disability among children in the United Kingdom, costing an estimated 200 million [pounds sterling] annually in direct costs to the NHS.[1] Recent research from England and Wales suggests that death...

Routine screening of children returning home from the tropics: retrospective study.
February 27, 1999... Parents who move to the tropics with their children often worry about tropical diseases. Most of the data available on screening children returning home from living in the tropics are from 1952-63 from American children.[1] More recent...

The bicycle and diseases of women.
February 27, 1999... Few persons deny that moderate exercise with the bicycle is excellent for healthy young women, but in the case of women suffering from pelvic disease the case is different. The matter has recently been discussed at a medical congress at...

Double blind, cluster randomised trial of low dose supplementation with vitamin A or [Beta] carotene on mortality related to pregnancy in Nepal.
February 27, 1999... Abstract Objective To assess the impact on mortality related to pregnancy of supplementing women of reproductive age each week with a recommended dietary allowance of vitamin A, either preformed or as [Beta] carotene. Design Double...

Influence of symptoms of anxiety on treatment of depression in later life in primary care: questionnaire survey.
February 27, 1999... While studies of the prevalence of major depressive disorders in elderly people have produced rates of 1% to 2%, depression that is clinically significant has been shown to have a prevalence of at least 10% among older people and represents...

There's nothing really new.
February 27, 1999... Once upon a time a King had a little daughter for whom he would do anything. She wanted an apple made of pure gold, and because he was rich he had one made for her. The princess wanted a pony with a coat of the purest white and because he was...

Genetically modified foods.
February 27, 1999... The use of genetic modification in food production is proving contentious and attracting much media coverage. Despite this, it can be difficult for anyone not directly involved to know how to obtain hard facts. Genetically modified foods...

A happy coincidence.
February 27, 1999... In the mid-1960s I worked on St Helena. At that time mail came at regular but infrequent intervals on the Union Castle Line ships, which than had the mail contract between the United Kingdom and South Africa. The BMJ arrived at about six...

Restrictive-constrictive heart failure masquerading as liver disease.
February 27, 1999... The clinical features of restrictive or constrictive heart disease can be non-specific,[1 2] and this may delay diagnosis. We describe three patients with heart disease whose initial presentation led to a wrong diagnosis of primary hepatic...

Our own way.(poem)
February 27, 1999... Go to the people Live with them Learn from them, Love them. Start with what they know, Build with what they have. But with the best leaders When the work is done the task is accomplished ...

Sexual problems associated with infertility, pregnancy, and ageing.
February 27, 1999... Sexuality and infertility Infertility may interact with a couple's or individual's sexuality and sexual expression in two main ways. Sexual problems may be caused or exacerbated by the diagnosis, investigation, and management of...

Health, health promotion, and homelessness.
February 27, 1999... Contemporary health promotion emphasises the concepts of lifestyle, risk, and preventive health behaviour alongside the broader societal Concerns of the environment, public policy, and culture.[1] The recent green paper Our Healthier Nation...

Unerring trust.
February 27, 1999... Mine is a rural practice in north Yorkshire, spanning over 20 villages. Needless to say, we have several branch surgeries, each of which has a different social grouping and a character of its own. Close to one distant surgery was a piece of...

Developing guidelines.
February 27, 1999... The methods of guideline development should ensure that treating patients according to the guidelines will achieve the outcomes that are desired. This article presents a combination of the literature about guideline development and the...

Patients not protocols.
February 27, 1999... "Dear Dr Elizabeth, "I am returning the Lipitor tablets as well as the Zocor. I take them about 3.0 p.m.; the first 2 days they did not have much effect, but on Thursday I had some aches and pains and wobbles and on Friday 1 did not know...

Call to needle times after acute myocardial infarction.
February 27, 1999... Delay in calling for help for chest pain EDITOR--We agree with the central message of Rawles et al's article, that for patients with acute myocardial infarction the first medical attendant has the ideal opportunity to provide early...

Advertising by pharmaceutical companies in eBMJ.
February 27, 1999... The issue should be debated properly EDITOR--It is regrettable that the BMJ has taken the decision to accept advertising from the pharmaceutical industry on its website. This will serve only to undermine the spirit and intended practice...

