Postgraduate Medical Journal articles from June 2002

Postgraduate Medical Journal archives from June 2002

Evidence based medicine; Clinical decision-making: coping with uncertainty.(Editorial)
June 1, 2002... SUMMARY Reliable research and audit information are essential to increasing medical knowledge and improving health service delivery. However there are limits to available information in terms of quality, reliability, and applicability....

Stroke care: how do we measure quality? (Review).
June 1, 2002... The purpose of this paper is to review the methods used to measure quality of stroke care. Relevant articles were searched for on Medline using the following key words: stroke, quality, outcome of care, process of care, structure of care....

Bacille Calmette-Guerin lymphadenits. (Review).
June 1, 2002... Bacille Calmette-Guerin (BCG) lymphadenitis is the most common complication of BCG vaccination. Two forms of BCG lymphadenitis can be recognised in its natural course -- simple or non-suppurative lymphadenitis, which usually regresses...

Rescue percutaneous coronary intervention for failed thrombolysis: results from a district general hospital. (Original Article).(Statistical Data Included)
June 1, 2002... Objective: To assess the outcome of a policy of emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and electrocadiographic (ECG) evidence of failed reper-fusion after thrombolysis. Design:...

Knowledge of aspects of acute care in trainee doctors. (Original Article).(Statistical Data Included)
June 1, 2002... Deficiencies in trainees' knowledge, skills, and attitudes have the potential to influence the initial assessment, treatment, and outcome of acutely ill ward patients. Knowledge of basic aspects of acute care were assessed among a group of 185...

An aggressive policy of bilateral saphenous vein harvest for infragenicular revascularisation in the era of multidrug resistant bacteria. (Original Article).(Statistical Data Included)
June 1, 2002... Background: The success of infragenicular revascularisation for lower limb ischaemia is limited by the high proportion of patients without ipsilateral long saphenous vein (LSV) of adequate length or quality. The aim of this study was to report...

Older people and ill fitting shoes. (Original Article).(Statistical Data Included)
June 1, 2002... Background: Foot health is an important issue in older people. Inappropriate shoes increase the risk of callous and ulcer formation, as well as increasing the risk of foils. There are no data defining the size of this problem. Objective:...

Medical anniversary.
June 1, 2002... Prosper Meniere (18 June 1799) Prosper Meniere (1799-1862) was born at Angers, Maine-et-Loire, France, son of a tradesman. He graduated in medicine in Paris with a gold medal (1826), MD (1828), and became assistant to Dupuytren at the...

Variable use of endoscopic haemostasis in the management of bleeding peptic ulcers. (Audit).(Statistical Data Included)
June 1, 2002... Background: Randomised controlled trials (RCTs) have shown that endoscopic haemostasis is beneficial for patients with a bleeding peptic ulcer. The relevance of such data to management outside of RCTs is unclear. Therefore we examined...

Henry Currey FRIBA (1820-1900): leading Victorian hospital architect, and early exponent of the "pavilion principle". (History of Medicine).
June 1, 2002... The "pavilion plan" for hospital design originated in France in the 18th century and was popularised in England by John Roberton and George Godwin in the mid-19th century; the underlying rationale was that with improved ventilation the...

Resolution of diabetic autonomic neuropathy. (Case Reports).
June 1, 2002... Many consider diabetic autonomic neuropathy to be an irreversible complication of diabetes of long duration. Three patients developed symptoms of autonomic neuropathy which subsequently resolved. Their autonomic neuropathy was not associated...

Immunological analysis of pleural fluid in post-cardiac injury syndrome. (Case Report).(Statistical Data Included)
June 1, 2002... Post-cardiac injury syndrome (PCIS) is an inflammatory process involving pleura and pericardium secondary to cardiac injury. Even though this clinical entity has been recognised for decades, diagnosis is difficult because of lack of a...

Vacuum assisted closure system in the management of enterocutaneous fistulae. (Case Report).
June 1, 2002... Background: A very important yet often troublesome element in the conservative management of enterocutaneous fistulae is the protection of the surrounding skin from contact with the effluent. This report describes the successful use of a vacuum...

