British Medical Journal articles from February 2000

British Medical Journal archives from February 2000

British tobacco company denies "orchestrating smuggling".(News)(Brief Article)(Statistical Data Included)
February 26, 2000... British American Tobacco (BAT), Britain's largest tobacco company, was "orchestrating, managing, and controlling cigarette smuggling in Asia and Latin America in the early 1990s," it was alleged in the House of Commons. The accusation...

Paediatricians "close to despair" over child protection laws.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... The Children Act is failing to protect children from severe abuse and neglect, according to a new study. This finding comes a week after the north Wales abuse tribunal's report showed the huge scale of suffering endured by children in care...

In brief.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... NHS chief executive resigns: Sir Alan Langlands, chief executive of the NHS in England since 1994, will leave the post at the end of August to become principal and vice chancellor of the University of Dundee. The shadow health secretary, Liam...

UK home secretary faces new problems over Pinochet.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... The UK home secretary, Jack Straw, has been urged by Switzerland not to block the extradition of the former Chilean dictator, Augusto Pinochet, claiming that the state of a person's health is no bar to extradition under international...

Screening changes recommended for osteoporosis and diabetes.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... Two new studies have recommended changes in the way that doctors screen for some of the most common and debilitating complications of two chronic and progressive diseases, osteoporosis and type 2 diabetes mellitus. In the first study,...

Albumin industry launches global promotion.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... The plasma products industry has launched a 1.4m [pounds sterling] ($2.2m) international programme to promote albumin despite recent official advice to restrict its use to very limited indications. Albumin use has declined substantially...

Britain's health league table attacked.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... A league table that ranked Manchester's health services as the worst in Great Britain, and Oxfordshire's as the best, has been condemned as misleading by NHS management leaders. The comparative survey of the 120 health authorities or boards...

Hospital infection rates in England out of control.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... The NHS in England could save an estimated 150m [pounds sterling] ($240m) and many hundreds of lives by tightening hygiene rules in hospitals and investing in infection control, according to the spending watchdog the National Audit Office....

Donors and relatives must place no conditions on organ use.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... Patients and relatives will be unable to impose any conditions on the use of donated organs under new rules due to be introduced by the UK government. The previous health secretary, Frank Dobson, ordered an inquiry in July 1999 after a...

Gynaecologist cleared in hysterectomy case.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... A consultant gynaecologist was cleared last week of serious professional misconduct after he admitted removing a patient's ovaries without her consent. Ian Fergusson, a consultant at Guy's and St Thomas's Hospital in London, admitted...

Spain's home healthcare programme goes nationwide.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... The Spanish health ministry is to extend nationwide a new service that has already improved the treatment and support of thousands of elderly, chronically ill patients at home. The service, delivered by multidisciplinary home healthcare...

British Columbia blocks tobacco move.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... The health charity Physicians for a Smoke-Free Canada has criticised the British Columbian government for refusing to release incriminating tobacco industry documents to the health community. The campaigning group argues that the papers were...

Cyanide spill threatens health in Hungary.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... A cyanide spill has rendered Hungary's second longest waterway, the Tisza River, "dead for years to come" and may threaten human health, government officials have warned. The spill occurred on 30 January at the Aurul precious metals...

Cirrhosis may be amenable to telomerase treatment.(News)(Brief Article)(Statistical Data Included)
February 26, 2000... The urgent need for liver transplantation in acute liver failure may be deferred by the findings of researchers in Boston, Massachusetts. Professor Ron DePinho and his team have been looking at ways to prolong the lives of people waiting for...

Painkillers "may need to be sex specific".(News)(Brief Article)(Statistical Data Included)
February 26, 2000... People who constantly complain about their agonising pain are probably telling the truth, according to Professor Jeffrey Mogil of the University of Illinois. He told the American Association for the Advancement of Science in Washington DC...

Correction.(To "Women taking combination HRT are at a greater risk of breast cancer," in February 5, 2000 issue, p 333)(Brief Article)(Statistical Data Included)
February 26, 2000... Women taking combination HRT are at greater risk of breast cancer Owing to an error in the editing of this article (5 February, p 333), it was stated that women in the trial on hormone replacement therapy received oestrogen and progesterone,...

