Postgraduate Medical Journal articles from August 2002

Postgraduate Medical Journal archives from August 2002

Chronic unexplained fatigue: "a riddle wrapped in a mystery inside an enigma". (Chronic Fatigue).(d)
August 1, 2002... After more than two years' gestation, an independent working group, set up by the previous Chief Medical Officer for England, published its final report on the subject of chronic fatigue syndrome (CFS) in January of this year. (1) This is a...

Humour and love: the origination of clown therapy; compassion, joy, love, and humour are essential to build healthy and peaceful societies. (The Love Strategy).
August 1, 2002... The events of terror in the United States on 11 September 2001 have provoked many reactions and the traditional revenge/fear action. The casual, quick acceptance of this response globally, instead of outrage over more senseless carnage, is...

Gesundheit. (Book Review).(Book Review)
August 1, 2002... Gesundheit (Patch Adams, Healing Arts Press, [pounds sterling]13.99; ISBN 0-89281-781-X) For anyone who has seen Robin Williams in Patch Adams this book is essential reading. The issues raised in the film about the relationships between...

Use of bacille Calmette-Guerin in superficial bladder cancer. (Review).
August 1, 2002... Intravesical bacille Calmette-Guerin (BCG) has been used by urologists for several years after its first reported use as a cancer therapy in the 1930s. Morales in 1976 described the usage of BCG as a once weekly intravesical instillation for...

Oral candidiasis. (Review).
August 1, 2002... Oral candidiasis is a common opportunistic infection of the oral cavity caused by an overgrowth of Candida species, the commonest being Candida albicans. The incidence varies depending on age and certain predisposing factors. There are three...

Multiple sclerosis and pregnancy. (Review).
August 1, 2002... Multiple sclerosis causes disability in young adults and, like most autoimmune diseases, affects women more commonly than men. The disease can therefore present at a time when many have, or are considering, starting a family. The effect of...

Acid suppression in gastro-oesophageal reflux disease: Why? How? How much and when? (Review).
August 1, 2002... For patients with suboptimal relief from lifestyle modifications, acid suppressive therapy remains a cornerstone of treatment for gastro-oesophageal reflux disease (GORD). While a great deal of attention is focused on complications of GORD,...

Congenital scoliosis in a neonate: can a neonatologist ignore it? (Review).
August 1, 2002... The frequency of diagnosis of congenital scoliosis in the neonatal period is expected to rise given the increasing survival of high risk neonates in the surfactant era and their frequent exposure to x rays. Considering its significant long term...

Superior lumbar hernia of Grynfellt. (Images in Medicine).(Brief Article)
August 1, 2002... A 44 year old woman was investigated for a soft, non-tender, reducible swelling, measuring 5 cm in diameter in her left lumbar region. There was no cough impulse. An abdominal computed tomogram revealed a superior lumbar hernia, first described...

Management of colorectal cancer. (Best Practice).
August 1, 2002... Colorectal cancer is the second most common cause of cancer death in the UK. Prompt investigation of suspicious symptoms is important, but there is increasing evidence that screening for the disease can produce significant reductions in...

Patient recall of medication details in the outpatient clinic. Audit and assessment of the value of printed instructions requesting patients to bring medications to clinic. (Original Article).
August 1, 2002... Objective: There is no ambiguity when a patient presents their medications in the correct packaging during a consultation and declares, "this is what I am taking, doctor, I take this many, at this time". The aim of this study was to establish...

Elbow fistulas using autogeneous vein: patency rates and results of revision. (Original Article).
August 1, 2002... Background: The provision and maintenance of vascular access remains a major cost to end stage renal failure programmes. There are few reports regarding the surgical revision of the failing native elbow arteriovenous fistula (AVF). ...

Latrogenic causes of falls in hospitalised elderly patients: a case-control study. (Original Article).
August 1, 2002... Objective: To explore risk factors associated with falls and to evaluate a strategy used by nurses to predict and prevent falls in a hospitalised cohort of elderly patients. Design: A case-control study of risk factors for falls in...

Unusual cardiac manifestation of hypereosinophilic syndrome. (Case Report).
August 1, 2002... Hypereosinophilic syndrome was diagnosed in a 14 year old girl who presented with recurrent syncope. An ambulatory electrocardiogram revealed intermittent type 2 second degree left atrioventricular (AV) block. Focal thinning of the...

