Postgraduate Medical Journal articles from July 2003

Postgraduate Medical Journal archives from July 2003

Abstinence under fire: it will take more than condoms to reverse the tide of sexually transmitted infections engulfing Britain's young people.(Sexual abstinence)
July 1, 2003... The Chief Medical Officer, Sir Liam Donaldson, unequivocally states in his first update for this year, that "Evidence does not exist to suggest that abstinence approaches are effective" (1) in reducing teenage pregnancy. This is an...

Recombinant erythropoietin in clinical practice.
July 1, 2003... The introduction of recombinant human erythropoietin (RHuEPO) has revolutionised the treatment of patients with anaemia of chronic renal disease. Clinical studies have demonstrated that RHuEPO is also useful in various non-uraemic conditions...

Osteoarthritis.
July 1, 2003... Osteoarthritis is a chronic degenerative disorder characterised by cartilage loss. It is extremely prevalent in society and is a major cause of disability. It is important to treat osteoarthritis effectively using a multidisciplinary approach...

Pulmonary manifestations of sickle cell disease.
July 1, 2003... Pulmonary complications account for significant morbidity and mortality in patients with sickle cell disease. Clinical lung involvement manifests in two major forms: the acute chest syndrome and sickle cell chronic lung disease. Acute chest...

Acute and chronic arsenic toxicity.
July 1, 2003... Arsenic toxicity is a global health problem affecting many millions of people. Contamination is caused by arsenic from natural geological sources leaching into aquifers, contaminating drinking water and may also occur from mining and other...

Single megadose vitamin A supplementation of Indian mothers and morbidity in breastfed young infants.
July 1, 2003... Background and objective: In developing countries low maternal vitamin A stores combined with increased demands of pregnancy and lactation may lead to its deficiency in breastfed infants. This study evaluates the effects of maternal...

An informative tattoo.(Images In Medicine)(Brief Article)
July 1, 2003... A 28 year old man with type 1 diabetes had this tattoo inscribed a few weeks after starting insulin. He was worried about hypoglycaemia and was particularly concerned about this being unrecognised by others. He decided to have a tattoo rather...

Patients' views on follow up of colorectal cancer: implications for risk communication and decision making.
July 1, 2003... Background: Medical views about the clinical value and potential detrimental effect on quality of life of postoperative follow up are divided. There is no literature on the views of British patients with colorectal cancer towards the follow up...

Autonomic neuropathy in patients with hepatic cirrhosis.
July 1, 2003... Background: Autonomic neuropathy has been reported in patients with alcoholic liver disease but information on its occurrence in patients with non-alcoholic liver disease is contradictory. Aim: To assess autonomic functions in patients with...

Clozapine associated dilated cardiomyopathy.(Adverse Drug Reaction)
July 1, 2003... A 31 year old white man was referred for investigation of a persistent sinus tachycardia. His only significant past medical history was of chronic schizophrenia for which he had been taking clozapine for six years. An electrocardiogram...

Metabolic alkalosis and myoclonus.(Case Report)
July 1, 2003... This is the first case reported of vomiting-induced metabolic alkalosis associated with myoclonus. The report describes an unusual presentation of myoclonus secondary to acid-base disturbance caused by recreational drug-induced vomiting. The...

Malignant potential in a Brunner's gland hamartoma.(Case Report)
July 1, 2003... Brunner's gland hamartomas are rare tumours of the duodenum. These lesions have previously been described as being benign, with no malignant potential. A case report is presented of a Brunner's gland hamartoma, whose histology revealed a focus...

A gangrenous foot.(Images In Medicine)(Brief Article)
July 1, 2003... The incidence of Kaposi's sarcoma in HIV infected individuals has declined since the advent of combination antiretroviral therapy in the mid-1990s. The patient, a 34 year old white homosexual man, presented with a swollen, ulcerated, and...

Low HbA1c levels in a poorly controlled diabetic.(Diabetes)
July 1, 2003... A 52 year old man was referred to the diabetic clinic because of weight loss and persistent osmotic symptoms. He was diagnosed three years before presentation and was on diet therapy. His general practitioner was concerned that he had a...

A bed bound patient.(Neurology)
July 1, 2003... A 62 year old retired woman was admitted to hospital with a 10 month history of pain and weakness in the muscles of both arms and legs. Her problems began with episodic weakness in both legs such that on occasions her legs gave way and she fell...

Lumbar facet synovial cyst.(Orthopaedics)
July 1, 2003... A 75 year old woman presented to the orthopaedic clinic with low back pain and left leg pain for last three months. The low back pain was of gradual onset and was progressive. The pain was aggravated on walking and standing. On clinical...

A misleading swelling of the tongue.(Oral pathology)
July 1, 2003... A 41 year old Indian man presented with a swelling on the tip of the tongue of six months' duration. He reported having irregular sharp teeth that caused repeated ulceration on the tongue, for which he had earlier sought orthodontic therapy....

An unusual cause of a discharging sinus.(Rheumatology)
July 1, 2003... A 37 year old man presented to the orthopaedic outpatient department complaining of a white liquid discharge coming out of the front of his right leg. Physical examination revealed that he had a discharging sinus on the anterior aspect of...

Do I need to be an endocrinologist to diagnose Cushing's disease?(Letters)
July 1, 2003... Around October 1999, while playing cricket after a long time, I fell down for no apparent reason. The same event happened a month later. Being mainly concerned about unexplained falls, I sought help from neurological colleagues. Two...

Thyrotoxic periodic paralysis in western countries.(Letters)(Letter to the Editor)
July 1, 2003... I read with interest the case report by Dixon and Jones on thyrotoxic periodic paralysis (TPP) in a white woman. (1) TPP is, indeed, extremely rare in women and also in the white population. However, TPP is an extremely common presentation with...