Sentinel node biopsy in breast cancer.
February 27, 1999... Effect on patients must be considered EDITOR--Careful consideration needs to be given to the implications for breast cancer patients from the use of the unevaluated technique of sentinel node biopsy.[1] Ideally, clinical trials to refine...

Women remain confused about breast cancer.
February 27, 1999... EDITOR--Lavelle and Charlton correctly identify the need for a new baseline of women's views on breast cancer.[1] A clear understanding of the fears and myths associated with the condition is useful to doctors and forms a critical component...

White paper on tobacco takes a laudable stance.
February 27, 1999... EDITOR--Whatever the domestic health impact of Britain's new white paper on tobacco,[1] it will resonate loudly and positively around the world. The United Kingdom has done what few countries have done to date--it has formally recognised the...

Paying for nicotine replacement therapy is cheaper than smoking [is less than or equal to] 20 cigarettes a day.
February 27, 1999... EDITOR--Fowler and Smeeth propose making nicotine replacement therapy available on the NHS, believing its high retail price remains prohibitive to many people.[1] A typical eight week course of patches of 21 mg/24 h bought from a pharmacy...

Appearance of the hymen in adolescents is not well documented.
February 27, 1999... EDITOR--As forensic paediatricians, we concur with Rogers and Stark's emphasis on the need for education about the nature of the hymen in postpubertal women.[1] Ten of the 20 women described by Logmans et al had been sexually abused.[2] The...

Role of conventional ovarian screening is questioned.
February 27, 1999... EDITOR--It is heartening to read Roylance and Waxman's personal view of cancer screening.[1] They say that current screening schedules are predominantly subjective and are heavily based on individuals' interpretation, and proposed that we...

Perinatal death associated with planned home birth in Australia.
February 27, 1999... Home births are not justified in Australia EDITOR--Bastian et al report the risk of perinatal death associated with planned home birth in Australia.[1] I have been criticising the role of home births in Queensland for the past two years,...

Obituaries.
February 27, 1999... Charles Nathaniel ("Natty") Armstrong Consultant physician Royal Victoria Infirmary, Newcastle upon Tyne, 1931-62 (b Newcastle upon Tyne 1897; q Durham 1921; MD, FRCP), d 19 December 1998. He served as a surgical sublieutenant in the...

Consultants object to government's action.
February 27, 1999... The chairman of the BMA's Central Consultants and Specialists Committee has written to all consultants in the United Kingdom pointing out that the government has singled out consultants from all other groups in the public sector by declining...

BMA seeks amendments to Health Bill.
February 27, 1999... The BMA has been putting down amendments for the committee stage of the Health Bill, which started in the House of Lords this week. It has been working closely with the General Medical Council and other regulatory bodies to ensure that the...

Casualty departments to get facelift.
February 27, 1999... A 30m [pounds sterling] programme to refurbish one third of hospital casualty traits in England in the next 12 months was initiated last week. The money will be spent on 80 schemes in 67 casualty departments. In addition the Department of...

Campaign will raise awareness about suicide.
February 27, 1999... The number of young men who killed themselves between 1980 and 1992 rose by 80%. The Doctor Patient Partnership has linked up with the Men's Health Forum and the Samaritans to raise awareness of the problems facing young men and to encourage...

BMA NOTICES.
February 27, 1999... Change in rifle of division Notice is hereby given that, with effect from 27 March 1999, the Burton on Trent Division of the BMA will be known as the Burton and District Division. Any member objecting to the above proposal is requested...

Publishing Your Medical Research Paper: What They Don't Teach You in Medical School.
February 27, 1999... Publishing Your Medical Research Paper: What They Don't Teach You in Medical School Daniel W Byrne Lippincott Williams and Wilkins, 16.95 [pounds sterling], pp 288 ISBN 0683 300 741 Rating * Nothing makes my toes curl more than...

Electronic DTB, eBNF/eMeReC.
February 27, 1999... Electronic DTB, eBNF/eMeReC Available from Consumers' Association, 65 [pounds sterling] for single user, 110 [pounds sterling] for two to five users Rating: *** as a book, ** as an electronic information source Electronic...

Hot potato.
February 27, 1999... The genetically modified food fandango has been a lesson in confusion. According to the Guardian on 20 February, over 1900 column inches had been published that week on the subject, and many more followed. Within a single week the spectre of...

