Postgraduate Medical Journal articles from February 2001

Postgraduate Medical Journal archives from February 2001

Professional accountability in a changing world.
February 1, 2001... The context in which medicine is practised in Britain has changed beyond all recognition since the profession took its first strides into the comprehensive system of heath care enshrined in the postwar ideal of a national health service. ...

Renal failure in atherosclerotic renovascular disease: pathogenesis, diagnosis, and intervention.
February 1, 2001... Atherosclerotic renovascular disease (ARVD) is increasingly recognised as an important cause of both chronic and end stage renal failure. These patients tend to do badly on dialysis, which reflects their systemic atherosclerotic burden. In an...

Modern management of oesophageal varices.
February 1, 2001... Abstract Haemorrhage from oesophageal varices is a life threatening emergency with a mortality rate in the order of 30%-50%. In the last three decades there have been many advances in the treatment and prevention of variceal bleeding. Over...

Non-steroidal anti-inflammatory drugs and gastrointestinal damage--problems and solutions.
February 1, 2001... Non-steroidal anti-inflammatory drugs (NSAIDs) have been used for many years for analgesic, anti-inflammatory, and more recently in the case of aspirin, antithrombotic purposes. The use of NSAIDs continues to increase; over 22 million...

Parkinson's disease and anxiety.
February 1, 2001... Abstract There has been a recent surge of interest in the subject of anxiety in patients with Parkinson's disease. Up to 40% of patients with Parkinson's disease experience clinically significant anxiety. This anxiety may be a...

New insights into atherosclerotic plaque rupture.
February 1, 2001... Coronary artery atherosclerosis is the major cause of mortality and morbidity in the industrialised world. Progressive narrowing of coronary arteries causes angina. However, it is rupture of the plaque that causes the catastrophic consequences...

Important points in the clinical evaluation of patients with syncope.
February 1, 2001... A careful history, physical examination, and an electrocardiogram (ECG) are the most important components of the evaluation of a syncopal episode. These three components will provide a diagnosis or determine whether diagnostic testing is...

Falls and confidence related quality of life outcome measures in an older British cohort.
February 1, 2001... Abstract Falls are common in older subjects and result in loss of confidence and independence. The Fails Efficacy Scale (FES) and the Activities-specific Balance Confidence scale (ABC) were developed in North America to quantify these...

Psychological stress, anxiety, depression, job satisfaction, and personality characteristics in preregistration house officers.
February 1, 2001... Abstract Work related stress and anxiety may have a profound effect on an individual's wellbeing. In the case of doctors this may also affect patient care. This study measured stress, anxiety, and job satisfaction and the influence of...

A case of cerebral haemorrhage--can Ginkgo biloba be implicated?
February 1, 2001... Abstract The case of a 56 year old man who suffered a spontaneous intracerebral haemorrhage after regular self medication with the herbal preparation, Ginkgo biloba leaf extract is described, and the possible association is discussed. ...

Angiotensin converting enzyme inhibitor induced hyperkalaemic paralysis.
February 1, 2001... Abstract Secondary hyperkalaemic paralysis is a rare condition often mimicking the Guillain-Barre syndrome. There have been a few case reports of hyperkalaemia caused by renal failure, trauma, and drugs where the presentation has been with...

Aortitis as a manifestation of myelodysplastic syndrome.
February 1, 2001... Abstract Aortitis is the inflammation of the wall of the aorta and can occur from an infection or autoimmune disease. Myelodysplastic syndrome (MDS) is characterised by abnormal haematopoiesis and a dysfunctional immune system. Autoimmune...

Candida endophthalmitis: an unusual complication of prolonged intravenous access.
February 1, 2001... Abstract A 16 year old boy awaiting a defunctioning colostomy for Crohn's disease complained of reduced vision in his left eye. Four weeks previously candida had been isolated from his central line used for parenteral feeds. Fundal...

Recurrent abdominal pain--the forgotten cause.
February 1, 2001... A 23 year old man presented to the casualty department with right periorbital oedema. A diagnosis of urticaria was made, antihistamines were prescribed, and he was discharged home. Within 24 hours he returned complaining of increased facial...

A rare coincidence and recurrent urinary tract infections.(weight loss and urinary tract infection)
February 1, 2001... A 68 year old woman was referred for recurrent episodes of urinary tract infection and weight loss of four months' duration. She gave a history of intermittent brownish discharge from her urethra for the same duration but was otherwise...

Obtunded sensorium in a trauma patient.(coma caused by hypoxia and hypotension)
February 1, 2001... A 36 year old man, a victim of road traffic accident, with head injury and epistaxis, was taken to a district hospital. He was intubated with an orotracheal tube and his scalp injury was dressed, and he was referred to this tertiary care...

Acute appendicitis: an unusual cause.(epithelial cancer of the ovary)
February 1, 2001... A 52 year old woman presented with a two day history of worsening central abdominal pain, with nausea, and vomiting. Over the previous month she had been treated for a flare up of rheumatoid arthritis. Her only medication was methotrexate 10...

Is spiral computed tomography the imaging modality of choice for renal colic?
February 1, 2001... A 59 year old women was admitted with left loin pain of three days' duration. There was no radiation of pain to her groin. She had no dysuria, urinary frequency, or vaginal discharge and was apyrexial. On examination she had no loin tenderness....

A young woman with intractable diarrhoea.
February 1, 2001... A 28 year old saleswoman reported loose motions of three years' duration. She was symptomatic with recurrent copious watery loose motions five to six times a day, which had progressively worsened. Symptomatic treatment with antimotility agents...

A young man with tachycardia.(Wolff-Parkinson-White syndrome)
February 1, 2001... A 30 year old man was admitted with palpitations of sudden onset. There was no history of previous episodes. He was a non-smoker, did not take excess alcohol or any recreational drugs, and there was no family history of ischaemic or any cardiac...

A small axillary nodule--a therapeutic dilemma?(infiltrating ductal breast cancer)
February 1, 2001... A 75 year, postmenopausal women presented with a lump in the left axilla associated with occasional pain for six months. There was no history suggestive of an increase in size, an awareness of a lump in either breast or the opposite axilla, or...

A farmer with artificial valve endocarditis.
February 1, 2001... A 29 year old Yemeni man, a farmer, with St Vincent aortic and mitral prosthesis replaced in April 1996, was admitted to hospital in February 1997 with a nine month history of intermittent fever, general weakness, and loss of appetite. Three...

Loss of weight in a female heavy smoker with diffuse interstitial pulmonary fibrosis.(lung cancer with diffuse interstitial pulmonary fibrosis)
February 1, 2001... A 75 year old hypertensive woman was admitted with a two month history of fever and cough with scanty sputum, loss of appetite and weight, and progressive exertional dyspnoea. She had habitually smoked 20-40 cigarettes a day since the age of 19...

Sri Lankan health care provision and medical education: a discussion.(transcultural medical education)
February 1, 2001... Abstract My elective was spent at a teaching hospital in Galle, in Sri Lanka. My time was spent shadowing final year students in the specialties of general medicine and paediatrics. This period provided me with much food for thought in...

LETTER TO THE EDITOR.(Thyroid disorders--an update)(Letter to the Editor)
February 1, 2001... Thyroid disorders--an update EDIToR,--I would like to make the following comments in relation to the review by Lazarus and Obuobie [1]: (1) Contrary to what is stated in table 5 (possibly a typographical error), corticosteroids...