Postgraduate Medical Journal articles from July 2002

Postgraduate Medical Journal archives from July 2002

Defining shared decision making and concordance: are they one and the same? (Decision Making).
July 1, 2002... Effective communication is an essential element of patient centred medical practice. Terminology has developed to describe different aspects of this interaction between health professionals and patients. While attempting to do research in this...

Methicillin resistant Staphylococcus aureus (MRSA) in the intensive care unit. (Review).
July 1, 2002... Methicillin resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality worldwide. MRSA strains are endemic in many American and European hospitals and account for 29%-35% of all clinical...

Neurological complications of coeliac disease. (Review).
July 1, 2002... A variety of neurological disorders have been reported in association with coeliac disease including epilepsy, ataxia, neuropathy, and myelopathy. The nature of this association is unclear and whether a specific neurological complication occurs...

Foreign body aspiration: clinical utility of flexible bronchoscopy. (Review).
July 1, 2002... Foreign body aspiration is a worldwide health problem which often results in life threatening complications. More than two thirds of foreign body aspirations occur among children younger than 3 years. Organic materials such as nuts, seeds, and...

Fatigue in cholestatic liver disease--a perplexing symptom. (Review).
July 1, 2002... Fatigue is an important symptom and a quality of life determinant in patients with cholestatic liver disease. The pathogenesis of fatigue is obscure, although alterations in central neurotransmission and peripheral muscle dysfunction have been...

Influence of thrombolytic therapy on the patterns of ventricular septal rupture after acute myocardial infarction. (Original Article).
July 1, 2002... Background: Post-myocardial infarction ventricular septal defect (VSD) complicates ~2% of myocardial infarctions. Thrombolytic therapy may accelerate the time from myocardial infarction to VSD formation. The effects of thrombolytic therapy in...

Survey of junior hospital doctors' attitudes to cardiopulmonary resuscitation. (Original Article).
July 1, 2002... Most cardiac arrest teams are made up of junior doctors. The stressful effect of cardiopulmonary resuscitation (CPR) on doctors has not previously been established. A questionnaire was sent to all 52 junior doctors who participated in the...

Proposed use of adrenaline (epinephrine) in anaphylaxis and related conditions: a study of senior house officers starting accident and emergency posts. (Original Article).
July 1, 2002... Senior house officers (SHOs) (n=78) at the start of their accident and emergency (A&E) post were given an anonymous five case history questionnaire, containing one case of true anaphylaxis, and asked to complete the medication they would...

Regional differences in incidence of gastric and colonic cancer in the Maori of New Zealand. (Original Article).
July 1, 2002... Background: It is known that there are ethnic differences in cancer in New Zealand between Maori (the indigenous people) and non-Maori, however, until now no regional comparisons have been made. Study design: A retrospective study of...

Mammary tuberculosis: report on 52 cases. (Original Article).
July 1, 2002... Fifty two cases of tuberculosis of the breast encountered over a 15 year period and accounting for 3% of all breast lesions are reported. The classic presentation was a breast lump with associated sinus in 39%, isolated breast lump in 23%,...

Spontaneous closure of an acquired ventricular septal defect. (Case Report).
July 1, 2002... Ventricular septal defect (VSD) is a rare but serious complication of acute myocardial infarction requiring early surgical intervention. A patient with acquired VSD that spontaneously closed over three months is presented. The literature on...

Cullen's sign in amoebic liver abscess. (Case Report).
July 1, 2002... A 45 year old woman presented with pain in her right upper abdomen and fever. Ultrasound of her abdomen showed a large liver abscess with subhepatic collection. She had Cullen's sign. The liver abscess was managed by percutaneous catheter...

Early diagnosis of colonic carcinoma: a haemorrhagic complication after the use of tissue plasminogen activator. (Case Report).
July 1, 2002... Haemorrhagic complications of thrombolytic therapy for myocardial infarction are common. A 68 year old man presented with a myocardial infarction and was started on tissue plasminogen activator. Soon after he experienced rectal bleeding and a...