Yoghurt biotherapy: contraindicated in immunosuppressed patients? (Case Report).
June 1, 2002... A fatal case of Lactobacillus rhamnosus septicaemia after prolonged oral vancomycin for recalcitrant Clostridium difficile infection is reported. The patient was immunosuppressed with cyclophosphamide and steroids for Sjogren's syndrome. The...

Lymphoma in an ileostomy. (Case Report).
June 1, 2002... Lymphoma developing in an ileostomy is an extremely rare complication. The presentation is similar to the commoner, yet still rare, adenocarcinoma but the staging and management of the condition differs. ********** A 78 year old man...

Fulminant ischaemic colitis with atypical clinical features complicating sickle cell disease. (Case Report).
June 1, 2002... Clinically significant ischaemic bowel injury is an exceedingly rare complication of sickle cell disease, It manifests as acute surgical abdomen and may respond to conservative treatment. An unusual fatal case of ischaemic colitis with minimal...

Images in medicine: a bleeding aortic graft enteric fistula diagnosed by push enteroscopy.(Brief Article)
June 1, 2002... A 72 year old man with a previous history of an emergency abdominal aortic aneurysm repair presented with rigors and recurrent episodes of melaena. Both oesophagoduodenogastroscopy and colonoscopy were unremarkable. Computed tomography with...

Back pain and systemic compromise. (Back Pain).(Brief Article)
June 1, 2002... Answers on p 377. A 30 year old white man presented to his local hospital with a four day history of lower back pain and leg weakness after a minor fall. His past medical history included a lumbar microdiscectomy eight years before. He was...

A bad dose of 'flu. (Cough, Fever, and Aching Muscles).
June 1, 2002... Answers on p 377. A 42 year old right handed joiner presented with a five day history of cough, fever, and aching muscles. He had previously enjoyed good health. Three days into his current illness he had attended his general practitioner...

A case of acute swelling of the left shoulder. (Swollen Left Shoulder).
June 1, 2002... Answers on p 378. A 59 year old African American woman presented to her primary care physician with acute pain and swelling of her left arm. The initial examination revealed oedema of her left upper extremity extending to her left breast...

Abdominal pain in a diabetic myeloma patient with cirrhosis. (Abdominal Pain).
June 1, 2002... Answers on p 379. A 57 year old woman with cirrhosis was admitted to the emergency room because of hepatic encephalopathy. She had a 10 year history of multiple myeloma but she tolerated chemotherapy poorly and had required plasmapheresis...

An eponymous reaction to a knife wound. (Trauma).(Brief Article)
June 1, 2002... Answers on p 379. A 27 year old man was admitted to casualty having been stabbed in the back at a nightclub. He had taken an ecstasy tablet and had consumed some alcohol. On assessment, he was alert and cooperative with a 2 cm long,...

Letters.(Letter to the Editor)
June 1, 2002... Acute myocardial infarction in young adults In the excellent case report and review by Osula et al, concerning acute myocardial infarction in young adults, comment was passed on the probable mechanism of the actual myocardial infarct...

Paediatric Radiology for MRCPCH and FRCR.
June 1, 2002... Edited by Christopher Schelvan, Annabel Copeman, Jane Young, Jacqueline Davis. (Pp 246; [pounds sterling]17.50.) Royal Society of Medicine Press, 2002. ISBN 1-85315-466.0. **** This is another book in this series of books to aid candidates...

Comprehensive Care for People with Epilepsy.
June 1, 2002... Edited by Margarete Pfafflin, Robert T Fraser, Rupprecht Thorbecke, Ulrich Specht, and Peter Wolf. (Pp 365; [pounds sterling]60.) John Libbey, 2001. ISBN 0-86196-610-4. ** The 37 chapters of this book are derived from presentations that...

Diary.
June 1, 2002... The Cell Biology of Reproduction 4-6 July 2002 (registration 3 July), St John's College, Cambridge, UK. The programme is aimed at scientists and clinicians with research interests and seeks to take understanding of the basic cellular...