Student BMJ articles from February 2003

Student BMJ archives from February 2003

Editor's Choice: A little bit of this, a little bit of that.
February 1, 2003... How intelligent are you? Are you brainy in the traditional sense? I've always thought that most students are relatively intelligent otherwise they wouldn't be studying at university. But maybe I'm wrong--what does intelligence mean? In the...

Racism and health: Kwame McKenzie says racism may be aetiologically important in the development of an illness. (Editorials).(patients being treated differently)(Editorial)
February 1, 2003... Discussion of racial discrimination in medicine has concerned mainly recruitment and career development. (1 2) This has overshadowed a growing literature showing an association between racism and morbidity and mortality. (3-7) Racism may be...

The challenge of myalgic encephalomyelitis: Samantha Radford looks at the controversy surrounding myalgic encephalomyelitis. (Editorials).(exact cause still unknown)(additional researcch required)(Editorial)
February 1, 2003... A collective sigh of relief was heard across the United Kingdom in January 2002 when the chief medical officer, Professor Liam Donaldson, published his working group report describing myalgic encephalomyelitis (ME) as a "real, debilitating,...

Former nursing student Laura Shave has ME; she shares her views. (Commentary).(Myalgic encephalomyelitis)
February 1, 2003... Myalgic encephalomyelitis is an illness that cuts against the grain of how doctors are trained and challenges them to the core. If you can't give a patient medication what can you do? Doctors choose to be doctors because they want to help...

Consent for intimate examinations may not be adequate. (News).
February 1, 2003... Doctors teaching students to do intimate examinations on anaesthetised patients do not obtain adequate consent in almost a quarter of cases, a study has shown. The study, led by a medical student, surveyed 386 students in the second, third,...

More doctors is not the answer to EU Working Time Directive. (News).(European Union)
February 1, 2003... "Recruiting additional doctors just to make all existing on call rotas compliant with the European Working Time Directive will not be an effective use of financial and human resources," warns the Department of Health in guidance issued this...

Cigarette possession becomes illegal in Nova Scotia for under 19s. (News).(Brief Article)
February 1, 2003... On 1 January it became illegal for people under the age of 19 in the Canadian province of Nova Scotia to possess or smoke cigarettes. Young people caught with cigarettes by police will not be charged or fined, but police will be authorised to...

Patients have more confidence in non obese doctors. (News).(Brief Article)
February 1, 2003... If medical students want to become trustworthy doctors then they need to get in shape, according to a study published in the journal Preventive Medicine in January. Researchers from Mercer University School of Medicine, Georgia, United...

Medical education in Germany slowly reforms. (News).
February 1, 2003... Current medical students in Germany will be the last to complete their undergraduate training before new federal curriculum regulations are implemented this autumn. The Approbationsordnung, which governs undergraduate training at all German...

Homosexuality is not a disease, says Thai government. (News).(Thailand's Department of Mental Health issues statement)(neither mental problem or disease)
February 1, 2003... The government of Thailand has belatedly agreed that homosexuality is not a disease. The recent statement comes after lobbying by Anjaree, Thailand's leading group campaigning for gay rights. The Thai Department of Mental Health issued a...

Countries with better health systems have better football teams. (News).(data can be misused)
February 1, 2003... When Bill Shankley, past manager of Liverpool Football Club, famously remarked that "some people think football is a matter of life and death... I can assure them it is much more serious than that," he might just have had a point. New...

Lack of new drugs is reaching crisis point, says review. (News).(drug application numbers down)(Illustration)
February 1, 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...

"Is painting the earliest portrayal of Down's syndrome? (News).(The Adoration of the Christ Child)(Brief Article)
February 1, 2003... Psychiatrists have identified what is believed to be one of the earliest paintings of someone with Down's syndrome. The 1515 Flemish painting (detail right), by an unknown artist, considerably predates John Langdon Down's first...

Ophthalmology: gritty, irritable eyes; in the fourth part of the series, Sophia Pathai and Andrew McNaught explain possible causes of gritty, irritable eyes. (Education).(related article: Key points)
February 1, 2003... Although it may seem a trivial problem, gritty irritable eyes cause discomfort for many patients. Patients on the ward will probably mention their symptoms to you and then expect you to help alleviate their problems. Irritable eyes also...

