British Medical Journal articles from May 2002

British Medical Journal archives from May 2002

On things not being what they seem. (Editor's Choice).(Brief Article)
May 25, 2002... Galen and our Irish columnist, Liam Farrell, have views in common. "You who are reading these writings," warns Galen, "must not pass judgement on the whole truth of it unless you have first observed for yourself the things that I have...

Postpartum urinary incontinence: the problem is clear, but there is no simple solution.(Editorial)(Brief Article)
May 25, 2002... Postpartum urinary incontinence is an important and often overlooked form of maternal morbidity. In this issue Chiarelli and Cockburn (p 1241) (1) highlight and confirm the work of other investigators who have shown that vaginal delivery...

Panayiotopoulos syndrome: a common benign but underdiagnosed and unexplored early childhood seizure syndrome.(Editorial)
May 25, 2002... Epilepsy affects 1% of the general population and 4% of children, encompassing heterogeneous seizure syndromes. (1) These are defined by distinct aetiology, age at onset, seizure type, and electroencephalographic features, which taken...

Regulating cosmetic surgery: members of the public would be better protected if they consulted their general practitioners first.(Brief Article)(Editorial)
May 25, 2002... Cosmetic surgery has become a growth industry and a public obsession. The demand for the top three procedures in the United States grew by 26% between 1999 and 2000, and this growth is mirrored in the United Kingdom. (1) The public perception...

Using telephones in primary care: a significant proportion of consultations might take place by phone.(Brief Article)(Editorial)
May 25, 2002... NHS Direct, the United Kingdom's open access telephone advice system, which is staffed by nurses supported by computer decision software, has been the subject of a long and often bitter debate. Is it value for money; is this system the most...

Health care for older people: Scottish report has international relevance.(Editorial)
May 25, 2002... In response to serious concerns about the health care provided to older people in Scotland the Scottish expert group on healthcare of older people, led by the chief medical officer, Dr E M Armstrong, has released an insightful report entitled...

Government should outlaw theft of DNA, commission says. (News).(Brief Article)
May 25, 2002... Taking people's DNA without their knowing should be a criminal offence, says the United Kingdom's genetics watchdog. The advice to outlaw DNA theft is just one of a series of recommendations made by the Human Genetics Commission this week...

Sex selection in China sees 117 boys born for every 100 girls. (News).(Brief Article)
May 25, 2002... Ted Plafker Beijing Chinese demographers are warning that the nations social fabric could unravel under pressure from an increasingly skewed sex ratio in newborns. According to figures published this month in state run Chinese media,...

Nigeria buys $4.2m worth of mosquito nets.(News in Brief)(Brief Article)
May 25, 2002... The Nigerian government has purchased 4.2m (2.9m [pounds sterling]; 4.6m [euro]) worth of insecticide treated bed nets to combat malaria. Malaria rather than AIDS remains the number one killer disease in Nigeria.

US pharmacist diluted 98 000 prescriptions.(News in Brief)(Robert Courtney)(Brief Article)
May 25, 2002... Robert Courtney, Owner and operator of two Kansas City pharmacies, has confessed to diluting 98 000 prescriptions written by 400 doctors since 1992. He has been sentenced to 17-30 years in jail, faces fines of up to $15m (10.3m [pounds...

WHO considers traditional and complementary medicine.(News in Brief)(World Health Organization)(Brief Article)
May 25, 2002... The WHO has released a global plan to address the safety of traditional and complementary medicines. The strategy aims to help countries regulate such medicines and to make them safer and more accessible to their populations and to ensure...

Belgium legalises euthanasia.(News in Brief)(Brief Article)
May 25, 2002... Belgium has become the second country after the Netherlands to legalise euthanasia. But the legislation, approved by the country's parliament on 16 May, lays down strict conditions for doctors and patients under which it may be practised.

BMJ moves into soap.(News in Brief)(Brief Article)
May 25, 2002... BMJ Careers is launching a soap opera in the autumn about the lives, loves, and careers of doctors. It will go on bmjcareers.com in weekly instalments, with a summary in Career Focus. Any doctor can apply to be the writer, and details on how...

