British Medical Journal articles from January 2003

British Medical Journal archives from January 2003

Single, small adenoma low risk for recurrent colon polyps. (Poem *).(*Patient-Oriented Evidence that Matters)
January 25, 2003... Question Which patients with colorectal polyps are at greater risk of early recurrence? Synopsis This retrospective cohort study comes from Erlangen, Germany. The authors used a registry of colorectal polyps to identify risk factors for...

War and learning. (Editor's choice).
January 25, 2003... Perhaps the most terrible decision a leader must take is to send a people to war. Hundreds of thousands, even millions, may die. Families are disrupted. Lives destroyed. Lands laid waste. It looks likely that the United States, Britain, and...

The causes of autism spectrum disorders: multiple factors have been identified, but a unifying cascade of events is still elusive. (Editorials).
January 25, 2003... Autism is a developmental disability with onset in infancy. Its clinical presentation is characterised by impairments in reciprocal social interaction and in communication with others, and by a preference for repetitive, stereotyped...

Governance for NHS foundation trusts: Mr Milburn's flawed model is a cacophony of accountabilities. (Editorials).
January 25, 2003... Now that England's health secretary, Alan Milburn, has published his Guide to NHS Foundation Trusts, (1) it is apparent that the proposed model is more radical in its implications but also more problematic in its implementation than had been...

Reinstitutionalisation in mental health care: this largely unnoticed process requires debate and evaluation. (Editorials).
January 25, 2003... Since the 1950s mental health care in most industrialised countries has been characterised by deinstitutionalisation, with national reforms varying in their pace, fashion, and exact results. (1 2) The development of comprehensive community...

A suite of online services to meet doctors' needs will be launched this year. (BMJ Learning).
January 25, 2003... The surprise about appraisal and revalidation for doctors in the United Kingdom is not that it is happening but that it was not introduced earlier. (1-3) For appraisal to be successful it will have to be centred on learning, which in...

Non-invasive ventilation in chronic obstructive pulmonary disease: effective in exacerbations with hypercapnic respiratory failure.
January 25, 2003... Chronic obstructive pulmonary disease is a leading cause of global morbidity and mortality, and about 15% of adults in industrialised countries have chronic obstructive pulmonary disease when defined by spirometry. Mild exacerbations are...

Health professionals challenge US smallpox vaccination plan. (News).
January 25, 2003... Plans to start vaccinating half a million US healthcare workers against smallpox as early as this week are facing growing resistance, as some hospitals, unions, and professional bodies question the rushed nature of the implementation. ...

Industry is deeply involved in funding US research. (News).
January 25, 2003... Industry supported 62% of biomedical research in the United States in 2000, almost double the proportion in 1980, while government support declined. About a quarter of academic investigators have affiliations to industry that could influence...

Briton ends his life at assisted suicide clinic.(Brief Article)
January 25, 2003... Briton ends his life at assisted suicide clinic: A British man with motor neurone disease ended his life this week at an assisted suicide clinic in Switzerland. Reginald Crew, aged 74, a retired car worker from Liverpool, whose last day was...

Doctors in Zimbabwe set up human rights group.(Brief Article)
January 25, 2003... Doctors in Zimbabwe set up human rights group: A group of doctors in Zimbabwe has set up the Zimbabwe Association of Doctors for Human Rights (ZADHR). The association will campaign for the observance of the provisions of the Universal...

One in three women stopped HRT after trial halted.(Brief Article)
January 25, 2003... One in three women stopped HRT after trial halted: Of 65 031 US women taking combined oestrogen and progestogen therapy through a large US prescription plan, 36% stopped taking the combination after the Women's Health Initiative stopped its...

Choice narrows in race for director general of WHO.
January 25, 2003... Choice narrows in race for director general of WHO: The World Health Organization's executive board shortlisted five candidates for the post of director general this week. They are Dr Julio Frenk, Mexico; Dr Jong Wook Lee, Republic of Korea;...

