British Medical Journal articles from November 2000

British Medical Journal archives from November 2000

Telling stories and listening to them.
November 25, 2000... There's a genre of writing unique to doctors: the tale of the in flight medical incident, where a request goes out for any doctors to make themselves known to the cabin crew. Usually in these stories the passenger doesn't have anything too...

Treating dyslipidaemia in primary care: the gap between policy and reality is large in the UK.(Editorial)
November 25, 2000... The gap between policy and reality is large in the UK Standards three and four of the NHS's National Service Framework for Coronary Heart Disease require primary care teams to identify and modify risk factors in patients who have a...

Accountability for reasonableness: establishing a fair process for priority setting is easier than agreeing on principles.(Editorial)
November 25, 2000... Establishing a fair process for priority setting is easier than agreeing on principles All health systems struggle with the issue of meeting population health needs fairly under resource constraints. Decisions about the implementation of...

The endometrium and embryo implantation: a receptive endometrium depends on more than hormonal influences.
November 25, 2000... A receptive endometrium depends on more than hormonal influences How embryos attach and implant remains a mystery. Implantation represents the remarkable synchronisation between the development of the embryo and the differentiation of the...

Treatment of bipolar affective disorder: new drug treatments are emerging, but more clinical evidence is required.(Editorial)
November 25, 2000... New drug treatments are emerging, but more clinical evidence is required Bipolar affective disorder is a common condition which, among mental illnesses, ranks second only to unipolar depression as a cause of worldwide disability.[1]...

The constant evolution of cataract surgery: it is more effective than ever but not available to many who need it.(Editorial)
November 25, 2000... It is more effective than ever but not available to many who need it Cataract surgery is possibly the world's oldest surgical procedure, introduced to Europe from India by the armies of Alexander the Great. It is now the most frequently...

Poor recovery facilities put patients' lives at risk.(News)
November 25, 2000... A report into the deaths of patients following surgery has said that many hospitals are operating on patients without adequate recovery facilities, putting their health at risk. The finding is one of several criticisms of the way that...

NICE recommends flu drug for "at risk" patients.(National Institute for Clinical Excellence)(News)
November 25, 2000... The National Institute for Clinical Excellence (NICE) recommended this week that zanamivir (Relenza) should be used to treat "at risk" adults when influenza is circulating in the community and if they present within 36 hours of developing...

In brief.(News)
November 25, 2000... BMA backs stem cell research: The BMA is backing the recommendation of the chief medical officer's expert group that research on human embryonic stem cells should be permitted under licence from the Human Fertilisation and Embryology...

Tobacco class action settled out of court.(News)
November 25, 2000... An out of court settlement reached between Israel's tobacco monopoly, the Dubek Tobacco Company, and 80 smokers suing it for compensation in a class action suit, has aroused surprise and anger in the government. The deal, reached after...

Triplets' parents win fight to damages for extra child.(News)
November 25, 2000... A couple who had triplets through in vitro fertilisation won an unprecedented compensation claim last week against a clinic that implanted three embryos instead of the two that the couple told the High Court in Sheffield they had agreed to....

Review condemns poor leadership of Oxford cardiac services.(News)
November 25, 2000... A review into cardiac services in Oxford has said that a lack of leadership, surgeons working autonomously, severe difficulties in recruiting and retaining nursing staff, and a culture of complacency and secrecy have all contributed to a...

AMA sells its membership database.(American Medical Association)(News)
November 25, 2000... The American Medical Association (AMA) has agreed to supply its files on 650 000 doctors to a company specialising in databases to create a joint venture called HealthCareProConnect. The association will earn about $18.8m (13.4m [pounds...

Surgical backup is needed for non-urgent angioplasties.(News)
November 25, 2000... Patients undergoing non-emergency angioplasty in medical centres where surgical backup was not available were twice as likely to die, a study presented last week at the American Heart Association's scientific sessions in New Orleans showed....