Systematic reviews and meta-analyses on treatment of asthma: critical evaluation.(Statistical Data Included)
February 26, 2000... Abstract Objective To evaluate the clinical, methodological, and reporting aspects of systematic reviews and meta-analyses on the treatment of asthma and to compare those published by the Cochrane Collaboration with those published in...

Qualitative study of interpretation of reassurance among patients attending rheumatology clinics: "just a touch of arthritis, doctor?".(Statistical Data Included)
February 26, 2000... Abstract Objectives To examine commonly used methods of reassurance by clinicians and explore their effect on patients. Design Qualitative study of tape recordings of in-depth, semistructured interviews with patients before and after...

Open access follow up for inflammatory bowel disease: pragmatic randomised trial and cost effectiveness study.(Statistical Data Included)
February 26, 2000... Abstract Objective To evaluate whether follow up of patients with inflammatory bowel disease is better through open access than by routine booked appointments. Design Pragmatic randomised controlled trial. Setting Two district...

Machiavelli on clinical management.(Statistical Data Included)
February 26, 2000... He who neglects what can be done for what ought to be done, sooner effects his ruin than his preservation. Machiavelli Submitted by David Stone, consultant cardiologist, Papworth Everard, Cambridgeshire

Five year follow up of a randomised controlled trial of a stroke rehabilitation unit.(Statistical Data Included)
February 26, 2000... Caring for stroke patients in stroke units, compared with other hospital locations, leads to decreased mortality and disability at one year.[1] A trial of a combined acute and rehabilitation ward in Trondheim, Norway, showed that hospital...

Randomised trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care.(Statistical Data Included)
February 26, 2000... Abstract Objective To test the effectiveness of two programmes to improve the treatment of acute depression in primary care. Design Randomised trial. Setting Primary care clinics in Seattle. Patients 613 patients starting...

Management of chronic uveitis.(Clinical Review)(Statistical Data Included)
February 26, 2000... To many, uveitis is an acute problem that resolves after treatment with topical corticosteroids. While this may be true of acute anterior uveitis, many forms of uveitis are chronic in nature and often require continuous treatment. The uveitis...

Acute and chronic management strategies.(Clinical Review)(Statistical Data Included)
February 26, 2000... Acute and chronic management strategies in heart failure are aimed at improving both symptoms and prognosis, although management in individual patients will depend on the underlying aetiology and the severity of the condition. It is...

Disease management in the American market.(Statistical Data Included)
February 26, 2000... In developed nations, the care of people with chronic disease consumes a large portion of the total expenditure on health. Yet chronic disease is often poorly treated and inadequately prevented. Disease management was introduced in the 1990s...

Commercial partnerships in chronic disease management: proceeding with caution.(Statistical Data Included)
February 26, 2000... The spirit of "new Labour" strongly supports efforts to align commercial and NHS interests. The use of private funding for capital projects, such as building hospitals, is now well established, although this practice is not without...

The role of patient care teams in chronic disease management.(Statistical Data Included)
February 26, 2000... "In the gradual division of labor, by which civilization has emerged from barbarism, the doctor and nurse have been evolved" Sir William Osier (1891) The delivery of health care by a coordinated team of individuals has always been...

Management of chronic disease by practitioners and patients: are we teaching the wrong things?(Statistical Data Included)
February 26, 2000... The patient should be the primary manager of chronic disease, guided and coached by a doctor or other practitioner to devise the best therapeutic regimen.[1] The practitioner and patient should work as partners,[2] developing strategies that...

A memorable patient Fascinating rhythm.(Statistical Data Included)(Brief Article)
February 26, 2000... A pianist in the Bill Evans style, he is a respected figure on the London jazz scene. His earliest icon was George Shearing, whom he heard as a teenager, but among his strongest influences were Horace Silver and Thelonius Monk. Like many of...

