Postgraduate Medical Journal articles from June 2003

Postgraduate Medical Journal archives from June 2003

What is the Commission for Health Improvement? An important part of the government's programme to modernise the NHS. (Editorial).
June 1, 2003... The Commission for Health Improvement (CHI) was set up by the 1999 Health Act to perform four core functions: to review the clinical governance* arrangements in every NHS organisation in England and Wales; to review and monitor implementation...

Role of the Royal College of Physicians adviser: a personal comment. (Personal View).
June 1, 2003... For the past two years I have been the Royal College of Physicians adviser (RCA) for South Trent. This post is considered to be a very high honour and nomination and election is done by colleagues who are Fellows of the College. However, in the...

Evaluation of abnormal liver function tests. (Review).
June 1, 2003... Interpretation of abnormalities in liver function tests is a common problem faced by clinicians. This has become more common with the introduction of automated routine laboratoy testing. Not all persons with one or more abnormalities in these...

Emergency management of atrial fibrillation. (Review).
June 1, 2003... Atrial fibrillation is the most common cardiac arrhythmia managed by emergency and acute general physicians. There is increasing evidence that selected patients with acute atrial fibrillation can be safely managed in the emergency department...

Osteoporosis and exercise. (Review).
June 1, 2003... Osteoporosis is a common medical problem. Lifestyle measures to prevent or help treat existing osteoporosis often only receive lip service. The evidence for the role of exercise in the prevention and treatment of osteoporosis is reviewed. ...

Post-exposure prophylaxis for blood borne viral infections in healthcare workers. (Review).
June 1, 2003... Healthcare workers have a high risk of occupational exposure, more so in developing countries, with high incidence of blood borne diseases and prevalence of unsafe practices. Among the various blood borne diseases, the most common and important...

Primary care referral protocol for wrist ganglia. (Review).
June 1, 2003... The paper summarises current knowledge on ganglia of the wrist including the views of patients and doctors. The efficacy of available treatment options are discussed. Summary points are derived from the available knowledge with a referral...

Management of stable angina. (Best Practice).
June 1, 2003... lschaemic heart disease may present as a wide variety of clinical entities including unstable or stable angina pectoris, acute myocardial infarction, and occasionally heart failure. Chronic stable angina is a common condition and results in a...

What determines patients' satisfaction with their mental health care and quality of life? (Original Article).
June 1, 2003... Objectives: This study investigated whether patients' satisfaction with their mental health care and quality of life is related to their age, gender, psychiatric diagnosis, and duration of mental disorder. Method: 120 adults of working age...

Hospital admissions for human T-cell lymphotropic virus type-1 (HTLV-1) associated diseases in Dominica. (Original Article).
June 1, 2003... Human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus that is endemic in certain regions of the world, and may account for significant morbidity and mortality among hospitalised patients. Sixty six HTLV-1 seropositive patients...

Spontaneous pneumothorax: use of aspiration and outcomes of management by respiratory and general physicians. (Audit).
June 1, 2003... Background: Spontaneous pneumothorax is a common problem in hospital practice. Despite the publication of guidelines controversy over its initial management still exists, particularly over the use of simple aspiration. Methods: The...

Aortic aneurysm replacement with Dacron graft in a 34 year old man. How long will the graft last? (Case Report).
June 1, 2003... A unique case of an abdominal aortic aneurysm replacement in a young man of Caribbean descent is presented. The initial working diagnosis was of a mycotic aneurysm, which has recently shown resurgence with intravenous drug abuse. Blood tests...

Surgical presentation of ischaemic hepatitis. (Case Report).
June 1, 2003... Intestinal ischaemia typically presents with signs suggestive of an acute surgical abdomen. A raised serum lactate may substantiate the diagnosis. The first case of ischaemic hepatitis mimicking intestinal ischaemia is reported. The recognition...

Magnetic resonance imaging in rabies. (Case Report).
June 1, 2003... Rabies encephalitis has a classical clinical presentation and its diagnosis is unmistakable. In about a fifth of cases rabies occurs as its paralytic form, which lacks the classic symptoms and may mimic other diseases, especially acute...

Images in medicine: an unusual cause of acute upper oesophageal obstruction.(Brief Article)
June 1, 2003... An 85 year old man was admitted with acute dysphagia after eating steak. Apart from a history of hypertension he was otherwise fit and well. Further examination and a standard soft tissue neck radiograph were normal. Although the need for chest...

Congenital renal anomaly in a patient with situs inversus. (Self Assessment Questions: Renal Medicine).
June 1, 2003... A 65 year old man was referred to the urology clinic with a two month history of right loin pain. He had no previous urological history. Situs inversus had been diagnosed previously during a routine appendicectomy. Clinical examination and...

A man with numbness and limb weakness. (Self Assessment Questions: Neurology).
June 1, 2003... A 45 year old man presented to the neurology clinic with a history of numbness for the previous two months followed by weakness for one month of all four limbs. The weakness involved the left upper limb followed by left lower limb, right lower...

An interesting case of hemiparesis. (Self Assessment Questions: Neurology).
June 1, 2003... A 40 year old man was brought to the hospital with a history of pain and progressive diminution of vision in his left eye for one month, weakness of left half of body for 15 days, and altered sensorium for five days. There was no history of...

A misdiagnosed potentially dangerous shoulder injury. (Self Assessment Questions: Orthopaedic Surgery).
June 1, 2003... A 40 year old engineer presented with a history of chronic left upper limb fatigue and pallor upon limb abduction and intermittent dysphagia. These symptoms caused significant interference with his daily life and had started after a fall onto...

A child with growth failure. (Self Assessment Questions: Growth Failure).
June 1, 2003... A 7 year old girl presented with growth failure. She was born of a consanguineous marriage, and mental as well as motor milestones had been delayed. On examination her height was 93 cm ( Investigations revealed a normal complete blood count....

Multiorgan involvement in thalassaemia major. (Self Assessment Questions: Endocrinology).
June 1, 2003... A 16 year old girl with a history of [beta]-thalassaemia major since birth was admitted as an emergency to hospital with a three day history of dyspnoea on exertion, facial puffiness, and carpopedal spasm. Physical examination revealed a thin,...

Letters.(Letter to the Editor)
June 1, 2003... Cost effective strategy for a safe diagnosis of deep vein thrombosis at a district general hospital We agree with the view of Walsh et al that it is not acceptable to miss a deep vein thrombosis (DVT) in any patient, and the negative...

Get through MRCP Part 1: 1000 MCQs and Best of Fives. (Book Reviews).(Book Review)
June 1, 2003... By Una Coales. (Pp 310; [pounds sterling]19.95.) Royal Society of Medicine Press, 2002. ISBN 1-85315-526-8. *** The MRCP examination is hard and daunting to get through but the better prepared the candidate then the chance of success early...

Review of Psychology for the MRCPsych. 2nd Ed. (Book Reviews).(Book Review)
June 1, 2003... By Marcus Munafo. (Pp 198; [pounds sterling]18.99.) Arnold Publishers Ltd, 2002. ISBN 0-340-80911-6. *** Any book which can increase the chances of passing membership examinations would be a welcome addition to a potential candidate's...