Paediatrician calls for shake up in handling child abuse cases. (News).
January 25, 2003... A radical shake up is needed in the way child protection cases are tackled, with a harder line being taken when professionals suspect premeditated abuse, argue UK paediatricians in two articles in the latest issue of Archives of Disease in...

Police uncover large scale organ trafficking in Punjab. (News).
January 25, 2003... The police in Amritsar city in Punjab state, northern India, have unearthed what they call "the mother of all scandals in human organ trafficking in India." The police have arrested several doctors, middlemen, and donors, including the...

Adjuvant chemotherapy improves survival in early ovarian cancer. (News).
January 25, 2003... Immediate treatment with chemotherapy after surgery significantly improves survival and reduces recurrence of cancer in women with early ovarian cancer, show two major international trials published this week. The first trial, the...

FDA halts gene therapy trials after leukaemia case in France. (News).
January 25, 2003... After the second occurrence of a leukaemia type illness in a patient in a gene therapy trial in France for X linked severe combined immune deficiency disorder (SCID), the US Food and Drug Administration has halted all trials that use...

The market for medical journals is "anticompetitive," says expert. (news roundup).
January 25, 2003... The market for scientific and medical journals is suffering from "true market failure," says Mark McCabe, an economist who worked for the US Department of Justice's anti-trust division for seven years. The result, said Professor McCabe,...

Pro-tobacco editorial content of young men's magazines rises by 70% between 1991 and 2000. (news roundup).
January 25, 2003... Researchers have attacked style magazines aimed at young men for the amount of content devoted to smoking. The researchers, who criticise levels of both pro-tobacco editorial content and advertisements, found that over one year the six...

"Author pays" may be the new science publishing model. (news roundup).
January 25, 2003... A consensus is emerging on how the internet will change file economics of scientific publishing. In future, authors are likely to be asked to pay journals the costs of publishing their original research articles online, and journals will...

US health care should focus on 20 areas. (news roundup).
January 25, 2003... To give Americans world class health care, the US government and private healthcare organisations should focus on 20 specific medical problems that could have the broadest impact on patients, families, and communities, including treatment of...

Restoring the profession's self esteem: the president of the General Medical Council, Graeme Catto, is charged with introducing revalidation by 2005. Geoff Watts asks him how plans are progressing. (News).
January 25, 2003... It's almost exactly 12 months since Professor Graeme Catto, dean of medicine at Guy's, King's, and St Thomas's Hospitals Schools of Medicine and Dentistry in London, took on the presidency of the General Medical Council. He enters his second...

Taking up cudgels for peace: in a week that has seen anti-war demonstrations take place around the world, Jocalyn Clark looks at what doctors in Europe, North America, and Australia are doing to promote peace. (News).
January 25, 2003... In what has been described as the strongest anti-war movement since Vietnam, scores of organisations representing health professionals around the world have joined thousands of international protesters opposing war on Iraq. Anti-war...

Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. (Papers).
January 25, 2003... Abstract Objectives To determine the effectiveness of non-invasive positive pressure ventilation (NPPV) in the management of respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease. Design...

NHS waiting lists and evidence of national or local failure: analysis of health service data. (Papers).
January 25, 2003... Abstract Objectives To investigate the national distribution of prolonged waiting for elective day case and inpatient surgery, and to examine associations of prolonged waiting with markers of NHS capacity, activity in the independent...

Man's chief occupation. (Endpiece).
January 25, 2003... The most common of all follies is to believe passionately in the palpably not true. It is the chief occupation of mankind. H L Mencken, American editor, author, and critic, 1880-1951

Case fatality rates after admission to hospital with stroke: linked database study. (Papers).
January 25, 2003... Population based mortality for stroke has declined in most Western countries during the past few decades. (1) This is probably because of a decrease in both the incidence of and case fatality from stroke over this period. (2-4) Routine...