Obituaries.(Statistical Data Included)(Brief Article)
February 26, 2000... Richard Stuart Atkinson Honorary consultant anaesthetist Southend-on-Sea and former vice dean of the Faculty (now Royal College) of Anaesthetists (b Yorkshire 1927; q Cambridge/St Bartholomew's 1951; FRCA; OBE), d 3 January 2000. Dick...

PM will address GPs' conference.(Medicopolitical Digest)(Statistical Data Included)(Brief Article)
February 26, 2000... The prime minister, Tony Blair, has agreed to take part in the GPC Conference 2000 in Harrogate next month and to answer questions via a live video link. The health secretary, Alan Milburn, has agreed to give the keynote address at the...

GPs agree that urgent action is needed after Shipman case.(Medicopolitical Digest)(Statistical Data Included)(Brief Article)
February 26, 2000... The General Practitioners Committee has welcomed the government's announcement of an inquiry into the case of Harold Shipman, who was convicted of murdering 15 patients (5 February, p 331). A GP will be on the inquiry and there has also been...

WMA begins consultation on Declaration of Helsinki.(Medicopolitical Digest)(Statistical Data Included)(Brief Article)
February 26, 2000... The World Medical Association has embarked on a worldwide public consultation exercise on the revision of the Declaration of Helsinki, which seeks to protect patients involved in biomedical research. The declaration was drawn up in 1946...

Incontinence.(Statistical Data Included)(Brief Article)(Review)
February 26, 2000... Incontinence Eds Malcolm Lucas, Simon Emery, John Beynon Blackwell Science, 69.50 [pounds sterling], pp 384 ISBN 0 632 05003 9 Rating: **** The idea that there are boundary walls in the pelvis labelled "urology" I gynaecology,"...

Schizophrenia: Concepts and Clinical Management.(Statistical Data Included)(Brief Article)(Review)
February 26, 2000... Schizophrenia: Concepts and Clinical Management Eve C Johnstone, Martin S Humphreys, Fiona H Lang, Stephen M Lawrie, Robert Sandier Cambridge University Press, 45 [pounds sterling], pp 271 ISBN 0 521 58084 6 Rating: ** ...

Handbook for Mortals: Guidance for People Facing Serious Illness.(Statistical Data Included)(Brief Article)(Review)
February 26, 2000... Handbook for Mortals: Guidance for People Facing Serious Illness Joanne Lynn, Joan Harrold Oxford University Press, 14.99 [pounds sterling], pp 256 ISBN 019 511662 3 Rating:**** A hundred years ago most adults died quickly...

Epilepsy: Problem Solving in Clinical Practice.(Statistical Data Included)(Brief Article)(Review)
February 26, 2000... Epilepsy: Problem Solving in Clinical Practice Dieter Schmidt, Steven C Schachter Martin Dunitz, 49.95 [pounds sterling], pp 489 ISBN 1 85317 504 8 Rating: *** I enjoyed reading Epilepsy. Although we now understand epilepsy and...

Hit Parade.(Most frequently read articles on web site)(Statistical Data Included)(Brief Article)
February 26, 2000... JANUARY 1 ABC of heart failure: Pathophysiology 2000;320:167-70 57 762 hits 2 Science, medicine, and the future: Allergic disorders 2000;320:231-4 53 932 hits 3 ABC of heart failure: Aetiology 2000;320:104-7 48 286...

Tuning Into Children.(Statistical Data Included)(Brief Article)
February 26, 2000... Tuning Into Children, BBC Radio 4, Wednesdays at 11 am, 26 January to 1 March Radio 4's daytime programming is a curious mix of arts and sciences: intellectual debate is interspersed with poetry and jazz, information and entertainment go...

WEBSITE OF THE WEEK.(Statistical Data Included)(Brief Article)
February 26, 2000... Disease management Those of us who look on in bewilderment at the US ability to commercialise anything will find such brash commercial solutions for human suffering as disease management distasteful. This week's BMJ carries a critique of the...

