Postgraduate Medical Journal articles from January 2003

Postgraduate Medical Journal archives from January 2003

Medicine in the Falkland Islands: a unique healthcare system. (Falkland Islands).
January 1, 2003... The Falklands are a British overseas territory just to the east of the southern tip of South America that came to world attention during the 1982 conflict with Argentina. The archipelago comprises two main islands and some 20 other inhabited...

Drotrecogin alfa (activated): a novel therapeutic strategy for severe sepsis. (Review).
January 1, 2003... Recent studies have highlighted the close link between activation of the coagulation system and the inflammatory response in the pathophysiology of severe sepsis. The protein C anticoagulant pathway plays an integral part in modulating the...

Acute disseminated encephalomyelitis. (Review).
January 1, 2003... Acute disseminated encephalomyelitis (ADEM) is an acute demyelinating disorder of the central nervous system, and is characterised by multifocal white matter involvement. Diffuse neurological signs along with multifocal lesions in brain and...

Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): a view from the 21st century. (Review).
January 1, 2003... Hereditary haemorrhagic telangiectasia (HHT) affects one in 5-8000, and no longer can be viewed as solely causing anaemia (due to nasal and gastrointestinal bleeding) and characteristic mucocutaneous telangiectasia. Arteriovenous malformations...

Evaluation and treatment of dyspepsia. (Review).
January 1, 2003... Dyspepsia is a common symptom. Dyspeptic symptoms may be caused by a variety of conditions such as peptic ulcer disease, gastro-oesophageal reflux, and malignancy. Most often, however, no cause is identified and dyspepsia is deemed to be...

Perichondritis: a complication of piercing auricular cartilage. (Images in Medicine).
January 1, 2003... A 20 year old woman presented to the ear, nose, and throat clinic with auricular perichondritis two days after piercing thc helix of her left ear with the aid of a piercing gun. Two thirds of the upper part of her auricle was swollen, red, and...

Evolution of diabetes medical nutrition therapy. (Review).
January 1, 2003... Research supports the importance of medical nutrition therapy in achieving diabetes treatment goals. For persons requiring insulin therapy, the first priority is to integrate an insulin regimen into the patient's lifestyle. For type 2 diabetes,...

HIV viral suppression in the era of antiretroviral therapy. (Best Practice).
January 1, 2003... Altogether 42 million people worldwide have been infected with HIV, and 1 2 million have died over the last 20 years. Effective antiretroviral therapy has lead to sustained HIV viral suppression and immunological recovery in patients who have...

Ulcer prophylaxis is unnecessary with short course NSAIDs. (Echo).(non-steroidal anti-inflammatory drugs)(Brief Article)
January 1, 2003... Patients embarking on a short course of non-steroidal anti-inflammatory drugs (NSAIDs) do not need prophylactic treatment against ulcers, even if they are infected with Helicobacter pylori. That is, according to a large randomised, double...

Total arterial revascularisation as a primary strategy for coronary artery bypass grafting. (Original Article).
January 1, 2003... Background: Bilateral internal thoracic arteries confer improved survival benefit after coronary artery bypass grafting (CABG). Despite increasing evidence, the use of arterial conduits has not been accepted as a primary practice in most of the...

Pupillary evaluation for differential diagnosis of coma. (Original Article).
January 1, 2003... Objectives: To determine the usefulness of bedside evaluation of pupils in determining the aetiology of coma by adopting a probabilistic approach. Patients and methods: One hundred and fifteen consecutive patients presenting with coma were...

Are medical reports on fitness to drive trustworthy? (Audit).
January 1, 2003... Purpose: Previous studies have shown that physicians often have poor knowledge of the medical restriction on fitness to drive, or submit poor quality medical reports. To determine the reliability of physicians' reports on fitness to drive, the...

Unusual complications of thyroid carcinoma. (Case Reports).
January 1, 2003... Thyroid carcinomas are the most frequent endocrine malignancies. Complications may arise from an established malignancy and these may lead to the initial clinical presentation or cause subsequent problems. In this case report two elderly...

Late small bowel obstruction after blunt abdominal trauma. (Case Report).
January 1, 2003... Blunt abdominal trauma with intraperitoneal iniury usually presents acutely. On rare occasions, such patients can present later on with features of small bowel obstruction due to stricture formation. It is thought that such a delayed stricture...

Phantom lymphadenopathy. An association with chronic fatigue syndrome. (Case Reports).
January 1, 2003... Ten patients with self diagnosed enlarged lymph glands were referred to a general medicine outpatient clinic and careful examination did not confirm lymphadenopathy. All patients also complained of severe chronic fatigue associated with aches...

Hyponatraemia in a woman with a pelvic mass. (Hyponatraemia).(inappropriate secretion of antidiuretic hormone caused by a reaction to chemotherapy)
January 1, 2003... Answers on p 63. A 57 year old Chinese woman was admitted with a bulky, right lower abdominal mass. She was known to have end stage renal disease and had received a cadaveric renal transplant eight years previously. Further investigation...

Multiple pulmonary nodules: diagnosis in an young afebrile patient. (Pulmonary Nodules).(pulmonary hydatid disease)
January 1, 2003... Answers on p 64. A 22 year old women presented with complaints of vague pain in the chest for three months and cough with expectoration for six days before admission. On examination, she was afebrile and non-dyspnoeic. Her pulse rate,...