Wales appoints a czar for breastfeeding.(News in Brief)(Brief Article)
May 25, 2002... Wales is to have a czar to lead the implementation of breastfeeding strategies. The job will include coordinating local initiatives, auditing results, and analysing feedback.

Australia turns to drug company representatives to cut prescribing. (News).(Brief Article)
May 25, 2002... In a bid to cut the rising costs of government subsidised drugs--a rise partly caused by inappropriate prescribing--the Australian government has opted to enlist the sales force of pharmaceutical companies. The decision has astonished...

Doctor sues company over unethical marketing. (News).(David Franklin, Warner-Lambert Pharmaceutical Company)(Brief Article)
May 25, 2002... Dr David Franklin, a former employee of the Warner-Lambert Pharmaceutical Company, has filed a lawsuit against the company, alleging that its sales representatives encouraged doctors to prescribe gabapentin (Neurontin) for unapproved uses....

NHS is not ready for a 48 hour working week. (News).(UK National Health Service)(Brief Article)
May 25, 2002... Health minister John Hutton admitted last week that the government did not have a strategy in place to deal with the introduction of the European working time directive, due to be incorporated into UK law by 2004. The government is...

Goverment proposes licensing system for doctors. (News).(Brief Article)
May 25, 2002... Doctors in the United Kingdom will soon be required by law to have a licence to practise, under new proposals from the government. Health minister John Hutton has issued a consultation document outlining the plans, which will form part of...

Diabetic drug is often prescribed inappropriately, researchers say. (news roundup).(metformin )(Brief Article)
May 25, 2002... Metformin, the most commonly prescribed branded diabetes drug in the United States, may often be inappropriately prescribed for patients with type 2 diabetes who have renal dysfunction and congestive heart failure, where it has been...

Moderate drinking may help women with type 2 diabetes, says study. (news roundup).(Brief Article)
May 25, 2002... Moderate alcohol intake may help control blood sugar in postmenopausal women with type 2 diabetes and may prevent the development of the disease and its cardiovascular sequelae in women at risk, a new report says (JAMA 2002;287:2559). ...

Greek doctors prescribe the most antibiotics. (news roundup).(Brief Article)
May 25, 2002... European countries differ substantially in the use of antibiotics, a study has found. The variations were in the volume of drugs dispensed and the types of antibiotics used in the 13 countries surveyed. There were also differences in...

Health bodies defend their right to use patient data. (news roundup).(Brief Article)
May 25, 2002... Clashes between the Department of Health and privacy campaigners looked set to continue beyond Westminster this week over new regulations to allow healthcare providers in England and Wales to pass on patients' data without their consent to...

Gene could give clue to cloning failures. (news roundup).(Brief Article)
May 25, 2002... Researchers believe they have discovered a crucial gene that explains why so few attempts to clone embryos are successful. Examining cloned mouse embryos, the researchers discovered that only a small number of embryos properly expressed...

WHO calls for countries to shift from acute to chronic care. (news roundup).(World Health Organization)(Brief Article)
May 25, 2002... Primary care providers in developing countries are ill equipped to deal with chronic conditions, a new report from the World Health Organization says. Defined as health problems that persist over time and require some degree of...

Pressure increases on government to remove anonymity from sperm donors. (news roundup).(Brief Article)
May 25, 2002... An adult and a child conceived through donor insemination went to the High Court in London this week to try to find out more information about the men who fathered them. Joanna Rose, 29, now a student in Brisbane, Australia, and a 6 year...

"Shortcomings in care" to blame for avoidable epilepsy deaths. (News).(Brief Article)
May 25, 2002... Poor management of patients with epilepsy may contribute to a substantial number of avoidable deaths related to epilepsy each year, an audit report published this week says. The report highlights weaknesses in service provision and calls...

Teenage suicides double as the future crumbles.(Buenos Aires)(News).(Brief Article)
May 25, 2002... Ramon Fernandez has been waiting in a hospital in Argentina for Over a month, desperately hoping someone will find him a pacemaker. The 54 year old farm worker from the province of Mendoza, in Argentina's central Andean region, would...

Entente not so cordiale: commons health committee chairman David Hinchliffe tells Jo Revill that if he had singlehandedly written his committee's report on relations between the NHS and the private sector it would have been more critical. (News).(UK National Health Service)(Brief Article)
May 25, 2002... David Hinchliffe, chairman of the parliamentary health select committee, has expressed his concern that the case for using the independent sector to clear waiting lists is unproved and could seriously undermine the NHS. His committee...

