Postgraduate Medical Journal articles from September 2002

Postgraduate Medical Journal archives from September 2002

Primary care trusts: the way forward? (Editorial).
September 1, 2002... Primary care trusts must become genuine public health organisations by maintaining their focus on key public health principles and developing meaningful partnerships. The All Party Parliamentary Group on Primary care and Public Health...

Time off: resolving the problems of staffing for the proposed 48 hour week needs radical thinking. (Doctors' Working Lives).
September 1, 2002... Managers are keen to develop the 24/7 philosophy in the NHS, realising that many facilities, overburdened during the 9-5 day, are empty or at least underused for the majority of the time. Operating theatres, secretarial offices, and outpatient...

Missing ring pull. (Images in Medicine).(foreign body removal)(Brief Article)
September 1, 2002... Ring pulls from aluminium cans can be swallowed or inhaled accidentally when the tab breaks off into the can and when the contents are drunk quickly. In this case, the tab was swallowed and was thought to be stuck in the oesophagus because...

Motor neurone disease. (Review).(amyotrophic lateral sclerosis)
September 1, 2002... Motor neurone disease (MND), or amyotrophic lateral sclerosis (ALS), is a neurodegenerative disorder of unknown aetiology. Progressive motor weakness and bulbar dysfunction lead to premature death, usually from respiratory failure. Confirming...

HIV associated thrombotic microangiopathy. (Review).
September 1, 2002... Thrombotic microangiopathy (TMA) is a known complication of HIV infection. Endothelial cell injury appears to be the primary event causing platelet activation and deposition in the microvasculature. Direct cytopathic roles of HIV as well as...

Osteoporosis. (Best Practice).
September 1, 2002... Osteoporosis is characterised by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and consequent increase in fracture risk. It is a common condition affecting one in three women and one in 12...

Investigation and management of iron deficiency anaemia in general practice: a cluster randomised controlled trial of a simple management prompt. (Original Article).
September 1, 2002... Background: Iron deficiency anaemia (IDA) remains the most common cause of anaemia and is frequently secondary to occult gastrointestinal blood loss requiring further investigation. The study was designed to prospectively assess the adequacy of...

Vaccination against hepatitis B infection in patients with end stage renal disease. (Original Article).
September 1, 2002... Background: Experience of hepatitis B vaccination in a contemporary renal replacement programme is reported. Methods: A total of 406 patients were involved: 214 on haemodialysis, 97 on continuous ambulatory peritoneal dialysis, 67...

Early recognition of diabetic neuropathy: evaluation of a simple outpatient procedure using thermal perception. (Original Article).
September 1, 2002... Objective: To determine the effectiveness of Tip-therm, a temperature discriminator, in making an early diagnosis of distal symmetrical polyneuropathy in diabetic patients and to compare its effectiveness with the Semmes-Weinstein monofilament...

How informed is consent? Understanding of pictorial and verbal probability information by medical inpatients. (Short Report).
September 1, 2002... Understanding probability information about treatment risks and benefits is a vital component of patients' decision making capacity. This study demonstrates extensive misunderstanding of verbal descriptions of probability by medical inpatients...

National audit of the management of peritonsillar abscess. (Audit).
September 1, 2002... An anonymous postal survey of 200 consultants was used to audit the current prevalent practices in the management of quinsy in the UK; 101 responded. The findings reveal that on average an otolaryngology department treats 29 cases per year, the...

Sources of inspiration. (Filler).
September 1, 2002... My most inspirational textbook was the 6th edition of Harrison's Principles of Internal Medicine, strangely enough, not because I read it in preparation for the membership, but because, years afterwards, I came to appreciate more fully the...

The medical career of Robert Seymour Bridges, FRCP (1844-1930): physician and Poet Laureate. (History of Medicine).
September 1, 2002... Robert Bridges OM is the only medical graduate (he was elected to the Fellowship of the Royal College of Physicians of London in 1900) to have held the office of Poet Laureate. Educated at Corpus Christi College, Oxford and St Bartholomew's...

Transient disappearance of left bundle branch block pattern: an unusual ECG presentation of acute pulmonary embolism. (Case Report).
September 1, 2002... A 61 year old man developed acute pulmonary embolism while in hospital. His previous and admission electrocardiograms (ECGs) showed a typical left bundle branch block (LBBB) pattern. Immediately after the onset of acute pulmonary embolism, LBBB...

Spinal reconstruction for symptomatic thoracic haemangioma using a titanium cage. (Case Report).
September 1, 2002... Most vertebral haemangiomas are asymptomotic. A case of spinal reconstruction for symplomatic extraosseous thoracic haemangioma using a titanium cage is reported. Radiographs of the T11 vertebra demonstrated characteristic vertical striations....

An unusual case of gestational diabetes mellitus. (Case Report).
September 1, 2002... The case of a woman, who developed gestational diabetes at six weeks in two successive pregnancies, is reported. She was in the high risk group to develop gestational diabetes. The first pregnancy terminated in abortion at 10 weeks. In the...

Enzyme replacement therapy in the management of longstanding skeletal and soft tissue salmonella infection in a patient with Gaucher's disease. (Case Report).
September 1, 2002... A splenectomised patient with Gaucher's disease who developed multiple foci of osteomyelitis and soft tissue abcesses, after a severe episode of group C salmonella sepsis, is described. Aggressive antibiotic treatment and surgical drainage had...

Unusual cause of fever, jaundice, and hepatomegaly in a middle aged man. (Fever, Jaundice, and Hepatomegaly).(Babesiosis)
September 1, 2002... A 48 year old man presented with gradual onset of fever, anorexia, episodic nausea and vomiting, a 40 pound weight loss, and deepening jaundice over a six week period. Fever was intermittent and associated with chills and rigors. There was no...

Failure to thrive in a 3 month old boy. (Failure to Thrive).
September 1, 2002... A 3 month old boy weighing 3.5 kg was admitted because of excessive bleeding from an intramuscular injection site for the past 12 hours. The mother had observed that his abdomen had been progressively distending since the first week of life and...

Refusal to walk in an afebrile well toddler. (Paediatrics).(discitis)
September 1, 2002... A 19 month old well boy presented with a week's history of refusal to walk unsupported and favouring crawling. He had been increasingly unsteady during the preceding three weeks and appeared to be in pain during nappy changes when both legs...

Letters.(Osteoporosis prophylaxis during corticosteriod treatment )(6-Mercaptopurine teratogenicity)(Letter to the Editor)
September 1, 2002... Osteoporosis prophylaxis during corticosteriod treatment We congratulate Hart and Green for flagging up a worrying concern--failure to provide appropriate osteoporosis prophylaxis during planned long term corticosteroid treatment. (1) We...