And it's not just verbal communication that could be improved. (Minerva).(illegible handwriting in medical notes also a problem)(Brief Article)
February 1, 2003... And it's not just verbal communication that could be improved, illegible handwriting in medical notes puts patients at risk, and it makes research and audit very difficult A Spanish survey found that 15% of all the notes examined were so...

10 minute consultation: food allergy; as part of a series of problems common in primary care (see p 1), Aziz Sheikh and Samantha Walker take you through food allergy. (Education).(related article: Self help groups)
February 1, 2003... A newly qualified teacher requests investigations for possible food allergies. She has been troubled with symptoms of tiredness, nausea, bloating, and intermittent diarrhoea. Bread and chocolate have been identified as possible triggers, and...

They just can't help it: Sara Alsaraf and Mary Robertson explain Tourette's syndrome and look at the disease behind a highly stigmatised illness. (Education).
February 1, 2003... Imagine you are expecting your first child. Nine months on, the miracle of having a child still overwhelms you. Your baby boy is tiny, beautiful, and full of energy. Back at home, aged six months, his energy is unrelenting. You can't...

The evidence based clinician: part 5--applying evidence to your patient; in the final part of this series, Christopher Ball explains how to apply evidence about prognosis to your patient. (Education).(Illustration)
February 1, 2003... Many clinical decisions depend on doctors making predictions about the likely consequences of diseases on patients. Unfortunately, risk can be difficult to understand--people and governments often behave illogically in response to perceived...

Vaginal bleeding and vomiting in early pregnancy. (Picture Quiz).
February 1, 2003... Case history A 45 year old woman was in the 14th week of her second pregnancy. Fourteen years ago she gave birth to a normal baby at term. She now complained of heavy vaginal bleeding to her general practitioner. She missed her...

Midlife medicine: Tosan Okoro talks to Ged Garbutt, a former sports scientist and professor of health science, about why he made the switch to medicine at the tender age of 41. (Careers).
February 1, 2003... What is the fascination with medicine? Why do we choose to pursue this career in an era when patients are dissatisfied and stories in the media paint a picture of doom and gloom? Recently, a 46 year old woman was accepted to study a new...

Emotional intelligence: in the second article in his series on intelligence, Brian McMullen explores how doctors can get in touch with their feelings and why this is important. (Careers).(managing emotion)
February 1, 2003... Again, we feel anger and fear without choice, but the virtues are modes of choice or involve choice. Aristotle, Nichomachean Ethics, book 3 A few years ago, when I worked as a full time general practitioner, I did not like certain...

Episode 1: The body in the evidence base room. (Soap Opera).(Fictional Work)
February 1, 2003... Since the last issue of student BMJ, BMJ careers has launched a soap opera. It is now up to episode 7, but you can read the first instalment here, but catch up with the rest and read it every week at bmjcareers.com There are cockroaches...

James Jobanputra: Sabina Dosani talks to the doctor behind Sexpression--a national network of sex education initiatives led by students in the community. (Profile).
February 1, 2003... "Youth is the power for change,' is one of James Jobanputra's mottoes. It is easy to see why: as a medical student, he taught AIDS awareness in Africa, sex education in Scotland, and founded Sexpression, which has become a national network of...

Teething symptoms: cross sectional survey of five groups of child health professionals. (Papers).(evidence-based medicine versus professional opinions)
February 1, 2003... "There can be no excuse for ascribing fever, fits, diarrhoea, bronchitis, or rashes to teething," said an editorial in the BMJ in 1975. (1) The intervening quarter century has seen the growth of evidence based medicine, yet it has also...

Commentary: Mona Okasha takes you through this paper and explains what it means. (Papers).(Wake and Hesketh study)(prevalence of symptoms associated with teething)(five groups of health professionals participated)
February 1, 2003... Over recent decades, doctors have been more and more encouraged to practise evidence based medicine--to base their medical decisions on research evidence--although clinical experience is still important. One of the foremost efforts in this...

Hey gringo: Jenny Hall spent a month working in a hospital in Honduras. She tells of her experiences working in a poorly funded health service and the great hospitality that she received. (Life).(fourth year medical student's elective)(related article: Key facts)
February 1, 2003... Until about three months ago I would have had trouble finding Honduras on a map, so I had no idea what to expect during my summer there. Honduras--the "knee" of Central America--is probably most widely known because of the devastation left by...