Career choices of United Kingdom medical graduates of 1999 and 2000: questionnaire surveys. (Papers).
January 25, 2003... The career choices of doctors at the end of their preregistration year have been studied for doctors who qualified in the United Kingdom in 1974, 1977, 1980, 1983, 1988, 1993 and 19967-4 We report here on the graduates of 1999 and 2000. ...

Barriers to accurate diagnosis and effective management of heart failure in primary care: qualitative study. (Primary care).
January 25, 2003... Abstract Objective To ascertain the beliefs, current practices, and decision making of general practitioners in the diagnosis and management of suspected heart failure in primary care, with a view to identifying barriers to good care....

Identifying depression in primary care: a comparison of different methods in a prospective cohort study. (Primary care).
January 25, 2003... Depressive disorders are a major health problem in primary care, and at least half of these disorders remain undetected. (1) There are two recommended approaches to diagnosing depression in primary care: one is to perform routine screening,...

Anaesthesia and swearing. (One hundred years ago).
January 25, 2003... Our armies, as we learn from My Uncle Toby, swore terribly in Flanders; and if the testimony of Mr. Kipling is to be accepted they do the same at the present day in India and elsewhere. In civil life the strong language of our ancestors has...

Ten ways to improve information technology in the NHS. (Information in practice).
January 25, 2003... I have a request for Richard Granger, the newly appointed director general of NHS Information Technology, (1) who is responsible for implementing the government's ambitious and very costly plans for the use of information technology in the...

An act of creation. (Endpiece).
January 25, 2003... Research is endlessly seductive; writing is hard work. One has to sit down on that chair and think and transform thought into readable, consecutive, interesting sentences that both make sense and make the reader turn the page. It is...

The patient's referral letter.
January 25, 2003... "Keep falling on left side, dizziness/feeling sick. Permanent pain over my right eye, sleep between 12-14 hours day. Co-ordination not very good, takes at least 4 hours to get ready to go out. Fear of going out too far from home. Bedwetting...

Onchocerciasis. (Science, medicine, and the future).
January 25, 2003... Endosymbiotic Wolbachia bacteria in the worms are targets for a new therapeutic approach Onchocerciasis, or river blindness, caused by the filaria Onchocerca volvulus, affects more than 17 million people in Africa, Latin America, and...

Fear of the dark in children: is stationary night blindness the cause? (Lesson of the week).
January 25, 2003... Fear of the dark is a common complaint of pre-teenage Children. (1 2) It should not be confused with night terrors or panics, in which a child becomes acutely agitated and terror-struck at night, appearing to be awake while in fact asleep and...

Corrections and clarifications.(To: "Visible signs of illness from the 14th to the 20th century: systematic review of portraits" in December 28, 2002 issue, Pp 1499-1501)(To: "Photofinish" in Christmas 2001 issue, p 1498)
January 25, 2003... Visible signs of illness from the 14th to the 20th century: systematic review of portraits In this article by C Als and colleagues in the Christmas issue of the BMJ (21-28 December, pp 1499-501), we added the wrong affiliation for one of...

Mark Twain on evidence based practice. (Endpiece).
January 25, 2003... It ain't what people don't know that hurts them it's what they know that ain't so. Mark Twain

Applying educational theory in practice. (ABC of learning and teaching in medicine).
January 25, 2003... How many times have we as teachers been confronted with situations in which we really were not sure what to do? We "flew by the seat of our pants," usually doing with our learners what had been done with us. It would be useful to be able to...

Man hater. (When I use a word).
January 25, 2003... In his review of Steve Jones' book about the Y chromosome (BMJ 2002;325:841), Fred Kavalier wonders what the male equivalent of a misogynist is. The Greeks had distinct words for man and mankind. A man (as opposed to a woman) was (aner;...

WHO responds. (Education and debate).
January 25, 2003... In November and early December we published Gavin Yamey's series examining whether the World Health Organization had dealt with its structural problems and rethought its functions--in effect, reinvented itself. Now WHO responds Summary...

