Postgraduate Medical Journal articles from March 2002

Postgraduate Medical Journal archives from March 2002

AIDS in Southern Africa. (AIDS).
March 1, 2002... The challenge of AIDS means rethinking established certainties and needs innovative solutions Noerine Kaleeba, a well known AIDS activist from Uganda, recently told the story of how her mother produced the photograph of Noerine's primary...

Clinical application of findings of clinical trials and systematic reviews. (Clinical Trials and Systematic Reviews).
March 1, 2002... The outcome obtained by a clinical team in a therapeutic trial may not be a reliable guide to management of their future patients The late Professor Archie Cochrane is probably best remembered for enunciating several key principles which...

Data and models determine treatment proposals--an illustration from meta-analysis. (Review).
March 1, 2002... A relevant problem in meta-analysis concerns the possible heterogeneity between trial results, If a test of heterogeneity is not significant the trials are often considered to be "homogeneous" and the individual trial results are replaced by...

Liver transplantation for chronic liver disease: advances and controversies in an era of organ shortages. (Review).
March 1, 2002... Since liver transplantation was first performed in 1968 by Starzl et al, advances in case selection, liver surgery, anaesthetics, and immunotherapy have significantly increased the indications for and success of this operation. Liver...

Understanding the pathology of schizophrenia: recent advances from the study of the molecular architecture of postmortem CNS tissue. (Review).(central nervous system)
March 1, 2002... The use of central nervous system (CNS) tissue obtained postmortem has long underpinned efforts to understand the neurobiology of schizophrenia, but the ability to use such tissue in conjunction with a wide variety of methodologies has seen a...

Primary care referral protocol for carpal tunnel syndrome. (Review).
March 1, 2002... Carpal tunnel syndrome is an extremely common upper limb nerve compression syndrome, widely distributed in the community. There are a variety of treatment options which may be applied to the syndrome, depending on the severity of symptoms. Some...

Living kidney donation: a comparison of laparoscopic and conventional open operations. (Original Article).
March 1, 2002... Laparoscopic donor nephrectomy has the potential to lessen the burden placed on live kidney donors. This study describes the first British comparison of donor morbidity and recovery following conventional open donor nephrectomy (ODN) and...

Misinterpretation of the chest X ray as a factor in the delayed diagnosis of lung cancer. (Original Article).
March 1, 2002... All patients in 1997 with a histologically proved diagnosis of lung cancer in Castle Hill Hospital in whom a full set of case notes and x rays could be retrieved were studied. All previous chest x rays were reviewed by a consultant chest...

Audit of a nurse endoscopist based one stop dyspepsia clinic. (Original Article).
March 1, 2002... As a response to the UK Health Department's "two week cancer wait" initiative a one stop dyspepsia clinic based on a nurse endoscopist was introduced, and the first 100 cases attending this clinic have been audited. After referral on a purpose...

Parasites in fine needle breast aspirates--assessment of host tissue response. (Original Article).
March 1, 2002... Parasites in the human breast are uncommon but not rare. Cysticercus and filariasis in fine needle breast aspirates have been documented and their cytomorphology is well characterised. However, the host tissue response to these parasites and...

Aortic root abscess presenting as unstable angina due to extrinsic compression of the left coronary artery. (Case Report).
March 1, 2002... Coronary ischaemia in acute endocarditis is usually due to pre-existing coronary disease or occasionally as a result of embolism from vegetations. A 68 year old man with known mixed aortic valve disease presented with a four week history of...

Pseudomyxoma peritonei. (Case Reports).
March 1, 2002... Pseudomyxoma peritonei is a relatively rare and poorly understood condition in which mucus accumulates within the peritoneal cavity. The presence of cells in the mucin, either inflammatory or neoplastic, distinguishes it from simple acellular...

Isolated splenic metastasis from carcinoma of the breast. (Case Report).
March 1, 2002... A case of isolated splenic metastasis from carcinoma of the breast in a 54 year old woman, two years after treatment for breast carcinoma, is presented. There was no involvement of other organs like liver, bone, lungs, etc. The patient...

Sister Joseph's nodule.(Images in Medicine)
March 1, 2002... Sister Joseph's nodule The umbilical lesion above was noted in an 32 year old man who presented with weight loss and abdominal pain. The lesion is known as a Sister Joseph's nodule. Sister Joseph, surgical assistant and later nursing...

Integrated care pathways for vascular surgery: an analysis of the first 18 months. (Clinical Audit).
March 1, 2002... Postgrad Med J 2002;78:175-177 Objectives: A review of the use of previously described integrated care pathways (ICPs) established for three elective vascular surgical procedures. Design: A retrospective analysis of information...

Human Rights Act 1998 and mental health legislation: implications for the management of mentally ill patients. (Personal View).
March 1, 2002... In the management of mentally ill patients, there is a tension between protecting the rights of individual patients and safeguarding public safety. The Human Rights Act 1998 emphasises on the former while two recent white papers focus on the...

A woman with painless burns. (Numbness and Burning).
March 1, 2002... A 53 year old woman was referred to the general medical outpatient clinic. She had no relevant past medical history. Her main complaints were those of numbness and burning over her entire right forearm and hand. She felt that a recent cough had...

An uncommon cause of lumbar radiculopathy. (Back Pain).
March 1, 2002... A 65 year old woman presented with a history of low back pain of 18 months' duration. There was radiation down the right lower limb posteriorly down to the ankle and the dorsum of the foot for the previous six months. Pain was aggravated by...

A painful and deformed wrist. (Orthopaedics).
March 1, 2002... A 54 year old man fell off stairs with his left wrist in the flexed position. He was seen in the accident and emergency department within one hour of the injury, with a painful and deformed wrist with dorsoulna displacement. There was a...

Massive haemoptysis in a young woman. (Haemoptysis).
March 1, 2002... A 24 year old woman was admitted to our hospital for a massive haemoptysis with abrupt onset. The average amount of blood expectorated was 200-250 ml in 24 hours. She was a nonsmoking housewife living in a rural area. Her medical history was...

An unusual presentation of calvarial tuberculosis. (Tuberculosis).
March 1, 2002... A 40 year old woman presented with a headache that she had for two years. There was no history of trauma, chronic illness, or exposure to tuberculosis. General and systemic examination revealed no abnormality; she had no neurological deficits....

Parkinson's Disease in Practice.
March 1, 2002... By Carl E Clarke. [Pp 103; [pounds sterling] 14.95.) Royal Society of Medicine Press, 2000. ISBN 1-85315-486.5.**** This is a little gem and the author is to be congratulated on managing to deliver what he set out to do and give a review on...

Surgical Critical Care.
March 1, 2002... Robert Ashford and Neal Evans. (Pp 247; [pounds sterling]22.50.) Greenwich Medical Media, 2001. ISBN 1-84110-066-8.*** I approached this book with interest, hoping that it would help me take on the responsibility of managing patients in a...

Emergency Cardiology.
March 1, 2002... Edited by Crispin Davies and Yaver Bashir. (Pp 390; [pounds sterling]35.) BMJ Books, 2001. (SBN 0-7279-1484-7.**** Intended for cardiologists and physicians dealing with critically ill patients, the overall emphasis of this well written,...