Caught between two worlds. (Life).(medical students in Honduras)(clinics for the indigenous people, the Lenca Indians)
February 1, 2003... Tin Do and Natasha Marston went to Honduras and spent time working with the indiginous population, the Lenca Indians. They learnt about many of the problems unique to indigenous people and talk about some of them here. We went to...

STA Travel. (Advertisement Feature).(services to student travelers)(Brief Article)(Advertisement)
February 1, 2003... STA Travel are specialists in student and young independent travel, offering low cost flights, accommodation, insurance, and adventure tours. STA Travel staff are experienced travellers, with 60 branches in the UK and 400 worldwide. With our...

Planning your elective--Honduras: Mark Wilson gives you some tips on arranging your elective in Honduras. (Life).(considerations for medical students)(related article: Hospitals)(Directory)
February 1, 2003... Despite being one of the world's biggest banana exporters, Honduras, as this month's elective reports show, is poor. Honduras has been independent from Spain since 1821, but military dictatorships prevented democracy until 1984. Natural...

Let's talk about sex: Sabina Dosani explains Sexpression, a project in which medical students go into schools and teach pupils about sex and relationships. (Life).
February 1, 2003... Who told you about sex, when you were at school? Was it a biology teacher, a parent, or a friend? It probably wasn't a medical student. You might be surprised that up and down the country medical students are learning how to teach about sex...

Filtering guinea worms in Sudan: Anita Suri Kass explains how Dr Anders Seim had the initiative to put a simple prevention measure into large scale production to help eradicate a painful and debilitating parasitic disease. (Life).(control of parasitic infection)(small pipe with filter to drink water)
February 1, 2003... The guinea worm or Dracunculus (Latin for little dragon) is thought to have existed since ancient times. To this day, treatment involves wrapping the worm around a stick. This ancient parasitic infection is nearing extinction, with only Sudan...

The Glostavent. (Life).(anaesthetic machine)(for use in difficult situations)
February 1, 2003... Victoria Harris explains the difficulties of using and maintaining anaesthetic equipment in isolated or developing parts of the world; she tells us how a doctor from Gloucester invented and developed a solution. Operating theatres have a...

Witty Ticcy: Nadeeja Koralage looks at the stigma around Tourette's syndrome and the impact of the media. (Life).(a look a how Tourette Syndrome is portrayed in four novels)
February 1, 2003... What does Tourette's syndrome make you think of? Ally McBeal or that episode of the Simpsons when Bart had to be put on haloperidol and he s-l-o-w-e-d right down? The facts Eminem recently claimed to have the symptoms of Tourette's...

Who examines evidence? (Life).(Very Senior Clinicians versus Omniscient Meta-analysts)
February 1, 2003... The case for evidence based medicine is strong. Some 50 years ago, teaching medical students was based on the experience of Very Senior Clinicians who wrote or edited medical textbooks. But if you read a textbook published just 20 years ago,...

The bag: Zoe Ash investigates the neurologist's bag and explains what you can tell about these specialists by the state of their toolkit. (Life).
February 1, 2003... You may know well the favourite game of many doctors: "I want you to tell me the diagnosis of the next patient within five seconds." (It is always Parkinson's disease.) I want to introduce the same game applied to doctors themselves. During a...

A neurologist says. (Life).(differences between United Kingdom and the United States)(Brief Article)
February 1, 2003... Only a neurologist with a petrified diaphragm could fail to enjoy the description of the neurologist's bag. The article also highlights certain salient aspects of the delivery of medical care. Neurologists in the United Kingdom spend most...

How to be Good. (Reviews).(Book Review)
February 1, 2003... With New Year's resolutions flying about perhaps it's the time of year to consider How to be Good--I was sad when I finished this book. Not that grieving at the end of a fantastic read, but because I thought it was going to be good. I felt...

Plague time: the New Germ Theory of Disease. (Reviews).(Book Review)
February 1, 2003... Yesterday's heresy is often tomorrow's fact and vice versa. This makes medical research exciting and, of course, necessary. Many examples support this statement, from the anatomist Vesalius's findings to the very latest research. Paul...

Nothing is Impossible: reflections on a New Life. (Reviews).(Book Review)
February 1, 2003... Falling from a horse in 1995 left Christopher Reeve quadriplegic, dependent on a ventilator. He wanted to be on his feet by his 50th birthday (in September 2002), and although he has not achieved this goal he has made remarkable progress. ...