Interaction revisited: the difference between two estimates. (Statistics Notes).
January 25, 2003... We often want to compare two estimates of the same quantity derived from separate analyses. Thus we might want to compare the treatment effect in subgroups in a randomised trial, such as two age groups. The term for such a comparison is a...

Open letter to Tony Blair: call to prevent escalating violence. (Letters).
January 25, 2003... EDITOR--Three important reports have been published in the past month on the humanitarian impacts of international violence and conflict. (1-3) All provide evidence of the short and long term adverse health impacts of the use of force...

Doctors and computers.
January 25, 2003... Poor system design and little investment mean hospital doctors do not use computers... EDITOR--Benson's article neatly summarises some of the difficulties hospital doctors have using computers? I would enthusiastically use computers in...

Rethinking management.
January 25, 2003... Fundamental rethink of medical management is needed EDITOR--Smith in his editorial on the rejection of the proposed consultant contract in England and Wales cites as a principal cause the widespread distrust among clinicians of hospital...

Risk factors for cot death increase danger from infection. (Letters).
January 25, 2003... EDITOR--Tappin et al found an increased risk of the sudden infant death syndrome in infants who slept on used mattresses, which was further increased if the used mattress was from another home. (1) They say that the increased risk might be...

Long term effects of advice to reduce dietary salt. (Letters).
January 25, 2003... Front cover was highly misleading EDITOR--That small reductions in salt intake (2 g/day) have a small but significant effect on blood pressure is hardly surprising.' Nevertheless, in populations this would have a large effect on reducing...

Indian objection to export of human tissue for research. (Letters).
January 25, 2003... Clarifications from authors of study EDITOR--With reference to our recent paper in the Proceedings of the National Academy of Sciences on the mutation rate of mtDNA, Murdur says that Indian scientists are accusing the foreign researchers...

Ethics dialogue between rich and poor countries is overdue. (Letters).
January 25, 2003... EDITOR--The agreement of the recent meeting organised by the European Group on Medical Ethics--that there should be more dialogue between rich and poor countries on cross cultural ethical issues--is long overdue. (1) Experts on medical ethics...

Issues relating to abortions are complicated in Nigeria. (Letters).
January 25, 2003... EDITOR--Raufu's news item drawing attention to Nigeria, where 20 000 deaths are reported to occur every year as a result of mostly illegal abortions, calls for definite remedial action. (1) I commend the dean of the medical school at Benin...

Obituaries.(Obituary)
January 25, 2003... Henk Leenen Dutch professor of social medicine and health law, patients' rights champion, and euthanasia campaigner Henk Leenen was both the architect of the Netherlands' euthanasia law and a fighter for patients' self determination....

Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia.(Book Review)
January 25, 2003... David Clark, Michael Wright Open University Press, 22.50 [pounds sterling], pp 299 ISBN 0 335 21286 7 Rating: *** Twenty five years ago, while I was still a medical student at the University of Gdansk, Poland, I was involved in...

Complexity and Healthcare: An Introduction.(Book Review)
January 25, 2003... Eds Kieran Sweeney, Frances Griffiths Radcliffe Medical Press, 24.95 [pounds sterling], pp 208 ISBN 1 85775 559 6 Rating: * Place three points on a piece of paper to mark the vertices of a triangle. Choose a position haphazardly...

Fat Land: How Americans Became the Fattest People in the World.(Book Review)
January 25, 2003... Greg Critser Houghton Mifflin, $24, pp 232 ISBN 0 618 16472 3 To order, see www. houghtonmifftinbooks.com Rating: *** James O Hill, a physiologist at the University of Colorado's Health Sciences Center, once said that becoming...

The Lost Prince.(Television Program Review)
January 25, 2003... BBC 1, 19 and 26 January at 8.30 pm Rating: *** The distinguished writer Stephen Poliakoff has pulled a royal rabbit out of history's hat for this two part series. He tells the true, but incredible, story of Prince John (1905-19),...