WEBSITE OF THE WEEK.
February 27, 1999... www.netlink.de/gen/home.html Biotechnology companies trying to introduce genetically modified food into Europe have found themselves up against well organised resistance. The battle for minds and stomachs continues, and on the internet the...

A sacrificial lamb.
February 27, 1999... The General Medical Council's press release of 10 December 1998 told the waiting public of the case of the first doctor who had been suspended by the GMC because of incompetence (2 January, p 2). This unfortunate doctor was a general...

NETLINES.
February 27, 1999... * An informative site on osteoporosis is located at http://www.osteovision.ch, and interested researchers will find many of the site's services helpful. It has a large, searchable database of workers in the specialty, details of forthcoming...

Conferences should be held where the problems are.
February 27, 1999... It is not often that I receive an invitation to attend an international conference. We who labour in the remote outposts of poor countries are hardly top of the list of likely candidates for such meetings. And, let me be honest, it is not a...

Smug.
February 27, 1999... "OK, OK, send her in and we'll take a look at her" said the senior house officer, his tone pregnant with studied insolence, as if he was talking to a mentally defective child of 2. "Don't patronise me, you smug little shift," I felt like...

Minerva.
February 27, 1999... Minerva was surprised to see a paper on asthma trends in a journal on infectious diseases (Eurosurveillance 1999;4:21-4). The editors explain, however, that respiratory viruses trigger asthma in susceptible individuals, making asthma research...

Descriptive study of cooperative language in primary care consultations by male and female doctors.
February 27, 1999... Abstract Objective To compare the use of some of the characteristics of male and female language by male and female primary care practitioners during consultations. Design Doctors' use of the language of dominance and support was...

$50m record damages awarded against tobacco company.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... A terminally ill former smoker was awarded $50m (31.25m [pounds sterling]) punitive damages against Philip Morris, the United States's largest tobacco company last week. Lawyers for the company have said that they would appeal. The...

English judge rules that smokers' claims are "too late".(News)(Brief Article)(Statistical Data Included)
February 20, 1999... The litigation by a group of people with lung cancer against two British tobacco companies was dealt a severe blow in the High Court last week. The High Court ruling in nine "lead" cases probably means that 36 of the 52 plaintiffs are...

In brief.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... Polio can be eliminated in two years: With a forceful vaccination campaign poliomyelitis can be eradicated within two years, according to the World Health Organisation's director general, Dr Gro Harlem Brundtland. She said that $370m (230m...

All UK doctors to be required to prove competence.(News)(Statistical Data Included)(Brief Article)
February 20, 1999... All doctors in the United Kingdom will be required to prove that they are competent, that their skills are up to date, and that they are willing to undergo continued monitoring of their skills if they wish to continue practising medicine,...

Minister to look again at NHS bill's threat to GMC.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... British doctors' concerns about government interference with the current system of professional self regulation by the General Medical Council were voiced during the second reading of the Health Bill in the House of Lords last week. The...

Scientists call for moratorium on genetically modified foods.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... A group of scientists from 13 countries has supported calls for a moratorium on the release of genetically modified foods after endorsing unpublished research that has raised fears of potential health hazards. The British government has...

Microscopic changes may double risk of breast cancer.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... Scientists have determined that a microscopic change in breast tissue may double the risk of breast cancer in some women. This finding may provide a way for doctors to evaluate the subsequent risk of breast cancer among women with otherwise...

NHS pay structure to be overhauled.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... Pay systems for staff in the NHS across the United Kingdom are to change radically under reforms initiated by the government last week, though it anticipates a long and difficult process of negotiation. According to a proposal document,...

Israel prepares for "Jerusalem syndrome".(News)(Brief Article)(Statistical Data Included)
February 20, 1999... Israel's mental health services met recently to prepare for a major increase in the "Jerusalem syndrome," with the expected increase in visitors to the Holy Land at the start of the next millennium. The temporary psychiatric...

Three women win in cancer screening case.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... Three women who launched High Court compensation claims over Britain's worst case of cervical screening blunders won a ruling this week that they were victims of medical negligence. Judge John Peppitt QC, sitting as a High Court judge in...

Beijing conference reviews Kashin-Beck disease.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... Life is hard for Tibetan farmers in the impoverished, remote regions of the Himalayan plateau, and a little understood, disabling osteoarticular disorder--Kashin-Beck disease--is causing even greater economic difficulties for some rural...

