Postgraduate Medical Journal articles from February 2003

Postgraduate Medical Journal archives from February 2003

Clinical challenges posed by new biotechnology: the case of nutrigenomics. (Editorial: Nutrigenomics).
February 1, 2003... If all goes as planned, the world in which we can obtain an inexpensive, easy to produce digital data version of our personal genome is not far in the future. (1) The idea of possessing genetic self knowledge is intriguing. Imagine holding an...

Present treatment options for atrial fibrillation. (Review).
February 1, 2003... Atrial fibrillation is the commonest sustained cardiac arrhythmia. It accounts for >35% of all hospital admissions for cardiac arrhythmias in the United States. The presence of atrial fibrillation increases the mortality of a population by up...

Effects of the civil procedure rules on clinical negligence claims. (Review).
February 1, 2003... The frequency with which clinicians can expect to face allegations of clinical negligence and court proceedings related to those allegations is likely to increase in coming years. The processes of investigation and defence have been modified by...

Juvenile myoclonic epilepsy: under-appreciated and under-diagnosed. (Review).
February 1, 2003... Juvenile myoclonic epilepsy (JME) is a hereditary, idiopathic, generalised epilepsy and is found in 5%-11% of patients with epilepsy. It is characterised by myoclonic jerks, occasional generalised tonic-clonic seizures, and sometimes absence...

Migraine, memory loss, and "multiple sclerosis". Neurological features of the antiphospholipid (Hughes') syndrome. (Review).
February 1, 2003... The antiphospholipid syndrome (APS, Hughes' syndrome), first described in 1983, is a prothrombotic disease in which neurological events feature prominently. Strokes, transient ischaemic attacks, and headaches (including migraine) are important...

Brachial plexus injury as an unusual complication of coronary artery bypass graft surgery. (Review).
February 1, 2003... Brachial plexus injury is an unusual and under-recognised complication of coronary artery bypass grafting especially when internal mammary artery harvesting takes place. It is believed to be due to sternal retraction resulting in compression of...

Management of stroke. (Best Practice).
February 1, 2003... This article outlines the current evidenced based practice for stroke care. It outlines many of the recommendations in the National Clinical Guidelines for Stroke published by the Royal College of Physicians. It also covers all aspects of...

Are district general hospital patients with unstable angina at a disadvantage? (Original Article).
February 1, 2003... Objective: To determine whether patients with non-ST elevation acute coronary syndromes requiring coronary angiography and revascularisation have inferior access to these services if admitted to district general hospitals (DGHs) compared with...

Illumination of x-rays: the usual lights exposed. (Original Article).
February 1, 2003... Aims: Faced with pressure of work and limited resource, doctors frequently use the nearest available light to examine x-ray films. The aim of this study was to examine the relative intensities of hospital light sources, and to compare these...

Dr D G James FRCP and the Fellowship of Postgraduate Medicine. (Fellowship Affairs).
February 1, 2003... Dr D G James recently retired as Vice President of the Fellowship of Postgraduate Medicine. The following article is based on a speech given at a dinner at the Athenaeum Club on 1 0 October 2002 to thank Dr James for his contributions to the...

Phthiriasis palpebrarum. (Images in Medicine).
February 1, 2003... A 28 year old unmarried, sexually active male came to us with generalised body itching of 15 days' duration. He also complained of itching and irritation of eyelid margins. He had noticed some concretions attached to his eyelashes and some...

Thallium poisoning: emphasis on early diagnosis and response to haemodialysis. (Case Report).
February 1, 2003... Thallium poisoning is known for its diverse manifestations and these can delay the diagnosis if a clear history of poisoning is not forthcoming. A 42 year old man presented on the third day of illness with flaccid quadriparesis and paresthesia,...

Simultaneous bilateral spontaneous pneumothorax in a patient with recurrent, extraosseous multiple myeloma. (Case Report).
February 1, 2003... A patient with simultaneous bilateral spontaneous pneumothorax (SBSP) due to pulmonary and pleural manifestations of recurrent multiple myeloma is presented. The patient died in shock of unknown cause. The diagnosis was suspected from pleural...

Roth's spots: an unusual presentation of HIV. (Case Report).
February 1, 2003... A 46 year old Nigerian man presented with a four week history of progressive bilateral visual loss. He had been unwell, with weight loss, fever, and night sweats for six months. Dilated fundoscopy revealed macular haemorrhages and diffuse...

D-lactic acidosis secondary to short bowel syndrome. (Case Report).
February 1, 2003... A 12 year old boy presented with 11 episodes of weakness, ataxia, nausea, slurred speech, dehydration, and sometimes severe lethargy bordering on coma. A year previously the boy had small intestinal resections leaving 20 cm of small bowel...

Hydatid cyst of liver. (Case Report).
February 1, 2003... Hydatid disease of the liver is still endemic in certain parts of the world. The diagnosis of non-complicated hydatid cyst of the liver depends on clinical suspicion. Ultrasonography and computed tomography, the most important diagnostic tools,...

The sweet cake that reaches parts other cakes can't! (Case Report).
February 1, 2003... This is a case report of a previously healthy woman of 56 years who presented with a life threatening tetraparesis, severe hypokalaemia, hypertension, and raised muscle enzymes. The cause of was finally found to be unusual and very much...

An audit at job application forms in response to adverts in the British Medical Journal. (Audit).
February 1, 2003... Objective: The aim of this study was to examine the speed of response of human resources departments to requests for job application forms for posts advertised in the British Medical Journal (BMJ). Of particular interest was the closing date...

Neck pain disguised as spondyloarthrosis. (Neck Pain).
February 1, 2003... A 70 year old man was referred to us complaining about neck pain that had irradiated to the left shoulder and clavicular region over 12 months. There was no history of external trauma, or exposure to radiation, and no other manifestations were...

Severe relapsing sulphonylurea-induced hypoglycaemia: a diagnostic and therapeutic challenge. (Hypoglycaemia).
February 1, 2003... Answers on p 123. A 62 year old woman was admitted with acute confusion and reduced mobility. She had recently been a surgical inpatient with pseudo-obstruction of the bowel that had been managed conservatively. Since discharge she had...

"Question mark" aorta. (Cardiology).
February 1, 2003... An 83 year old woman with dementia was admitted to our hospital with cough and febrile illness. Her past medical history included previous chole-cystectomy and latent syphilis, for which she had a full course of penicillin treatment three years...