Postgraduate Medical Journal articles from April 2003

Postgraduate Medical Journal archives from April 2003

New approaches to training general practitioners: educating for capability is essential.(Editorial)
April 1, 2003... Vocational training for general practice has been one of the most successful and creative developments in medical education in recent years. The systematic selection, training, support, and monitoring of teachers in local postgraduate deaneries...

Modern treatment of acromegaly. (Review).
April 1, 2003... Acromegaly is an endocrine disorder characterised by increased morbidity and mortality. It is usually caused by a growth hormone secreting pituitary adenoma and is manifested by a variety of clinical features. Surgery is usually the treatment...

Mechanisms of oxidative stress and vascular dysfunction. (Review).
April 1, 2003... The endothelium regulates vascular homoeostasis through local elaboration of mediators that modulate vascular tone, platelet adhesion, inflammation, fibrinolysis, and vascular growth. Impaired vascular function contributes to the pathogenesis...

Impact of respiratory viral infections on cystic fibrosis. (Review).
April 1, 2003... The life expectancy for patients with cystic fibrosis has improved remarkably over the last 20 years. Progressive deterioration of pulmonary function continues despite the aggressive use of antimicrobials. The absence of fever, neutrophilia,...

What should a suspended doctor do when his actions could save a patient's life? (Review).
April 1, 2003... Suspension from duty is becoming an increasing threat for medical practitioners. While under suspension a doctor may, in extreme circumstances, find themselves in a difficult legal dilemma as to their duty of care towards others. A suspended...

Acute glomerulonephritis. (Best Practice).
April 1, 2003... Glomerulonephritis is an important cause of renal failure thought to be caused by autoimmune damage to the kidney. While each type of glomerulonephritis begins with a unique initiating stimulus, subsequent common inflammatory and fibrotic...

Chest radiographs in the emergency department: is the radiologist really necessary? (Original Article).
April 1, 2003... Background: The chest radiograph is considered one of the most complex imaging modalities to interpret. Several studies have evaluated radiograph interpretation in the emergency department, and considerable disagreement among clinical...

Using rifampicin against TB risks a rare reaction. (Echo).(tuberculosis)(Brief Article)
April 1, 2003... A case study of pneumonia induced by rifampicin in pulmonary tuberculosis should remind doctors to be alert to this very rare--but potentially fatal--reaction. The case was of an 81 year old man being treated in hospital for pulmonary...

Oral vitamin B12 can change our practice. (Original Article).
April 1, 2003... Oral vitamin B12 can provide an effective alternative to intramuscular injections, so giving patients a choice and reducing costs in primary care. This study investigated the effectiveness, safety, and acceptability of oral vitamin B12 as...

Rice bodies in ischiogluteal bursitis. (Images in Medicine).(Brief Article)
April 1, 2003... A 58 year old woman with rheumatoid arthritis suffered from pain and swelling in the right buttock. The pain was greatly aggravated by sitting. Computed tomography and magnetic resonance imaging (MRI) revealed a cystic mass lesion with thick...

Results of a programme to improve house staff use of metered dose inhalers and spacers. (Original Article).
April 1, 2003... Purpose: Metered dose inhalers (MDIs) and spacers are used widely in the treatment of asthma. Medical personnel who are responsible for training patients must themselves be proficient with the devices. The proficiency of a group of new medical...

Fellowship affairs.
April 1, 2003... Dr. Barry Hoffbrand Last year, Barry Hoffbrand demitted office as a member of the editorial board of the Fellowship of Postgraduate Medicine on retiring from full time clinical practice. Barry joined the editorial board 30 years ago;...

Iron deficiency anaemia: are the British Society of Gastroenterology guidelines being adhered to? (Audit).
April 1, 2003... Background: The British Society of Gastroenterology (BSG) issued guidelines on the investigation of iron deficiency anaemia (IDA) ensuring standardised and comprehensive gastrointestinal investigation in all patients. It was apparent that not...