War of words over Iraq: should medical journals have a role in the debate over military intervention? (Journals).
January 25, 2003... The possibility of a war against Iraq currently has some medical editors at each other's throats. What is at issue, however, is not so much the potential conflict itself, but whether or not medical journals should contribute to the debate...

Website of the week.
January 25, 2003... Bioterrorism While the United Nations weapons inspectors continue their search for weapons of mass destruction in Iraq, the discovery of ricin in a flat in north London has focused attention on weapons of mass destruction a little closer to...

A tabloid story. (Personal View).
January 25, 2003... It was a scandal of national magnitude, or so the tabloids thought. And because that is what they thought, it did become a scandal of national magnitude. The story broke in June 2000 at the height of the doctor bashing frenzy....

Geese of a different feather. (Soundings).
January 25, 2003... The cost of drugs in America has become so high that those who can afford them complain, and those who cannot afford them sometimes go without. Not a week passes without some newspaper commenting about high drug prices and exploding hospital...

Minerva.
January 25, 2003... Chemists from California have created a new form of life--a bacterium that makes proteins out of 21 amino acids, one more than the 20 used by almost every other organism on earth. The new Escherichia coli can manufacture the extra amino acid,...

Why WHO matters. (Editor's choice).
January 18, 2003... My friend from WHO, Rafael Bengoa, has a powerful slide that shows severely underweight children side by side with obese children. This is the double health burden of many developing countries. Peter Sims from Papua New Guinea describes how...

Montelukast helps chronic urticaria. (Poem *).(*Patient Oriented Evidence that Matters)
January 18, 2003... Question Is montelukast (Singulair) effective in the treatment of chronic idiopathic urticaria? Synopsis Chronic idiopathic urticaria is a frustrating entity that is sometimes refractory to antihistamines or avoidance therapy....

Monitoring the marketing of infant formula feeds: manufacturers of breast milk substitutes violate the WHO code--again.
January 18, 2003... Breast feeding is one of the most cost effective interventions to improve health and prevent illness in early childhood. Protection of breast feeding from commercial exploitation should be among the highest priorities for the international...

Preventing skin cancer: messages should emphasise the need to cover up and stay out of the sun. (Editorials).
January 18, 2003... Health promotion strategies to prevent deaths from skin cancer, particularly melanoma, have two components: advice on early recognition and advice on prevention. The population is perhaps heeding advice on early recognition. Five year...

Levelling the playing field for regulation of nicotine: existing laws in Britain offer a promising framework. (Editorials).
January 18, 2003... In a bold new report, the tobacco advisory group of the Royal College of Physicians of London has called for the establishment of a nicotine regulatory authority in the United Kingdom. (1) Regulation of tobacco has not been a conspicuous...

Doctors and managers: a constructive dialogue has to replace mutual suspicion. (Editorials).
January 18, 2003... The rejection of the contract for UK consultants has brought the relationship between doctors and managers into sharp focus. The BMA and consultants got a bad press. Managers were characterised as everything from the unwilling pawns of a...

Preventing and treating tetanus: the challenge continues in the face of neglect and lack of research. (Editorials).
January 18, 2003... One hundred and twenty years ago, the BMJ contained the following report: "Death from tetanus induced by hypodermic injection. An inquest was held by the coroner for the city of Dublin last week on the body of a governess, aged fifty-six...

Online polls: results.
January 18, 2003... We've conducted several online polls in conjunction with recent editorials. Here are the final results (http://bmj.com/misc/ strawpolls.shtml). Journal policies on competing interests Q: Should the BMJ require authors and reviewers...

Lack of new drugs is reaching crisis point, says review. (News).
January 18, 2003... The number of new drugs approved in the United States last year fell to half the annual average over the past five years. Only 15 new drugs were approved by the Food and Drug Administration in 2002, compared with a five year annual...