How whistleblowing cost one doctor 550 000 [pounds sterling]. (News).
May 25, 2002... Dutch former medical researcher Dr Koos Stiekema is convinced of the "potentially disastrous" effects for doctors working inindustry after a court's decision to award huge damages against him for whistleblowing. Dr Stiekema left the...

Promoting urinary continence in women after delivery: randomised controlled trial. (Papers).
May 25, 2002... Abstract Objectives To test the effectiveness of a physiotherapist delivered intervention designed to prevent urinary incontinence among women three months after giving birth. Design Prospective randomised controlled trial with women...

Assessing the outcome of compulsory psychiatric treatment in the community: epidemiological study in Western Australia. (Papers).
May 25, 2002... Abstract Objective To examine whether community treatment orders for psychiatric patients reduce subsequent use of health services in comparison with control patients not placed on an order. Design Epidemiological study with a before...

Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men. (Papers).
May 25, 2002... Abstract Objectives To examine the association between self perceived psychological stress and cardiovascular disease in a population where stress was not associated with social disadvantage. Design Prospective observational study...

Psychosocial factors and health: strengthening the evidence base. (Papers).(Commentary)(Brief Article)
May 25, 2002... Reading the paper by Macleod and colleagues I am reminded of growing up in Australia, where my parents impressed upon me the importance of not being a "whinger." In fact, it was common for my grandmother when asked how she was feeling to...

Prevalence of morbidity associated with abortion before and after legalisation in South Africa. (Papers).
May 25, 2002... Abortion on request has been legal in South Africa since 1997. The Choice in Termination of Pregnancy Act of South Africa 1996 allows abortion on request up to 20 weeks' gestation. Since it was introduced, 40 000 legal abortions have been...

Drug points: metabolic decompensation in pump users due to lispro insulin precipitation. (Papers).(Brief Article)
May 25, 2002... Small, short term studies show that lispro insulin (Humalog; Eli Lilly & Co, Indianapolis, IN), commonly used in pump therapy, is stable in insulin pumps. (1) However, in agreement with reports by others, (2) we have noted several patients...

General practice based intervention to prevent repeat episodes of deliberate self harm: cluster randomised controlled trial. (Primary Care).
May 25, 2002... Abstract Objectives To evaluate the impact of an intervention based in general practice on the incidence of repeat episodes of deliberate self harm. Design Cluster randomised controlled trial in which 98 general practices were...

Clinical guidelines have limitation. (Primary care).(Commentary)(Brief Article)
May 25, 2002... Bennewith et al provide further evidence that the provision of centrally derived clinical guidelines to general practitioners may be insufficient to improve the outcome of patients with mental health problems. The problems with the...

Management of genital prolapse. (Regular Review).
May 25, 2002... Summary points Doctors should consider the patient's history of rectal prolapse, bladder and bowel function, and sexual activity It is important to treat predisposing factors such as obesity, obstructive airway disease, constipation,...

A warning. (Endpiece).(Brief Article)
May 25, 2002... You who are reading these writings must not pass judgement on the whole truth of it unless you have first observed for yourself the things that I have described. Galen, On the usefulness of parts. Book 14, II, 297. New York: Cornell...

Helicobacter pylori breath tests. (How Does It Work?).(Brief Article)
May 25, 2002... 1 Virtually all duodenal ulcers and 80% of gastric ulcers are associated with Helicobacter pylori infections (1) [ILLUSTRATION OMITTED] 2 H pyiori survives in gastric acid by excreting large amounts of urease. This enzyme...

Conditions affecting the left side of the heart. (ABC of Clinical Electrocardiography).
May 25, 2002... Many cardiac and systemic illnesses can affect the left side of the heart. After a careful history and examination, electrocardiography and chest radiography are first line investigations. Electrocardiography can provide supportive evidence...

The passing of the beard.(One Hundred Years Ago)(Brief Article)
May 25, 2002... DR. ALEXANDER DOWNIE in his new Zion, from which he has banished all regular professors of the healing art, has lately issued an ordinance making the wearing of beards compulsory on all men. Elsewhere, however, there are signs that the doom...