Scanning technique shows if heart has irreversible damage.(News)
November 25, 2000... A specialised technique using contrast enhanced magnetic resonance imaging can accurately predict which patients with heart disease will benefit the most from undergoing revascularisation, according to a new study. In the study 50 people...

Hospitals lack proper facilities for patients with tuberculosis.(News)
November 25, 2000... NHS patients and staff are being put at risk of multidrug resistant tuberculosis by the failure of hospital trusts to comply with Department of Health's guidance on isolation. A study to be published next month shows that only 35% of...

WHO's plan to police health websites rejected.(World Health Organization)(News)
November 25, 2000... The body that approves so called "top level" domain names for the internet last week rejected a plan that would have made the World Health Organization (WHO) one of the most powerful players on the world wide web. The WHO wanted to...

GP struck off after 30 patients are infected with hepatitis B.(News)
November 25, 2000... A 70 year old GP in London who served a jail term for performing illegal abortions was struck off the medical register for the second time last week after he admitted causing an outbreak of acute hepatitis B. Madhusudan Shivadikar, who...

National electronic Library for Health goes live.(News)
November 25, 2000... The NHS National electronic Library for Health goes on line next week. A pilot version of the library will be launched to coincide with the first conference of the NHS Information Authority. The library, whose declared aim is to become...

Doctors now able to diagnose sleep apnoea from ECGs.(News)
November 25, 2000... Irish researchers have developed software that enables doctors to diagnose sleep apnoea from electrocardiograms (ECGs). The process could lead to cheaper diagnosis of the sleep disturbance condition. The research was carried out at the...

Cancer pain still undertreated.(News)
November 25, 2000... Pain in cancer continues to be inadequately managed, according to a report of a survey of UK patients with cancer published this week. More than two thirds (70%) of the 157 patients with cancer taking part in the survey reported that they...

US doctors' incomes fell in 1999.(News)(Statistical Data Included)
November 25, 2000... A survey conducted by Medical Economics, a medical business journal, showed a decline in gross and net annual income of many American doctors in 1999. Compared with 1998, the median gross revenue for internists fell by 6.4% to $202 560...

Travellers should be warned of thrombosis risk.(News)
November 25, 2000... Air travellers should in future be given a health briefing at the beginning of their flight, just as they are now given a talk on safety, a report from the House of Lords Select Committee on Science and Technology said this week. The...

Parents "not told" of hospital errors.(News)
November 25, 2000... Nearly half the parents whose children were given the wrong treatment at the Royal Hospital for Sick Children in Glasgow were never told about the mistake, a new survey says. The study, which reviewed five years of treatment errors at the...

State income inequality, household income, and maternal mental and physical health: cross sectional national survey.
November 25, 2000... Abstract Objective To examine the association of state income inequality and individual household income with the mental and physical health of women with young children. Design Cross sectional study. Individual level data (outcomes,...

Enough is enough.
November 25, 2000... The majority of physicians are surfeited to the point of illness by the reading of journals. Cited and translated by D A Kronick in A history of scientific and technical periodicals. New York: The Scarecrow Press, 1962:206-7. ...

Priority setting for new technologies in medicine: qualitative case study.
November 25, 2000... Abstract Objective To describe priority setting for new technologies in medicine. Design Qualitative study using case studies and grounded theory. Setting Two committees advising on priorities for new technologies in cancer and...

Serosurveillance of prevalence of undiagnosed HIV-1 infection in homosexual men with acute sexually transmitted infection.(Statistical Data Included)
November 25, 2000... The prevalence of HIV-1 infection among homosexual and bisexual men attending genitourinary medicine clinics, measured through anonymised testing of samples taken to test for syphilis, has declined in recent years.[1] This decline may be...

Body mass and probability of pregnancy during assisted reproduction treatment: retrospective study.
November 25, 2000... Being underweight or overweight has an adverse effect on reproduction.[1 2] Overweight women have a higher incidence of menstrual dysfunction and anovulation, possibly because of altered secretion of pulsatile gonadotropin releasing hormone,...