Facing the challenges of long term care.(Statistical Data Included)(Brief Article)
February 26, 2000... I grew up in the United States thinking that Britain was the most caring country in the world because the NHS provided free health care to everyone regardless of race, creed, age, or financial circumstances. I worked in the finest hospitals...

And how is sir today?(Statistical Data Included)(Brief Article)
February 26, 2000... A long time ago, when I was a lean young surgeon lieutenant drifting agreeably on locum duties through a series of naval ships and establishments, the calm of the sickbay would be ruffled from time to time by the arrival of a patient of the...

Minerva.(Statistical Data Included)(Brief Article)
February 26, 2000... Earlier this year Minerva mentioned two Israeli doctors who said chicken soup should be classed as a drug. Cynics who want hard evidence of benefit will be interested in an almost forgotten controlled trial of chicken soup published by Chest...

Government inquiry finds inadequate beds provision.(News)
February 19, 2000... The fall in the number of hospital beds in England over the past 40 years has left the NHS unable to cope with healthcare needs, and a "radically different approach" is needed to managing care, according to a consultation document from the...

In brief.
February 19, 2000... Police investigate GP: South Yorkshire police are to investigate deaths of patients of retired Doncaster GP Robert Dickson, aged 74, over 20 years of practice. The inquiry was sparked by a phone call by his estranged wife to a television chat...

Police question medical MP over "euthanasia".(News)
February 19, 2000... Police are to hold a murder inquiry into the case of a doctor MP who mentioned during a parliamentary debate that he had withdrawn treatment from a 2 year old boy with leukaemia at the parents' request to save him any more distress. ...

Clinic sued for unauthorised use of sperm.(News)
February 19, 2000... The London Gynaecology and Fertility Centre, run by the infertility specialist Ian Craft, last week settled a unique High Court claim by an Austrian businessman that the clinic used his semen without his consent. Michael von Schonburg...

Senators introduce bill to improve patient safety.(News)
February 19, 2000... Two US senators are introducing a bill to improve patient safety, following the publication last November of a report from the Institute of Medicine of the National Academy of Sciences, which claimed that medical errors kill from 44 000 to 98...

Doctor's book shames French prisons.(News)
February 19, 2000... The publication last month of the diary of a prison doctor has shocked the French public and prompted parliament to vote unanimously to create a commission to investigate "in depth" the living conditions of prisoners and working conditions of...

GMC speeds up disciplinary action against doctors.(General Medical Council)(News)
February 19, 2000... The General Medical Council is seeking to reform its disciplinary procedures, following four years of internal discussions. Among the council's proposals are new powers to suspend doctors from the medical register during police...

GMC reprimands doctor for denigrating rival's service.(General Medical Council)(News)
February 19, 2000... The head of gastroenterology at Bath's Royal United Hospital was found guilty of serious professional misconduct and reprimanded by the General Medical Council last week for unjustifiably casting doubt on the results of a rival endoscopy...

Bristol inquiry hears closing submissions.(News)
February 19, 2000... The inquiry into children's heart surgery services at the Bristol Royal Infirmary was urged last week to ask the General Medical Council to re-examine its "flawed conclusions" that three doctors were guilty of serious professional misconduct....

Heart disease rising in central and eastern Europe.(News)
February 19, 2000... Europe's policymakers are being asked to make improvements in cardiovascular health a major political priority as evidence emerges of the spread of heart disease across social and geographical boundaries. Cardiovascular disease is already...

Clinton outlaws genetic discrimination in federal jobs.(News)
February 19, 2000... President Clinton has signed an executive order forbidding the US federal government from using genetic information in employment decisions. The order, which is effective immediately, protects all 2.8 million federal employees from genetic...

Nestle accused of breaking international code.(News)
February 19, 2000... A former employee of Nestle, Syed Aamar Raza, has publicised internal company documents that he says provide evidence that the company has breached the international code on marketing breast milk substitutes (BMJ 1997;314:165). The...

