Postgraduate Medical Journal articles from November 2002

Postgraduate Medical Journal archives from November 2002

What's so good about placement learning? Expertise and judgment. (Editorial).
November 1, 2002... Placement learning seems a good thing. It's where you pick up all the things they didn't and couldn't teach you in medical school. It's where you finally learn what you need to learn to acquire expertise in your chosen field. Expertise requires...

Role of the clinical tutor: impending changes in organisation of postgraduate medical education risk loss of benefits of the clinical tutor. (Medical Education).
November 1, 2002... The clinical tutor function was established in the mid-1960s in parallel with provision of Exchequer funding for postgraduate education. Recognition of the need for educational facilities in district general hospitals resulted in the...

Magnesium in stroke treatment. (Review).
November 1, 2002... Magnesium is involved in multiple physiological processes that may be relevant to cerebral ischaemia, including antagonism of glutamate release, NMDA receptor blockade, calcium channel antagonism, and maintenance of cerebral blood flow....

Hospital experience as a patient. (A Life Defining Moment).(Brief Article)
November 1, 2002... Being in hospital for a life threatening condition is without doubt a significant event in a person's life, We doctors though, tend to forget that we are also vulnerable to such diseases. I was only 24 at the time, having just finished my final...

Improving the utility of prostate specific antigen (PSA) in the diagnosis of prostate cancer: The use of PSA derivatives and novel markers. (Review).
November 1, 2002... Prostate specific antigen (PSA) testing is now a routine part of the investigation of men with suspected prostate cancer. While a very useful test it still has its problems, in particular its lack of specificity means abnormal results are often...

The NHS complaints system: this paper reviews the methods by which complaints are currently handled within the NHS. (Review).(UK National Health Service)
November 1, 2002... The NHS complaints Procedure was set up in response to "Being Heard". This followed the report of a review committee, which had been chaired by Professor Alan Wilson in 1993. Its purpose had been to review how complaints were dealt with in the...

Epidemiology of perforated colonic diverticular disease. (Review).
November 1, 2002... Perforated colonic diverticular disease results in considerable mortality and morbidity. This review appraises existing evidence on the epidemiology and mechanisms of perforation, highlights areas of further study, and suggests an...

New definition of MI lacks evidence base. (Echo).(Brief Article)
November 1, 2002... The European Society of Cardiology (ESC) and American College of Cardiology (ACC) have proposed a new definition of ML which differs substantially from the widely used WHO definition and hinges on increased troponin concentration as a marker...

Managing liver failure. (Best Practice).
November 1, 2002... Liver disease is rare in childhood, but important new developments have altered the natural history and outcome. It is important that clinicians are aware of these diseases and their management. Acute liver failure is most often due to viral...

Costs of waiting for gall bladder surgery. (Original Article).
November 1, 2002... Laparoscopic cholecystectomy is one of the most commonly awaited general surgical procedures in the UK. However, many patients awaiting a cholecystectomy are admitted with recurrent gallstone related symptoms while on the waiting list,...

Defensive practice among psychiatrists: A questionnaire survey. (Original Article).
November 1, 2002... Objective: There has been little research on the prevalence of defensive practice within hospital settings. The aim of this report was to examine the extent of defensiveness among psychiatrists and to examine the relationship between...

Anxiety and depression in an older research population and their impact on clinical outcomes in a randomised controlled trial. (Original Article).
November 1, 2002... Introduction: Anxiety and depression are common in older people living in the community. The aim of the study was to investigate their impact on clinical outcomes during a randomised controlled trial investigating the cost benefits of influenza...

Cardiac involvement in HIV infected people in Yaounde, Cameroon. (Original Article).
November 1, 2002... Objective: To study the cardiac abnormalities in HIV infected patients in relation to the clinical stage of the disease and the immunological status of the patients. Methods: A total 75 consecutive patients tested for HIV on the basis of...