Sometimes life isn't fair.(A Memorable Patient)
November 25, 2000... I was working as a locum house officer during my vocational training in a local teaching hospital. The senior house officer and I had split the work between us, he to the accident and emergency department and I had gone to the general...

Lipid concentrations and the use of lipid lowering drugs: evidence from a national cross sectional survey.
November 25, 2000... Abstract Objective To evaluate the prevalence of the use of lipid lowering agents and its relation to blood lipid concentrations in English adults. Design Cross sectional survey. Setting England, 1998. Participants...

Christmas Cards and Calenders.(One Hundred Years Ago)
November 25, 2000... That the habit of sending Christmas and New Year cards has not greatly declined, as some years ago seemed likely to occur, but has, on the contrary, rather increased, is probably due to the greater artistic meat of even the cheaper sorts of...

Management of urinary incontinence in women.
November 25, 2000... Urinary incontinence is defined by the International Continence Society as an involuntary loss of urine that is objectively shown and a social and hygiene problem.[1] Urinary incontinence not only causes considerable personal discomfort but...

Corrections and clarifications.(Correction Notice)
November 25, 2000... Obituaries We apologise for saying that Dr John Sarkies (16 September, p 709) served in the Indian Civil Service; he in fact served in the Indian Medical Service. Lesson of the week: Right sided aortic arch in children with...

A converted "Fruitarian".(One Hundred Years Ago)
November 25, 2000... Mr. Hector Waylen, who not long ago was a militant "fruitarian," and taught that fruits and nuts were the "natural and ultimate food" of mankind, has had his eyes opened to the error of his dietetic ways, and frankly confesses the fact in...

Effectiveness of follow up.(ABC of Colorectal Cancer)
November 25, 2000... Population based studies show that for rectal cancer the incidence of local recurrence after apparently curative resection is about 20%. Local recurrence after surgery for colon cancer is less common. The liver is the commonest site of...

A plastic plug resurfaces.(A Memorable Patient)
November 25, 2000... In 1984 an 8 year old boy was rushed into our general practice from school with a sudden onset of a violent cough. His teacher had noticed him chewing his ballpoint pen immediately before the coughing spasm. He denied that he had inhaled a...

"Is there a doctor on the aircraft?" Top 10 in-flight medical emergencies.(Education and Debate)
November 25, 2000... In the year ending 31 March 1999 British Airways carried 36.8 million passengers and there were 3386 reported in-flight medical incidents: about 1 per 11 000 passengers. Though 70% were managed by cabin crew without the assistance of an...

Age.
November 25, 2000... An aged man is but a paltry thing, A tattered coat upon a stick, unless Soul clap its hands and sing. William Buffer Yeats (1865-1939) Submitted by Fred Charatan, retired geriatric physician, Florida

In-flight medical emergencies: an overview.(Education and Debate)
November 25, 2000... In-flight medical emergencies are attracting increasing interest from the media, travelling public, aviation industry, and medical profession. I discuss the reasons for this and the magnitude of the problem estimated from available data....

Lifestyle medicines.(Education and Debate)
November 25, 2000... Sildenafil and orlistat, prescribed for erectile dysfunction and obesity respectively, have been labelled as "lifestyle drugs" in the popular imagination. Although this description may trivialise serious medical conditions for which the drugs...

Loss of examination status.(Memorable Patients)
November 25, 2000... Lennie was a teacher; knowingly or otherwise, he certainly taught me a lot. It was my first medical firm attachment as a clinical student. Lennie wasn't the first patient who I was responsible for, but he was the most memorable. He had a...

Obituaries.(Obituary)
November 25, 2000... Martha Dorothy Faulkner Former medical missionary Manchuria (b Co Tyrone 1902; q Belfast 1926), d 21 September 2000. In 1926 she went to Manchuria as a missionary with the Irish Presbyterian Church, where she ran the mission hospital at...