Additives may be displayed on cigarette packs.(News)
February 19, 2000... Cigarette manufacturers in Europe may be forced to display a list of then products' top 10 additives on the side of then packets. Giving evidence to the House of Commons health select committee last week, the health secretary, Alan Milburn,...

Extent and determinants of error in doctors' prognoses in terminally ill patients: prospective cohort study.
February 19, 2000... Abstract Objective To describe doctors' prognostic accuracy in terminally ill patients and to evaluate the determinants of that accuracy. Design Prospective cohort study. Setting Five outpatient hospice programmes in Chicago....

The scars of the Jewish holocaust.(A memorable patient)
February 19, 2000... Although the holocaust of the Jewish people ended officially more than 50 years ago, the scars of that atrocity can be seen to this day. A 72 year old woman, married without children, came to the emergency room with abdominal pain that had...

Factors influencing the effect of age on prognosis in breast cancer: population based study.
February 19, 2000... Abstract Objective To investigate whether young age at diagnosis is a negative prognostic factor in primary breast cancer and how stage of disease at diagnosis and treatment influences such an association. Design Retrospective cohort...

Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study.
February 19, 2000... Abstract Objective To assess whether sleep apnoea syndrome is an independent risk factor for hypertension. Design Population study. Setting Sleep clinic in Toronto. Participants 2677 adults, aged 20-85 years, referred to the...

Drug points.
February 19, 2000... Effectiveness of modified release isosorbide mononitrate affected by incorrect use James D Hider, Zaid Shehab, R Courteney-Harris, Ear, Nose, and Throat Department, City General Hospital, Newcastle under Lyme, Staffordshire We...

Misunderstandings in prescribing decisions in general practice: qualitative study.
February 19, 2000... Abstract Objectives To identify and describe misunderstandings between patients and doctors associated with prescribing decisions in general practice. Design Qualitative study. Setting 20 general practices in the West Midlands...

Before birth.
February 19, 2000... I am not yet born; rehearse me In the parts I must play and the cues I must take when old men lecture me, bureaucrats hector me, mountains frown at me, lovers laugh at me, the white waves call me to folly and...

Mortality variations as a measure of general practitioner performance: implications of the Shipman case.
February 19, 2000... Changes in the organisation of the NHS or in the management of health professionals are often made within the context of inquiries into specific medical catastrophes rather than through a measured process of policy formulation. Examples...

Tropical medicine.(Clinical Review)
February 19, 2000... Considerable progress has been made towards three key objectives in tropical infectious diseases in recent years: a clearer understanding of basic microbiology, pathogenesis, and host defence; expanded epidemiology; and new approaches to...

Correction.(to 'Hyponatraemic seizures and excessive intake of hypotonic fluids in young children,' in December 11, 1999 issue)(Correction Notice)
February 19, 2000... Hyponatraemic seizures and excessive intake of hypotonic fluids in young children In this Lesson of the Week by P Bhalla et al (11 December, pp 1554-7), parentheses were omitted in the calculation for the dose of hypertonic saline (p 1557)....

St Columba's case book.
February 19, 2000... Was St Columba of Iona a doctor or a saint? St Columba was an early Christian saint who founded a monastery on Iona, but his Life, published at the end of the fifth century by Adomnan, suggests that he was also one of Britain's early GPs.[1]...

Management: digoxin and other inotropes, beta blockers, and antiarrhythmic and antithrombotic treatment.(ABC of Heart Failure)
February 19, 2000... Digoxin Use of digoxin for heart failure varies between countries across Europe, with high rates in Germany and low rates in the United Kingdom. It is potentially invaluable in patients with atrial fibrillation and coexistent heart...

Internal and external morality of medicine: lessons from New Zealand.
February 19, 2000... Summary The stories we tell about failures of good medical practice, such as about the Bristol case and the New Zealand cervical cancer study, can. restrict our thinking about solutions In New Zealand, the stories told in the report...

Expressing the magnitude of adverse effects in case-control studies: "the number of patients needed to be treated for one additional patient to be harmed".
February 19, 2000... Summary points Results of epidemiological studies need to be expressed in understandable terms if they are to be of practical use to clinicians and policy makers Case-control studies are often used to study adverse effects of...