Multifocal cardiac leiomyosarcoma. Diagnosis and surveillance by transoesophageal echocardiography and contrast enhanced cardiovascular magnetic resonance. (Case Report).
August 1, 2002... Primary cardiac sarcomas are rare and typically undergo aggressive local spread. There is no reliable definitive treatment, although radical surgical resection can provide palliation in the medium term. A case of a pleomorphic leiomyosarcoma...

Idiopathic heterotopic ossification in the intensive care setting. (Case Report).
August 1, 2002... Heterotopic ossification is characterised by the periarticular deposition of ectopic bone. It typically occurs after trauma, neurogenic injury, or congenitol causes. Idiopathic heterotopic ossification has been rarely reported. A patient who...

Free gas in the peritoneal cavity: the final hazard of diathermy. (Case Report).
August 1, 2002... Fires and explosions in the operating theatre are rare events, but are devastating in terms of structural damage to the equipment in theatres and to human lives. Fuel, oxygen, and source of ignition are the three factors causing explosion....

Eosinophilic gastroenteritis mimicking pancreatic cancer. (Case Report).
August 1, 2002... Eosinophilic gastroenteritis is a condition characterised by easinophilic infiltration of the gastrointestinal tract. Biliary obstruction is an unusual presentation. A case where the initial investigations were consistent with carcinoma of the...

Homocysteine and "Buerger's disease".
August 1, 2002... A 42 year old woman presented with ischaemic left leg pain. There had been a right above knee amputation two years previously when Buerger's disease was diagnosed. However, on review of the arteriogram there was proximal disease in the...

A patient with bag of pancreatic stones. (Pancreatic Stones).
August 1, 2002... A 26 year old woman presented with history of recurrent colicky abdominal pain since childhood. There was a history suggestive of steatorrhoea, polyuria, and polydipsia of eight years' duration. On general examination she had pulse rate of 80...

Ischaemic foot: an unusual cause. (Ischaemic Foot).
August 1, 2002... A 15 year old boy presented with a four month history of intermittent claudication of right calf at 500 yards, which gradually got worse and he subsequently developed numbness and discoloration of the right foot. He was a non-smoker,...

Type IV Ehlers-Danlos syndrome: a surgical emergency. (Ehlers-Danlos Syndrome).
August 1, 2002... A 35 year old man was admitted with abdominal pain, distension and vomiting for three days, and haematochezia for one day. He was known to have type IV Ehlers-Danlos syndrome, and this had previously caused an intracerebral bleed and...

Galactorrhoea in a 16 year old girl with a large sellar mass. (Galactorrhoea).
August 1, 2002... A 16 year old girl was admitted because of low grade fever, headache, and nuchal rigidity. She complained of galactorrhoea during the preceding year and irregular menstruation since menarche at 13 years old. Physical examination was...

An unusual complication of ulcerative colitis. (Ulcerative Colitis).
August 1, 2002... A 48 year old man presented with cough, purulent sputum production, wheeze, and reduced exercise capacity. He described rapid weight loss of 9 kg over six months, associated with night sweats. He denied chest pain or haemoptysis. He had a 30...

Principles for Best Practice in Clinical Audit. (Book Reviews).(Book Review)
August 1, 2002... By NHS, National Institute for Clinical Excellence, CHI (Commission for Health Improvement), Royal College of Nursing, University of Leicester. (Pp 196, paperback plus CD ROM; [pounds sterling]19.95 For NHS staff and organisations, [pounds...

A Guide to Medical Publishing and Writing. (Book Reviews).(Book Review)
August 1, 2002... Edited by Peter Richardson. (Pp 145; [pounds sterling]10.99.) Quay Books, 2002. ISBN 1-85642-222-4.*** This is a 14 author, 15 chapter booklet containing a collection of pieces on electronic and paper writing and publishing. It was...

Atrial Fibrillation in Practice. (Book Reviews).(Book Review)
August 1, 2002... By Gregory Y H Lip. (Pp 68; [pounds sterling]14.95.) Royal Society of Medicine Press, 2002. ISBN 1-85315-484-9.**** This monograph published by the Royal Society of Medicine is an excellent overview of the most common cardiac arrhythmia,...