Flawless.(Review)
November 25, 2000... Flawless Written and directed by Joel Schumacher MGM & Optimum Releasing, on worldwide general release, in British cinemas 24 November Rating: *** After Flatliners (1990) and Dying Young (1991), Joel Schumacher continues Iris...

Dynamic Practical, Electrocardiography: A Virtual Clinic and Classroom.(Review)
November 25, 2000... Dynamic Practical, Electrocardiography: A Virtual Clinic and Classroom Galen S Wagner, Robert A Waugh, William T Lawson Jr Lippincott-Williams and Wilkins, 42 [pounds sterling] ISBN: 0 683 30380 3 Rating: *** This CD Rom is a timely...

Comprehensive Respiratory Medicine.(Review)
November 25, 2000... Comprehensive Respiratory Medicine Richard Albert, Stephen Spiro, James Jett Mosby, 99.95 [pounds sterling]. pp 800 ISBN 0 7234 3118 3 Rating: **** If you enjoy reading, then textbooks are companions, not to be discarded lightly. New...

Changing Practice in Health and Social Care.(Review)
November 25, 2000... Changing Practice in Health and Social Care Eds Celia Davies, Linda Finlay, Anne Bullman Sage Press, 15.99 [pounds sterling], pp 400 ISBN 0 7619 6497 5 Rating: *** In studying social policy we should be guided by two things--a...

Rational rationing.(Personal Views)
November 25, 2000... Professor Sir Michael Rawlins is the chairman of the National Institute for Clinical Excellence (NICE), the organisation charged with determining best medical treatments. Medical evidence is often contradictory and value laden; many decisions...

Flying and health.(Website of the Week)
November 25, 2000... Flying and health Two articles in this week's BMJ outline the basics of treating people who become unwell while aboard an aircraft. Few doctors will encounter more than one or two of these patients during a lifetime, and, with luck, the...

The treatment of AIDS must be a worldwide effort.(Personal Views)
November 25, 2000... HIV is the cause of AIDS, and the main route of transmission remains unprotected sex. But it is the stigma of HIV that is killing people. As long as people are ostracised for being HIV positive, and as long as sex is not discussed openly,...

Auntie Pat.(Soundings)
November 25, 2000... As a medical student you have to develop an understanding of what is common and what is rare. "Look out of the window," our teachers would say with elaborate sarcasm. "Is that a sparrow or a lesser sulphur-crested cockatoo?" Knowing what...

Minerva.
November 25, 2000... Stress at work is a popular scapegoat for a range of health problems including heart disease and cancer, although a recent cross sectional study suggests that if stress does cause cancer, the mechanism has nothing to do with smoking,...

The well and the not so well read.(Brief Article)(Editorial)
November 18, 2000... Book reviews in the BMJ are not well read. In the past if you had something important to say, you wrote a book. Now you are more likely to opt for a television programme, a newspaper article, or a website. Our age is too impatient for books....

Diagnosing suspected ectopic pregnancy.(Editorial)
November 18, 2000... HCG monitoring and transvaginal ultrasound lead the way Ectopic pregnancy is an important cause of maternal deaths in early pregnancy. In the United Kingdom nine deaths were registered in 1991-3 and 12 in 1994-6. This raises the death...

Ketorolac versus morphine for severe pain.(Editorial)
November 18, 2000... Ketorolac is more effective, cheaper, and has fewer side effects Morphine, titrated intravenously, is the gold standard analgesic for severe pain in emergencies. It is effective and cheap. But morphine has well documented side effects...

The importance of injecting vaccines into muscle.(Editorial)
November 18, 2000... Different patients need different needle sizes Most vaccines should be given via the intramuscular route into the deltoid or the anterolateral aspect of the thigh. This optimises the immunogenicity of the vaccine and minimises adverse...