History of the development of geriatric medicine in the UK. (History of Medicine).
April 1, 2003... In this review the development of the specialty of geriatric medicine in the UK is traced from its humble beginnings. Elderly medicine is now thriving and represents the largest group of physician members of the Royal Colleges of Physicians....

Latrogenic injury to the breast bud causing breast hypoplasia. (Case Report).
April 1, 2003... A 14 year old girl with iatrogenic breast asymmetry is reported. She had multiple operations to the left anterior chest wall in the neonatal period for diaphragmatic hernia that resulted in multiple scars, which damaged the left breast bud. A...

Unusual cause of infective discitis in an adolescent. (Case Report).
April 1, 2003... The first case of infective discitis caused by Eikenella corrodens in an adolescent is presented. The need for anaerobic cultures when dealing with infective pathology in the spine is stressed. A 14 year old boy presented with acute...

Recurrent autumnal psychosis. (Case Report).
April 1, 2003... Acute confusional states in the older patient often have a remediable cause. Every effort should be made to ascertain the cause so that appropriate treatment can be given and future episodes prevented. A patient is described who presented with...

Facial and dental appearance of Williams syndrome. (Images in Medicine).
April 1, 2003... Williams syndrome is a genetic condition, which predominantly occurs as a sporadic disorder, although some families have been reported showing autosomal dominant inheritance with varying penetrance. The incidence of Williams syndrome is...

A case of reduced consciousness and hypoventilation. (Reduced Consciousness and Hypoventilation).
April 1, 2003... A 45 year old housewife was admitted to hospital after a fall at home, after which she had had three fits. Although her eyes were open, she was not responding to questions and her husband gave the history. A month previously she had been...

Dyspnoea and a subcutaneous swelling. (Respiratory Medicine).
April 1, 2003... An 81 year old electrician was admitted with exertional dyspnoea and weight loss. His exercise tolerance was decreased to 50 yards. He did not smoke, and denied chest pain or haemoptysis. On examination there were decreased movements of the...

Recurrent gastrointestinal bleed. (Gastrointestinal Bleed).
April 1, 2003... A 21 year old man was admitted with three episodes of recurrent haematemesis and colicky right upper quadrant abdominal pain. After the first bleed he developed jaundice, which was short lasting. This was associated with fever, chills, and...

Acute severe anaemia in an elderly patient with hereditary sphaerocytosis. (Infection).
April 1, 2003... A 63 year old man with known hereditary sphaerocytosis was admitted to our hospital with a two day history of fever up to 37.9[degrees]C and chills. On clinical examination, he was icteric and had splenomegaly. His blood pressure was 130/70 mm...

Key Questions in Surgical Critical Care. (Book Reviews).(Book Review)
April 1, 2003... By R U Ashford, T N Evans, R A Archbold. (Pp 235; [pounds sterling]24.50,) Greenwich Medical Media, 2003. ISBN 1-84110.092-7. **** I really liked this book. It deals with most of the critical care topics that come up in surgical MRCS...

Surgical Critical Care--Vivas. (Book Reviews).(Book Review)
April 1, 2003... By Mazyar Kanani. (Pp 233; [pounds sterling] 19.50.) Greenwich Medical Media, 2003. ISBN 1-84110-131-1. *** This concise revision aid is directed towards the MRCS candidate but deserves a wider readership. Sixty five topics such as airway...

Recent Advances in Paediatrics. (Book Reviews).(Book Review)
April 1, 2003... Edited by Professor Tim J David. (Pp 231; [pounds sterling]35.) Royal Society of Medicine Press Ltd, 2002. ISBN l.85315-509-8. **** This paperback book edited by Professor Tim David has 14 chapters written by experts in their field, both...

Books received.(Bibliography)
April 1, 2003... The receipt of these books is acknowledged and this listing must be regarded as sufficient return for the courtesy of the sender. Books that appear to be of particular interest will be reviewed space permitted. The journal does not publish...