Child soldiers: understanding the context. (Education and Debate).
May 25, 2002... Summary points The recruitment and use of children as soldiers should be condemned and prohibited Understanding why children choose to fight is important for preventing it Factors that prompt children to join armed groups...

Peer review of statistics in medical research: the other problem. (Education and Debate).
May 25, 2002... Summary points Peer reviewers often make unfounded statistical criticisms, particularly in difficult areas such as sample size and multiple comparisons These spurious statistical comments waste time and sap morale Reasons...

Only external things. (Endpiece).(Brief Article)
May 25, 2002... He was a strong man in business and in politics, but these are external things: only a fool gives his soul to them. Robertson Davies (1913-95), What's bred in the bone, London: Penguin, 1986

Obituaries.(Obituary)
May 25, 2002... Manuel Velasco-Suarez Mexico's father of neurosurgery and a campaigner against nuclear weapons Manuel Velasco-Suarez was one of Mexico's wise elders and was usually revered in his home country with the title of "maestro." He became...

Theater of Disorder: Patients, Doctors, and the Construction of Illness.
May 25, 2002... Brant Wenegrat Oxford University Press, 26.50 [pounds sterling], pp 292 ISBN 019 514087 7 Rating: **** In this bold, intellectual tour de force Brant Wenegrat argues that many of the more exotic neuroses of our time (multiple...

Medicine Matters After All: Measuring the Benefits of Medical Care, a Healthy Lifestyle, and a Just Social Environment.
May 25, 2002... John Bunker The Nuffield Trust, 12 [pounds sterling], pp 120 ISBN 011 702 728 6 See www.nuffieldtrust.org.uk/ public/current/current.htm for ordering details Rating: ** Which should we spend more on: medicine, health promotion, or...

Camera Obscura.
May 25, 2002... By Lorenzo DeStefano, based on The Inman Diary, by Arthur Crew Inman Directed by Jonathan Miller Almeida Rehearsal Rooms, 108 Upper Street, Islington, London N1, until 8 June 2002 Theatre Royal, Bath, 11-15 June 2002 Theatre Royal,...

Peer review.(Website of the Week)(Brief Article)
May 25, 2002... Peer review In this week's BMJ, Peter Bacchetti complains about another side of peer review: finding errors when they are not there (p 1271). All those involved in peer review certainly know about the shortcomings of the process, but I am not...

Bookcase.(books on obesity)(Bibliography)
May 25, 2002... The United Kingdom has one of the fastest growing rates of obesity in Europe. One in five adults is now classified as obese. More and more evidence points to the cause being a complex mix of genetic and environmental factors. Four books, each...

Chronic fatigue syndrome guidelines spark media row: value of evidence based medicine at centre of dispute.(Press)(Brief Article)
May 25, 2002... A media furore erupted even before long awaited clinical practice guidelines for chronic fatigue syndrome were published in Australia. "Sick and tired patients in uproar" blared one front page headline in a leading daily newspaper....

Breaking bad news. (Personal View).(Brief Article)
May 25, 2002... Lady on low fat diet to waiter: "How do you prepare the chicken?" Waiter: "We give it to them straight, madam. We tell them: `You're going to die.'" Early in 2000, I noticed a change in my speaking voice. First it went deeper, then...

I'm a believer. (Soundings).
May 25, 2002... "Once a man stops believing in God," said G K Chesterton, "he doesn't believe in nothing, he believes in anything." Yeah right, I thought, what would he know? But the Road to Damascus can come in unlikely forms. Being a cynic is not something...

Minerva.
May 25, 2002... Women with polycystic ovarian syndrome can find it difficult to conceive. Some are given clomiphene to induce ovulation, but it doesn't always work. Given that insulin resistance may play a key role in the syndrome, some people think that...

Myopia and the private finance initiative. (Editor's Choice).
May 18, 2002... Editing is dangerous. Editors may suffer deep vein thrombosis from physical inactivity, oral cancer through chewing cigars, hubris because of flying too close to the sun, verbal abuse from offending readers, and now, this BMJ declares (p...

