Postgraduate Medical Journal articles from June 2001

Postgraduate Medical Journal archives from June 2001

Learning to teach.
June 1, 2001... "See one, do one, teach one" is a phrase commonly usea to describe the way in which doctors learn their craft. Although clearly a caricature, like many, there is an element of truth in it. In the traditional apprenticeship style of learning,...

Aborted sudden cardiac death: a clinical perspective.
June 1, 2001... Abstract Sudden cardiac death in the community remains a major public health problem. The purpose of this article is to outline the epidemiology, pathophysiology, and immediate treatment of the cardiac arrest victim. The subsequent...

Alternative opioids to morphine in palliative care: a review of current practice and evidence.
June 1, 2001... This is a review of current practice of opioid use in palliative care, conducted from the perspective of a practising clinician working in the increasingly complex area of symptom control. In examining alternative opioids to morphine, choice...

Multiple system atrophy.
June 1, 2001... Multiple system atrophy (MSA) is a degenerative disease of the central nervous system. Dejerine and Thomas in 1900 were the first to use the term olivopontocerebellar atrophy (OPCA) in two sporadic cases, [1] although Menzel described the first...

Surgical treatment of diabetes mellitus by islet celland pancreas transplantation.
June 1, 2001... The incidence and progression of chronic diabetic complications can be reduced by achieving normoglycaemia (box 1). Unfortunately the recent Diabetes Control and Complications Trial has shown that intensive, subcutaneous insulin regimens that...

Resuscitation decisions in adult patients.(Ethical, Professional, and Legal Obligations in Clinical Practice, part 3)
June 1, 2001... This is the third discussion topic in a series of five dealing with ethical, professional, and legal obligations of clinical practice. Junior doctors tend to lack confidence in these subjects, and thus I organised a series of informal...

Churg-Strauss syndrome associated with montelukast.
June 1, 2001... Abstract Churg-Strauss syndrome (CSS) has re cently been reported in patients with asthma receiving leukotriene receptor antagonists (LTRAs). In this paper a case of CSS after treatment with montelukast is described. As in other LTRA...

Survey of hospital doctors' attitudes and knowledge of oral conditions in older patients.
June 1, 2001... Abstract The study was designed to assess the views and knowledge of hospital doctors in gen eral and geriatric medicine on oral health in older people. Eighty two doctors in gen eral and geriatric medicine at two hospi tals were shown 12...

Silent myocardial ischaemia in patients with proved coronary artery disease: a comparison of diabetic and non-diabetic patients.
June 1, 2001... Abstract Objective--To determine whether diabetic patients with coronary artery disease are more likely to experience silent myocar dial ischaemia than subjects without diabetes. Subjects--Patients undergoing coronary angiography at a...

Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetes centre in southern India.
June 1, 2001... Abstract Objective--The aim of this study was to determine the prevalence and risk factors for microalbuminuria among south Indian type 2 diabetic patients attending a diabetes centre. Methods--One thousand four hundred and twenty five...

Withdrawing cardiovascular medications at a syncope clinic.
June 1, 2001... Abstract It is widely assumed in clinical practice that drug treatment associated with hypotension can result in falls and syncope, but there is actually very little evidence to support this. Therefore the data in all patients whose...

The heart of stone.(heart calcification)
June 1, 2001... A 31 year old woman with end stage renal disease secondary to hypertension and on haemodialysis for 10 years was admitted with shortness of breath, cough, and low grade fever. She had a past history of hypercalcae mia, which had developed due...

Intermittent jaundice and rigors in a patient with longstanding ulcerative colitis.
June 1, 2001... A 44 year old man was admitted with a history of intermittent jaundice and rigors. Three months previously he had been admitted to another hospital with similar symptoms and half a stone (3.2 kg) weight loss. At this time his problems were...

An elderly man with pleural effusion and abnormal behaviour.
June 1, 2001... A 76 year old man, who had been an asbestos insulation worker, presented with a four month history of right sided severe diffuse chest pain, breathlessness on exertion, and weight loss of 10 kg. He had recurrent episodes of lethargy, agitation,...

A difficult case of gastrointestinal haemorrhage.
June 1, 2001... A 64 year old man presented to the accident and emergency department, having been found collapsed in the street. He gave a four day history of melaena. On examination he was shocked, with a pulse of 140 beats/min and a blood pressure of 70/40...

Recurrent pulmonary oedema in a 53 year old woman.
June 1, 2001... A 53 year old woman presented with pulmo nary oedema after an inferior myocardial infarction three months earlier. Blood pressure on admission was 210/120 mm Hg. Initial treatment included diuretics, nitrates, and oxygen and her symptoms...

A case of unusual septicaemia.
June 1, 2001... A 74 year old man was admitted with lethargy. There was no significant past medical history. General examination was unremarkable. Inves tigations revealed iron deficiency anaemia with a haemoglobin concentration of 90 g/l. He developed...

Hydronephrosis and a hard neck swelling.
June 1, 2001... A 45 year old woman presented to a surgical clinic with an eight month history of intermit tent colicky right loin and suprapubic pain associated with nausea, with no exacerbating or relieving factors. She had lost 1 stone (8 kg) in weight over...

A woman with an abnormal mass in the thyroid gland.
June 1, 2001... A 69 year old woman presented with a sudden history of dysphagia and stridor. A month ear lier she had noticed neck swelling and hoarse ness of voice after a bout of flu. Her appetite was fine, weight steady, and there was no history of fever...

A hungry baby fails to thrive.
June 1, 2001... A 6 week old boy, who had been well at birth after a normal delivery at term, was admitted to the local children's hospital in Belfast with a two day history of irritability and poor colour. He had been feeding well and always appeared hungry,...

An unusual case of diarrhoea and weight loss.
June 1, 2001... A 70 year old man had been attending an out patient clinic for investigation of diarrhoea, loss of appetite and weight loss, for which full clinical investigation (including duodenal and colonic biopsy series) had revealed no clear cause. Over...

LETTERS TO THE EDITOR.(Letter to the Editor)
June 1, 2001... The real cost of aspirin EDITOR,--In the context of coronary heart disease the poor perception of the hidden cost of aspirin [1] partly stems from under recognition of alternative therapeutic strategies for achieving the objective of...

Teaching & Learning Communication Skills in Medicine.(Review)
June 1, 2001... Teaching & Learning Communication Skills in Medicine. By Suzanne Kurtz, Jonathan Silverman, and Juliet Draper. (Pp 245; [pound]35.) Radcliffe Medical Press, 1999. ISBN 1-85775-273-2. [****] This book provided an evidence based guide to the...

Narrative Based Medicine.(Review)
June 1, 2001... Edited by Trisha Greenhalgh and Brian Hurwitz. (Pp xvi + 286; [pound]19.95.) BMJ Books, 1998. ISBN 0-7279-1223-2. [***] After two introductory contributions, the remaining 23 chapters (written by 29 contributors) are arranged under the...

Statistics with Confidence.(Review)
June 1, 2001... 2nd Ed. Edited by Douglas G Altman, David Machin, Trevor N Bryant, and Martin J Gardner. (Pp 240; [pound]18.95.) BMJ Books, 2000. ISBN 0-7279-1375-1. [****] This book is written by senior statisticians with a wealth of experience in...

Introduction to Clinical Neurology.(Review)
June 1, 2001... 2nd Ed. By Douglas J Gelb. (Pp 386; [pound]22.50.) Butterworth Heinemann, 2000. ISBN 0-7506-7202-1. [****] The stimulus to write this book is the recent change in healthcare policy in the United States whereby there is a move away from...