Medicines Control Agency must be more open. (News).
January 18, 2003... The UK Medicines Control Agency needs to communicate better with the public about the safety of medicines and to become more transparent about the way it operates, says an independent review. In its report, the National Audit Office has...

Half of British workers worry about workplace smoking.(Brief Article)
January 18, 2003... Half of British workers worry about workplace smoking: More than 12 million UK workers are concerned about the risks of developing lung cancer from passive smoking at work, estimates a MORI survey published this week. It also says that over a...

Vaccine campaign reduces illness in hajj travellers.(Brief Article)
January 18, 2003... Vaccine campaign reduces illness in hajj travellers: A meningitis vaccination campaign, launched in 2001 to offer immunisation to the 50 000 UK Muslims who travel on the annual hajj pilgrimage to Mecca each year, has dramatically cut the...

Pertussis outbreak in Afghanistan.
January 18, 2003... Pertussis outbreak in Afghanistan: WHO has reported 115 cases and 17 deaths from pertussis in the district of Khwahan, in Afghanistan's northeastern province of Badakhshan. A team consisting of health workers from the Afghan Ministry of...

Antipsychotic drug helps to cut suicide rate.(Brief Article)
January 18, 2003... Antipsychotic drug helps to cut suicide rate: Clozapine has been found to reduce the risk of suicide in people with schizophrenia. Results from the international suicide prevention trial study, published this week (Archives of General...

Company launches campaign to "counter" BMJ claims. (News).
January 18, 2003... A public relations company with clients in the pharmaceutical and biotechnology industry has launched a global campaign to "counter" a recent BMJ article on "female sexual dysfunction" that detailed drug company sponsorship of medical...

Environmentalist accused of scientific dishonesty. (News).
January 18, 2003... A leading international environmentalist, Professor Bjorn Lomborg, has been found guilty of scientific dishonesty by the Danish government committees that investigate scientific fraud and misconduct. But the ruling has sparked a future,...

Government publishes strategy to improve diabetes care. (News).
January 18, 2003... Initiatives to prevent the complications associated with diabetes have been set out in the National Service Framework for Diabetes: Delivery Strategy, published by the Department of Health this week. The strategy is the second of the...

Nigerian immunisation programme sees results. (News).
January 18, 2003... The National Programme on Immunisation (NPI) has just released a report that shows a continuing and dramatic decline in the incidence of fatal child* hood diseases in Nigeria. Diseases covered by the report include tetanus, poliomyelitis,...

More resources should go into core funding. (News).(Interview)
January 18, 2003... What will be your priorities on taking office? The overriding priority of WHO, and the measure of its success, is its performance in different countries. WHO must transform itself into an increasingly central force in improving the health...

WHO must help countries deal with non-communicable diseases and mental health. (News).(Interview)
January 18, 2003... What will be your priorities on taking office? My overriding goal is to contribute to realising the vision of WHO as a trusted and leading agency in global health that is capable of galvanising the energies of all relevant actors towards...

Partnerships with the drug industry would be constructive. (News).(Interview)
January 18, 2003... What will be your priorities on taking office? Emphasis must be placed on public health programme-stackling such issues as nutrition, access to essential health needs, access to medicines in developing nations, maternal and child care,...

Resources should be decentralised to countries. (News).(Interview)
January 18, 2003... What will be your priorities on taking office? First, I will change the way we work as an organisation in support of member states, ensuring that we achieve tangible and measurable health outcomes. Second, I will improve our efficiency...

Regions with a high disease burden should be prioritized. (News).(Interview)
January 18, 2003... What will be your priorities on taking office? As director general I would work intensively with international development and financing agencies to keep health at the top of the development agenda and to achieve our long stated goal of...

Comparing national health systems should continue. (News).(Interview)
January 18, 2003... What will be your priorities on taking office? As the world's advocate for health, WHO and its work must represent scientific and technical excellence while being responsive and relevant to health needs of individual countries. As...