Barrett's oesophagus: the continuing conundrum.(Editorial)
November 18, 2000... Surveillance should be confined to the surgically fit In 1950 Barrett wrote a treatise to clarify confusion over oesophagitis which connote[s] one thing to some people and something quite different to others."[1] He described gastric...

Screening chromosome ends for learning disability.(Editorial)
November 18, 2000... Small chromosomal rearrangements may be behind idiopathic learning disability Learning disability affects about 3% of the population, yet the cause remains unknown in about 40% of people with moderate to severe learning disability (IQ...

France prepares for more cases of vCJD.(News)(Brief Article)
November 18, 2000... France can expect many cases of variant Creutzfeldt-Jakob disease (vCJD), the country's health minister, Dominique Gillot, has warned. Although only three confirmed cases of the disease have emerged in France, Ms Gillot admitted that many...

Statins can help prevent dementia.(News)(Brief Article)
November 18, 2000... The class of cholesterol lowering drugs known as statins, already widely used to prevent heart disease and stroke, may also reduce the risk of Alzheimer's disease and other dementias, according to two new studies. In the first study,...

In brief.(News)(Brief Article)
November 18, 2000... BMA criticises abolition of health councils: The BMA believes that advocacy for patients will be threatened if community health councils are abolished as is proposed in the NHS Plan for England. It has told the health secretary that any new...

Israel's military condemned over cigarettes handout.(News)(Brief Article)
November 18, 2000... The Israel Defence Forces (IDF) have been condemned for distributing free cigarettes to soldiers assigned to protect Jewish settlements during the current Palestinian uprising. The distribution violates a 1983 law that bars "anyone from...

Families to sue over organ removals.(News)(Brief Article)
November 18, 2000... Families of dead children whose organs were removed at postmortem examinations and stored are to sue the Diana, Princess of Wales Children's Hospital in Birmingham for acting without their consent and for giving them misleading information....

Canada waives examination rules for foreign cancer specialists.(News)(Brief Article)
November 18, 2000... Canadian provinces are so short of oncologists that some are asking regulatory bodies to allow foreign trained specialists to treat cancer patients without first having to pass Canadian specialist examinations. The province of Saskatchewan...

Suicides rise after Diana's death.(News)(Brief Article)
November 18, 2000... A rise in the suicide rate in England and Wales followed the funeral of Diana, Princess of Wales, three years ago, a new study shows. The University of Oxford Centre for Suicide Research found that the overall suicide rate in England and...

German doctors condemn kidney offer.(News)(Brief Article)
November 18, 2000... Patients undergoing dialysis in Germany have received a circular in recent weeks from an organisation based in the Czech Republic offering kidney transplants without waiting lists from live donors. The president of the German Medical...

NHS trust "condoned" abuse of elderly patients.(News)(Brief Article)
November 18, 2000... An NHS trust allowed the repeated abuse of elderly patients to go unchecked for three years, a report by independent investigators found. Patients on a ward at the Garlands Hospital near Carlisle, run by the North Lakeland Healthcare NHS...

Pfizer considers appeal over Viagra ruling.(News)(Brief Article)
November 18, 2000... Pfizer is considering launching an appeal against a court ruling in London that removed patent protection from a key ingredient in Viagra. The patent on Viagra as a compound remains, but the patent covering the use of the phosphodiesterase 5...

NICE to reconsider evidence on interferon beta.(News)(Brief Article)
November 18, 2000... The National Institute for Clinical Excellence (NICE) is to reconsider the evidence for using interferon beta in the treatment of multiple sclerosis. The move follows an appeal against the provisional opinion of the appraisal committee of...

Lowered air pressure on planes may cause thrombosis.(News)(Brief Article)
November 18, 2000... Long haul air travellers may be at increased risk of venous thrombosis, not just in the cramped conditions of economy class but throughout the plane, because of reduced air pressure. A Norwegian research team exposed 20 healthy male...