Medicine and Art. (Reviews).(Book Review)
February 1, 2003... Alan Emery is a distinguished British neurologist and an amateur painter; his wife, Marcia, is a librarian and trained psychologist. This book reflects their shared love of art and history, and contains more than 50 colour illustrations of...

Creative intentions. (Personal View).(sleepiness detector--the Z-ometer)(now on the back burner)
February 1, 2003... Somewhere in the rut of last winter's bleak and eternal hopelessness, I had my annual creativity crisis. Huffing and puffing at the barren wilderness of revision for finals, I realised it was time to take action, to do something radical,...

Always a medical student. (Personal View).(professor is still learning)
February 1, 2003... I started as a medical student 15 years ago. Now I am part of a teaching faculty, but I still feel like a student. The professor also feels the same way after 40 years. Science is always changing, and whatever we learn today is soon washed...

Physician--heal thyself? (Soundings).(doctors and medical students )(need to pay attention to their own health issues)
February 1, 2003... A woman who had been recently diagnosed as having cancer decided not to accept any treatment because she felt that there was "no point." I was surprised by this because the chances sounded quite good to me. Two years have later I have...

Spiders inspire legendary levels of fear and anxiety. (Minerva).(few significant clinical effects to spider bites)(Brief Article)
February 1, 2003... Spiders inspire legendary levels of fear and anxiety. But an Australian prospective follow up study of 750 people who attended emergency departments with definite spider bites found surprisingly few significant clinical effects. Among these...

Here's the latest search for another use of statins. (Minerva).(treatment of multiple sclerosis)(Brief Article)
February 1, 2003... Here's the latest search for another use of statins: this time they are being tested as a treatment for multiple sclerosis. American scientists used mouse models to show that atorvastatin prevented disease relapse and lowered levels of...

A UK national programme. (Minerva).(United Kingdom)(reporting of clinical errors)(Brief Article)
February 1, 2003... A UK national programme launched in October encourages the reporting of all clinical errors and significant events in order to learn from them. The US healthcare system has recently come under similar close scrutiny. One survey of patients...

Baby slings are catching on in countries more used to pushchairs and prams. (Minerva).(Brief Article)
February 1, 2003... Baby slings are catching on in countries more used to pushchairs and prams. But are they safe? A small, short term crossover trial of preterm and term babies carried horizontally or vertically in slings, and lying in prams, reports that sling...

Do men and women differ in their response to antidepressants? (Minerva).(Brief Article)
February 1, 2003... Do men and women differ in their response to antidepressants? Some studies suggest they do, and menopausal status may influence matters too. However, data from almost 2000 patients collected over 20 years from one outpatient department refute...

A meta-analysis of randomised controlled trials that looked at acupuncture. (Minerva).(small benefit for disability due to stroke)(Brief Article)
February 1, 2003... A meta-analysis of randomised controlled trials that looked at acupuncture as a way of improving motor recovery after stroke found that acupuncture offers no additional effect on this, but has a small positive effect on disability. The...

As graft versus host disease is thought to derive from direct T cell injury of target tissues. (Minerva).(Brief Article)
February 1, 2003... As graft versus host disease is thought to derive from direct T cell injury of target tissues and to be mediated by inflammatory markers such as interleukin-1, it makes sense to see what happens when interleukin-1 is blocked. When the...

People with diabetes may need to watch not just what food they eat. (Minerva).(and how to cook it)(Brief Article)
February 1, 2003... People with diabetes may need to watch not just what food they eat, but how they cook it (www.pnas.org/cgi/doi/10.1073/pnas.242407999) "Advanced glycation end products" are the toxic byproducts of spontaneous interactions between sugars,...

Some countries recommend giving iron supplements to young babies. (Minerva).(another study indicates may produce negative effects)(iron deficiency anaemia)(Brief Article)
February 1, 2003... Some countries recommend giving iron supplements to young babies, even though the prevalence of iron deficiency anaemia is low. The jury is still out about the wisdom of giving iron supplements to low risk babies, but one randomised placebo...

Much attention has been focused on "care in the community" for people with mental health problems. (Minerva).(acute inpatient care being neglected)(Brief Article)
February 1, 2003... Much attention has been focused on "care in the community" for people with mental health problems, and acute inpatient care has been somewhat neglected. Writing in Psychiatric Bulletin (2002;26:428-3), one medical director painfully notes...