Emergency vascular surgery: patients need to travel for specialist treatment.(Editorial)
May 18, 2002... The services of vascular specialists are in demand to treat common vascular emergencies--patients with acute ischaemia of the limbs and leaking aortic aneurysms. (1-4) The management of these problems has become increasingly complex, often...

Improving the response rates to questionnaires: several common sense strategies are effective.(Editorial)
May 18, 2002... Most readers of the BMJ probably receive postal questionnaires from time to time. Whether such questionnaires are dutifully completed and returned, left to gather dust, or rapidly thrown away may seem like a random process of little...

Implications of the EU directive on clinical trials for emergency medicine: many trials in emergency medicine will not be possible.(Editorial)
May 18, 2002... A laudable attempt by the European Union to implement good clinical practice in the conduct of clinical trials on drugs for human use will, unless amended, make impossible a range of potentially life saving studies after May 2004. ...

Selection of medical students: affirmative action goes beyond the selection process.(Editorial)
May 18, 2002... In many aspects of human endeavour great achievers enter their chosen field with an innate ability that enables them to outperform their peers who have a similar education or training. Medical educators, perhaps vainly, pay a lot of attention...

Twenty thousand conversations: rapid responses suggest new models of knowledge creation.(Editorial)
May 18, 2002... Conversation is a meeting of minds with different memories and habits. When minds meet, they don't just exchange facts: they transform them, reshape them, draw different implications from them, and engage in new trains of thought....

MPs call for more publicly funded capital projects in the NHS. (News).(Members of Parliament, UK National Health Service)(Brief Article)
May 18, 2002... More public capital funds should be invested in NHS developments to provide value for money comparisons with the controversial private finance initiative (PFI), an all party committee of backbench MPs has urged. The long awaited report...

Life expectancy is consistently underestimated, say researchers. (News).(Brief Article)
May 18, 2002... Life expectancy has increased by 40 years since 1840 and shows no sign of having peaked, claim population researchers. But governments have planned their health and social policies on projections of life span that are wedded to the concept of...

Diane Pretty dies.(News in Brief)(Brief Article)
May 18, 2002... Diane Pretty, the woman who went to the European Court of Human Rights in her battle for the right to have her husband help her to commit suicide, has died. Mrs Pretty, aged 43, who had motor neurone disease and lost her case in the European...

Oregon judge reduces damages in tobacco case.(News in Brief)(Brief Article)
May 18, 2002... Judge Roosevelt Robinson, who heard the case against Philip Morris in Portland (6 April, p 208), has reduced the punitive damages of $150m (103m [pounds sterling]; 165m [euro]) to $100m saying the original amount was "grossly excessive." A...

Street offenders to be "fast tracked" to drug treatment.(News in Brief)(Brief Article)
May 18, 2002... Street crime offenders with drug offences in the United Kingdom will be referred to drug treatment services within 24 hours of release as part of the government's strategy to tackle street crime.

Female condoms will soon be introduced in India.(News in Brief)(Brief Article)
May 18, 2002... The public sector company Hindustan Latex, in collaboration with the Female Health Company, is shortly to introduce female condoms into India. Initially, the companies will just repackage and market the condoms, which are made in the United...

Malpractice insurer leaves New Jersey doctors in the lurch.(News in Brief)(Brief Article)
May 18, 2002... The MIIX Group, founded by New Jersey doctors 25 years ago when no one else would insure them at affordable rates, is ending its coverage for 7000 doctors in the state. The company lost more than $200m (136m [pounds sterling]; 220m [euro]) in...

Muslim patients suffer as Hindu doctors fear for their safety. (News).(Brief Article)
May 18, 2002... Doctors in the riot hit Indian city of Ahmedabad have not been working in its Muslim neighbourhoods for several weeks, because of security concerns and a disruption in medical services. Consultants and general practitioners belonging to...

Trusts cancel 10% of operating theatre sessions. (News).(Brief Article)(Statistical Data Included)
May 18, 2002... Thousands more operations could be carried out in the NHS each year if operating theatres were better managed, says a report published by the Audit Commission. Poor management information systems, failure to restructure historic patterns...