"Where name and image meet"--the argument for "adrenaline".
February 19, 2000... Summary points A European Commission directive requiring member states to use recommended international non-proprietary names for all drugs is soon to be implemented For most drug names there will be little or no change For...

The Royal Academy Exhibition.(one hundred years ago)
February 19, 2000... General art criticism of a comprehensive and sweeping nature hardly comes within our journalistic limits, but without stepping very far from beyond our proper sphere, we may cordially congratulate the Academy on the undoubted success of their...

Obituaries.(Obituary)
February 19, 2000... Arnold Steadman Aldis Consultant surgeon Cardiff, 1939-75, and postgraduate dean, 1970-6 (b China 1910; q University College Hospital 1937; FRCS; CBE), d 13 October 1999. His ambition to return to China as a missionary like his parents...

NHS funding confused by lack of clarity.(Medicopolitical Digest)
February 19, 2000... The BMA says that lack of clarity is confusing the issue of NHS spending in England and calls for less "spinning" of funding announcements. In a briefing paper from its health policy and economic research unit the association says that...

Guidance issued on discretionary points.(Medicopolitical Digest)
February 19, 2000... The BMA's Central Consultants and Specialists Committee has produced interim guidance on the changes to the discretionary points system, which will start in April. From 1 April employers will be able to award a minimum of 0.35 points per...

Deaf patients do not get such good treatment.(Medicopolitical Digest)
February 19, 2000... More than a fifth of deaf and hard of hearing patients leave a doctor's appointment unsure what is wrong with them, according to research by the Royal National Institute for Deaf People (RNID). A quarter said that their GP did not check that...

Patients with hip fracture need better care.(Medicopolitical Digest)
February 19, 2000... A study by the Audit Commission shows that patients with hip fractures are still waiting too long in accident and emergency departments, that operations are often delayed, and that joint working by consultant physicians and surgeons is still...

The Magic Bullet and Other Medical Stories.(Review)
February 19, 2000... Eds Stefan Slater, Robin Downie, Giles Gordon, Richard Smith Royal College of Physicians and Surgeons of Glasgow, 6 [pounds sterling], pp 101 ISBN 0 953 5833 09 Books available from the college Rating: *** In medicine today,...

Assuming the Risk: The Mavericks, the Lawyers, and the Whistleblowers Who Beat Big Tobacco.(Review)
February 19, 2000... Michael Orey Little Brown, 15.33 [pounds sterling], pp 352 ISBN 0 316 66489 8 Rating: *** To anyone but the US audience for whom this book is intended, the defeat of "Big Tobacco" heralded in the book's title has yet to...

ADAM Interactive Anatomy.(Evaluation)
February 19, 2000... ADAM Interactive Anatomy ADAM Software Harcourt Brace, 1091.49 [pounds sterling] ISBN 1 572 45099 1 Rating: ** *** The teaching of anatomy is undergoing something of a revolution. Increasing numbers of medical schools are giving...

The Anatomy Project.(Evaluation)
February 19, 2000... The Anatomy Project Debra Hastings-Nield Parthenon Publishing, each CD 79.90 [pounds sterling] (free demonstration CD) ISBN 185070 9106 Rating: ** *** The teaching of anatomy is undergoing something of a revolution. Increasing...

NETLINES.
February 19, 2000... * An interesting and a potentially useful service for doctors hoping to get papers published can be found at www.publist.com/indexes/health.html. This lists publications (both conventional print and online publications) and provides data...

The stigma of schizophrenia.
February 19, 2000... When four psychiatrists published a study showing that six out of 23 schizophrenic patients carried weapons during psychotic episodes, little did they realise how their work would be presented to the public. The day after it appeared in the...

Tropical medicine.(Website of the Week)
February 19, 2000... Tropical medicine Some giant leaps but mostly tardy progress is the message delivered by Murray and colleagues in this week's BMJ (p 490). Our understanding of tropical infections might have improved, but drug and vaccine development has been...