Purple skin and a swollen thigh in an alcoholic. (Self Assessment Questions).
July 1, 2002... A 46 year old man with a history of alcohol abuse was admitted with insidious onset, progressive left thigh swelling and abnormal skin lesions over an extensive part of his left thigh. There was no history of trauma. Examination revealed a...

An unusual case of multiple infarcts. (Self Assessment Questions).
July 1, 2002... A 44 year old woman presented to the accident and emergency department with sudden onset of severe dyspnoea, right sided weakness, and loss of speech. She was a smoker, but had no other identifiable risk factors for premature atherosclerotic...

Abdominal distension. (Self Assessment Questions).
July 1, 2002... An 87 year old woman presented with a two month history of abdominal distension and vomiting. Previous investigations for iron deficiency anaemia had been normal. There was no recent change in bowel habit. On examination she was afebrile. The...

Prolonged fever with recurrent diarrhoea. (Self Assessment Questions).
July 1, 2002... 52 year old man presented with a history of right groin pain. He also recollected at least three self limiting episodes of rigors, diarrhoea, and vomiting lasting for about four days in the recent past. Over the past year he had travelled...

Pleuritic pain and a rare complication. (Self Assessment Questions).
July 1, 2002... A 25 year old man presented with a two week history of malaise. Following a sore throat he had developed dyspnoea, a productive cough, anorexia, and vomiting. Two days before admission he had haemoptysis and left sided pleuritic pain with...

An unusual endocrine cause of hyponatraemia. (Self Assessment Questions).
July 1, 2002... A 60 year old woman with no medical history of note except panproctocolectomy and ileostomy for Crohn's disease was admitted with a week's history of dizziness, lethargy, anorexia, vomiting, and confusion. She was found to have increased stoma...

Fatal haemorrhagic pulmonary oedema and associated angioedema after the ingestion of rofecoxib. (Adverse Drug Reaction).
July 1, 2002... Angioedema is a recognised side effect of rofecoxib, a cyclo-oxygenase-2 (COX-2) inhibitor. But death resulting from a haemorrhagic pulmonary oedema after its ingestion has not been recorded. The case of a 60 year old man who died from...

David Samwell (1751-98): surgeon on the Discovery. (History of Medicine).
July 1, 2002... David Samwell, born in North Wales, was surgeon on the Discovery during the third and last voyage of Captain James Cook. Samwell wrote a biography of Cook and was a distinguished poet. He also served on several more voyages, retiring from the...

Letters.(von Hippel-Lindau disease complicated by pheochromocytoma)(Troponin T elevation in lobar lung disease)(Testing factual medical knowledge is inappropriate)(Hyperemesis gravidarum)(Letter to the Editor)
July 1, 2002... von Hippel-Lindau disease complicated by pheochromocytoma We read with interest the excellent case report of von Hippel-Lindau disease complicated by pheochromocytoma. (1) However, the authors proceeded directly to imaging and radionuelide...

Law and Ethics for Clinicians.
July 1, 2002... Edited by Jacqulyn Kay Hail. (Pp 391; $34.95 + $5.00 shipping.) Jackhall Books, 2001, (Contact Jackhall Books, 18 Notting-ham Road, Amarillo, TX 79124, USA; werner@ama.ttuhsc.edu.) ISBN 1-888856-00-9. (***) If, on first picking up this...

800 Individual Statement Questions for MRCPsych Part 1.
July 1, 2002... By M Mathews. (Pp 200; [pounds sterling]14.95.) Royal Society of Medicine, 2001. ISBN 1-85315-505-5. (****) This book does exactly what it says on the cover. It contains 800 individual statement questions in the new examination format of...

Statistics at Square One, 10th ed.
July 1, 2002... By T D V Swinscow and M J Campbell. (Pp 158; [pounds sterling]10.95.) BMJ Books, 2002. ISBN 0-7279-1552-5. (***) This very helpful little book introduces health professionals and students to the basic statistical concepts and methods most...