Thoracoscopic sympathectomy for palmar hyperhidrosis and Raynaud's phenomenon of the upper limb and excessive facial blushing: A five year experience. (Original Article).
November 1, 2002... Primary hyperhidrosis of the palms, face, and axillae has a strong negative impact on social and professional life. A retrospective analysis of 40 laparoscopic transaxillary thoracic sympathectomies performed in a district general hospital over...

Polyarteritis nodosa presenting as a pyrexia of unknown origin. (Case Report).
November 1, 2002... A case of on 18 year old woman is reported who presented with a pyrexia of unknown origin having returned from a trip to India. She initially had constitutional symptoms only, which rapidly progressed to a multisystem disorder. The difficulty...

Thyrotoxic periodic paralysis in a white woman. (Case Report).
November 1, 2002... A 24 year old white woman presented with sudden onset of flaccid quadriparesis and hypokalaemia. She was later found to be thyrotoxic. Paralysis resolved with potassium supplements, and after initiation of antithyroid medication she had no...

Bullous lungs: diverse aetiology. (Respiratory Medicine).
November 1, 2002... CASE 1 A 26 year man, a non-addict, was referred to us as he had a right sided spontaneous pneumothorax. His past medical history included surgery done at the age of 12 years for bilateral inguinal hernia and aphakia of both eyes. On...

Persistent dizziness. (Dizziness).
November 1, 2002... An 80 year old woman was investigated for palpitations, dizziness, and episodes of syncope. The electrocardiogram (ECG) showed atrial fibrillation. Twenty four hour Holter recording revealed atrial fibrillation throughout with intermittent...

Young man with progressive weight loss, fevers, and a hilar mass. (Malaise and Fatigue).
November 1, 2002... A 27 year old white man with no significant past medical history presented with progressive malaise and fatigue for one month. Two weeks before admission he had developed a cough productive of yellow-green sputum. He had also noted fevers as...

Painful knees. (Orthopaedics).
November 1, 2002... A 55 year old woman, suffering from osteoarthritis of the knee joints, presented with sudden worsening of pain for two months. The pain in the knee joints had gradually increased over the last 10 years. At the time of presentation the patient...

James Lind's Treatise of the Scurvy (1753). (History of Medicine).
November 1, 2002... Lind is revered as the first doctor to conduct systematic clinical trials of potential cures for scurvy--trials in which oranges and lemons came out as decisive winners. The following paper argues that our modern understanding of scurvy and...

Letters.
November 1, 2002... Knowledge of aspects of acute care in trainee doctors Aspects of acute care which may be more fundamental than those elicited by the questionnaire of 12 acute care topics (1) include criteria which enable healthcare workers (including...

Stress Management for Primary Health Care Professionals. (Book Reviews).(Book Review)
November 1, 2002... By Usha R Rout and Jaya K Rout. (Pp 218; [pounds sterling]38.50.) Kluwer/Plenum Publishers, 2002. ISBN 0-306-47240-6. *** The subject of this book, written by a general practitioner and research psychologist, is probably more pertinent...

Basic Statistics and Epidemiology. A Practical Guide. (Book Reviews).(Book Review)
November 1, 2002... By Antony Stewart. (Pp 160; [pounds sterling]19.95.) Radcliffe Medical Press, 2002. ISBN 1-85775-589-8. **** According to Mark Thvain "When in doubt, tell the truth". There are few situations in medicine in which there is not an element of...

Accident and Emergency Diagnosis and Management. (Book Reviews).(Book Review)
November 1, 2002... By Anthony F T Brown. (Pp 442; [pounds sterling]18.99.) Edward Arnold, 2002. ISBN 0-340-80720-2. **** Dr Brown has produced this new edition of his book for the first time in Britain, and it is primarily for young doctors entering accident...

Scientific Writing--Easy when you know how. (Book Reviews).(Book Review)
November 1, 2002... By Jennifer Peat, Elizabeth Elliott, Louise Baur, and Victoria Keena. (Pp 312; [pounds sterling]22.50.) BMJ Books, 2002. ISBN 0-7279.1625-4.**** This book provides clear advice on how to write scientific articles and how to get published....