English prison doctor struck off.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... A retired prison doctor was struck off the UK medical register last week for prescribing lethal doses of methadone to two prisoners without checking their medical history. The General Medical Council found Dr Archibald Alexander, aged 63,...

Legal suit over Norplant collapses.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... A compensation claim by 275 British women over alleged side effects of the contraceptive implant Norplant has collapsed after the Legal Aid Board withdrew funding. The claim against Hoechst Marion Roussel, the UK distributors of...

Preventing sexually transmitted diseases may not reduce HIV risk.(News)(Statistical Data Included)(Brief Article)
February 20, 1999... A Ugandan project designed to prevent sexually transmitted diseases (STD) has shown no reduction in the risk of HIV-1 transmission, according to results published last week that conflict with previous studies. Researchers working in the...

Bristol parents protest over removal of hearts.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... The United Bristol Healthcare Trust was this week in talks with parents over the future of 180 hearts removed during post-mortem examinations. The hearts were taken from children who died after surgery between 1976 and 1995. Some of the...

Bristol chief executive appeals against GMC.(News)(Brief Article)(Statistical Data Included)
February 20, 1999... Dr John Roylance, former chief executive of the NHS trust at the centre of the inquiry into paediatric heart surgery in Bristol, accused the president of the General Medical Council, Sir Donald Irvine, of bias last week as he launched an...

Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women.(Statistical Data Included)
February 20, 1999... Abstract Objective To compare the effect of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment for genuine stress incontinence. Design Stratified, single blind, randomised controlled trial. Setting...

Assessment of competence to complete advance directives: validation of a patient centred approach.(Statistical Data Included)
February 20, 1999... Abstract Objective To develop a patient centred approach for the assessment of competence to complete advance directives ("living wills") of elderly people with cognitive impairment. Design Semistructured interviews. Setting...

Database study of antibiotic resistant tuberculosis in the United Kingdom, 1994-6.(Education and Debate)(Statistical Data Included)
February 20, 1999... The global increase in tuberculosis which has occurred in the 1980s and 1990s, and the associated re-emergence of resistance to antituberculous drugs, has focused attention on recent trends in resistance in Europe and the United States.[1-3]...

Correction.(To: "Preventing fatal diseases increases healthcare costs: cause elimination life table approach" in vol 316, pp 26-9)(Statistical Data Included)(Brief Article)
February 20, 1999... Preventing fatal diseases increases healthcare costs: cause elimination life table approach An error occurred in this paper by Luc Bonneux and colleagues (volume 316, pp 26-9). In the table, allocated costs should have been in 1m [pounds...

Two case reports of possible noise trauma after inflation of air bags in low speed car crashes.(Statistical Data Included)(Brief Article)
February 20, 1999... Air bags have contributed substantially to the safety of car occupants in road accidents, but concern exists that they may inflate unnecessarily in low speed crashes.[1] Previous articles have reported eye, face, upper limb, and chest...

Questionnaire survey of advice given to patients with fractures.(Statistical Data Included)(Brief Article)
February 20, 1999... Osteoporosis, which contributes to some 150 000 fractures annually, cost the NHS 750 million [pounds sterling] in 1994,[1] and current estimates exceed this figure. Department of Health guidelines on osteoporosis published in November 1994[1]...

Cataract extraction in a lioness.(One Hundred Years Ago)(Statistical Data Included)(Brief Article)
February 20, 1999... Professor Gustavo Pisenti, of the University of Perugia, has lately had a thrilling experience in extracting a cataract from a powerful lioness about three years old. The animal was placed in a suitable cage in the middle of the menagerie,...

Symptomatic gastro-oesophageal reflux disease: double blind controlled study of intermittent treatment with omeprazole or ranitidine.
February 20, 1999... Abstract Objective To assess intermittent treatment over 12 months in patients with symptomatic gastro-oesophageal reflux disease. Design Randomised, multicentre, double blind, controlled study. Patients with heartburn and normal...

Randomised controlled trial of effect of feedback on general practitioners' prescribing in Australia.
February 20, 1999... Abstract Objective To evaluate the effect on general practitioners' prescribing of feedback on their levels of prescribing. Design Randomised controlled trial. Setting General practice in rural Australia. Participants 2440...