Enzyme discovery may help curb antibiotic resistant bacteria.(News)(Brief Article)
November 18, 2000... A group of enzymes capable of duplicating damaged DNA and creating new mutations has been discovered by scientists at Israel's Weizmann Institute of Science in Rehovot. The discovery could help researchers find ways to slow the spread of...

EU plans new food authority.(News)(Brief Article)
November 18, 2000... The European Union is set to have its own food authority to help improve safety standards across the 15 nation bloc under plans published by the European Commission earlier this month. Already the proposals have the backing of members of the...

Predisposition for long life may be shared by family members.(News)(Brief Article)
November 18, 2000... Family members may share a genetic predisposition to live to be 100 years or older, according to the results of a new study (Journal of the American Geriatrics Society 2000;48:1483-5). Researchers, led by a team from Harvard Medical...

Milburn promises more hospital beds.(News)(Brief Article)
November 18, 2000... The steady fall in the number of acute hospital beds in England must be reversed if the government is to achieve its aim of expanding NHS capacity and treating more patients, Alan Milburn, the health secretary, told a Commons committee. ...

Ireland opts to encourage breast feeding at work.(News)(Brief Article)
November 18, 2000... Employers in Ireland will have to provide breastfeeding facilities during working hours for the first four months after childbirth if new mothers choose not to take their full maternity leave. The government has also promised to bring the...

Cost effectiveness analysis of intravenous ketorolac and morphine for treating pain after limb injury: double blind randomised controlled trial.
November 18, 2000... Abstract Objectives To investigate the cost effectiveness of intravenous ketorolac compared with intravenous morphine in relieving pain after blunt limb injury in an accident and emergency department. Design Double blind, randomised,...

Fads in medicine.(Brief Article)
November 18, 2000... One is instantly reminded of the malign influence of fashion on medicine, more than any other science. Even nowadays it is subject to fads, although no science is actually more profitable. Pliny the Elder, AD 23-79 Submitted by...

Final results from 10 year cohort of patients undergoing surveillance for Barrett's oesophagus: observational study.
November 18, 2000... Abstract Objectives To review the benefit of an endoscopic surveillance programme for patients with Barrett's oesophagus. Design Observational study. Setting University teaching hospital. Participants 409 patients in whom...

Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study.
November 18, 2000... Abstract Objective To study the impact of interpregnancy interval on maternal morbidity and mortality. Design Retrospective cross sectional study with data from the Perinatal Information System database of the Latin American Centre...

The timing of the "fertile window" in the menstrual cycle: day specific estimates from a prospective study.
November 18, 2000... Abstract Objectives To provide specific estimates of the likely occurrence of the six fertile days (the "fertile window") during the menstrual cycle. Design Prospective cohort study. Participants 221 healthy women who were...

Cross sectional study of differences in coronary artery calcification by socioeconomic status.
November 18, 2000... The relative contribution of socioeconomic differences in risk factors in adulthood versus earlier life to the social class gradient in coronary heart disease is controversial.[1] Socioeconomic position in childhood was a strong predictor of...

Corneal donation in the accident and emergency department: observational study.
November 18, 2000... Corneal grafting restores sight to individuals with corneal damage. Corneal donations have decreased recently from 4419 in 1996 to 3346 in 1998.[1] Patients pronounced dead in accident and emergency departments are potential donors of corneas...

Not an ordinary sore throat.
November 18, 2000... It was a busy Saturday morning surgery. The patient was a 52 year old Menorcan waiter whom I knew vaguely, having seen him a few times when his marriage was in trouble. His new partner made the call at about 10 30 am when there were still 15...

"Hospital at home" versus hospital care in patients with exacerbations of chronic obstructive pulmonary disease: prospective randomised controlled trial.
November 18, 2000... Abstract Objectives To compare "hospital at home" and hospital care as an inpatient in acute exacerbations of chronic obstructive pulmonary disease. Design Prospective randomised controlled trial with three months' follow up. ...