Patients with small abdominal aortic aneurysms should "wait and see". (News).(Brief Article)
May 18, 2002... Two new studies suggest that patients with small abdominal aortic aneurysms are safer adopting a wait and see approach rather than having immediate surgery to repair the weakened vessel. The two new studies--one British, one...

Trial shows azithromycin is no better than vitamin C for bronchitis. (News).(Brief Article)
May 18, 2002... An antibiotic commonly prescribed for acute bronchitis is no better than low doses of vitamin C, according to new research. A double blind, randomised controlled trial has concluded that azithromycin is ineffective and should not be...

United States reviews smallpox vaccination policy. (news roundup).(Brief Article)
May 18, 2002... US public health doctors and preventive medicine specialists met in Atlanta, Georgia, last week to consider whether to continue the policy of prohibiting vaccinations against smallpox unless a smallpox bioterrorist attack takes place or...

Campaign to eliminate disfiguring disease is stepped up. (news roundup).(lymphatic filariasis)(Brief Article)
May 18, 2002... A global campaign spearheaded by the World Health Organization to eliminate one of the world's most disfiguring diseases, lymphatic filariasis, has been stepped up to reach 350 million people--a third of the billion people at risk--by 2005....

Decoding of soil bacterium genome points way to new antibiotics. (news roundup).(Brief Article)
May 18, 2002... A British consortium of scientists has decoded the complete genome sequence of Streptomyces coelicolor A3(2), a common soil bacterium that is the source of more than two thirds of the antibiotics in current use and the harmless relative of...

US Senate considers proposal to tighten drug patent law. (news roundup).(Brief Article)
May 18, 2002... The US Senate is considering a bill to close a loophole in the drag patent laws that has enabled drugs companies to get easy and frequent extensions of 30 months to their patents. The hotly debated new Greater Access to Pharmaceuticals...

Journals are inconsistent in choice of articles to be fast-tracked. (news roundup).(Brief Article)
May 18, 2002... A study of accelerated publication versus the usual forms of publication in two leading medical journals shows that current practices for selecting articles to be "fast-tracked" are inconsistent. Authors of the study, which appears in...

Australia's detention policy puts refugees' health at risk. (news roundup).(Brief Article)
May 18, 2002... Australia's tough stance on asylum seekers and refugees has come under fire from a broad alliance of the country's main health and medical groups. The detention of thousands of asylum seekers, including hundreds of children, and the lack...

Psychiatrist settles dispute with Toronto University. (news roundup).(David Healy)(Brief Article)
May 18, 2002... David Healy, the psychiatrist from the University of Wales who sued the University of Toronto for $C9.4 million (4.1m [pounds sterling]; $US6m; 6.6m [euro]), claiming violation of academic freedom and defamation as a scientist and physician,...

Trust chiefs cause flood of serious cases to GMC. (news roundup).(General Medical Council)(Brief Article)
May 18, 2002... Nearly two thirds of professional conduct complaints languish for more than a year between committees because of an upsurge in the number of serious cases referred to the General Medical Council. The GMC has admitted that some "fitness to...

PFI is here to stay: with the publication this week of the Commons health committee's inquiry into the role of the private sector in the NHS, Seamus Ward looks at the failures and successes of the private finance initiative. (News).(private finance initiative, UK National Health Service)(Brief Article)
May 18, 2002... The private finance initiative (PFI) is here to stay. That much was confirmed with April's Budget, when ministers announced that the initiative would be extended into primary care and that by 2008 there will be 42 new major hospitals, most of...

Improving teenagers' knowledge of emergency contraception: cluster randomised controlled trial of a teacher led intervention. (Papers).
May 18, 2002... Introduction In recent decades in England the age at which first sexual intercourse is reported as having occurred has declined steadily. (1) The conception rate among teenagers under 18 years old in England is among the highest in the...

Increasing response rates to postal questionnaires: systematic review. (Papers).
May 18, 2002... Introduction Postal questionnaires are widely used to collect data in health research and are often the only financially viable option when collecting information from large, geographically dispersed populations. Non-response to postal...

Corrections and clarifications.(Correction Notice)
May 18, 2002... This Week in the BMJ We inadvertently gave the dates the wrong way round in the key to the figure that accompanied the summary of the paper by Chiara Pandolfini and Maurizio Bonati (9 March, pp 582-3). This gave the impression that the...