Postgraduate Medical Journal articles from September 2003

Postgraduate Medical Journal archives from September 2003

Herbal medicines.(Herbal Medicines)
September 1, 2003... Always ask your patient about herbal medicines Complementary and alternative medicine (CAM) is a generic term for a range of therapies and practices including herbal medicine and acupuncture. Herbal medicines are the most widely used from...

The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis.(Review)
September 1, 2003... The electrocardiogram is considered an essential part of the diagnosis and initial evaluation of patients with chest pain. This review summarises the information that can be obtained from the admission electrocardiogram in patients with ST...

Fear of pregnancy and childbirth.(Review)
September 1, 2003... Pregnancy is a major life event for all women. However, when a psychiatric disorder is added to or exacerbated by the pregnancy then the problem requires expert knowledge from more than one area of medicine. This paper looks at pregnancy and...

Giant cell arteritis.(Review)
September 1, 2003... Giant cell arteritis (GCA), temporal arteritis or Horton's arteritis, is a systemic vasculitis which involves large and medium sized vessels, especially the extracranial branches of the carotid arteries, in persons usually older than 50 years....

What is a Caldicott guardian?(Review)
September 1, 2003... A review of patient confidentiality issues was commissioned and its findings published as the Caldicott Report in December 1997. It made 16 recommendations and formulated six principals. To help in remembering these principles the mnemonic...

Role of microbiological investigations in the management of non-perineal cutaneous abscesses.(Audit)
September 1, 2003... Postgrad Med J 2003;79:519-521 Background: Pus samples for microbiological examination are routinely sent after incision and drainage of abscesses. There is no evidence that microbiology reports influence treatment for non-perineal...

Effects of diltiazem on platelet activation and cytosolic calcium during percutaneous transluminal coronary angioplasty.(Original Article)
September 1, 2003... Postgrad Med J 2003;79:522-526 Aims: To evaluate effects of diltiazem on platelet hyper-reactivity in situations associated with endothelial injury and their possible relationship to cytosolic calcium concentration. Methods: Blood...

Cellular profile of bronchoalveolar lavage fluid in Turkish miners.(Original Article)
September 1, 2003... Postgrad Med J 2003;79:527-530 Pneumoconiosis is still a health problem in Turkey and has a relatively high incidence. Retired underground miners were investigated to document alveolitis, and to observe the difference in the cellular...

Retrobulbar haemorrhage associated with chronic Gingko biloba ingestion.(Case Report)
September 1, 2003... Postgrad Med J 2003;79:531-532 Retrobulbar haemorrhage is a rare and potentially sight threatening complication after peribulbar local anaesthetic injection for cataract surgery. A case is reported of a woman who developed this complication...

Images in medicine: three channelled aortic dissection.(Brief Article)
September 1, 2003... A 37 year old man with Marfan's syndrome complained of a second episode of sudden chest pain. He had undergone Bentall's operation at another hospital because of a diagnosis of Stanford type A aortic dissection. Enhanced computed tomography...

Laparoscopic colon resection with intraoperative polyp localisation with high resolution ultrasonography coupled with colour power Doppler.(Case Report)
September 1, 2003... Postgrad Med J 2003;79:533-534 A 40 year old woman with a 3 cm sigmoid polyp lesion who underwent a laparoscopic colon resection after intraoperative localisation of the lesion using laparoscopic ultrasonography coupled with colour power...

Sarcoidosis and HIV infection: a case report and a review of the literature.(Case Report)
September 1, 2003... Postgrad Med J 2003;79:535-538 Sarcoidosis occurring in patients with AIDS is rare. This infrequent association has been attributed to the impairment of the immune system that may interfere with the granuloma formation in HIV infected...

Images in medicine: technetium-99m labelled red blood cell blood pool imaging versus contrast venography in a patient with extensive blue rubber bleb naevi.
September 1, 2003... A 16 year old boy with non-familial, multiple subcutaneous blue rubber bleb nevi (BRBN) since birth presented to us at the age of 13. The BRBN had increased in size over the years. He also had other minor dysmorphic anomalies and was mentally...

An unusual electrocardiographic abnormality.(Cardiology)(Brief Article)
September 1, 2003... A 70 year old man with chronic obstructive pulmonary disease and hypertension was admitted to hospital with a two month history of worsening dyspnoea on exertion and ankle swelling. On examination, the patient was in atrial fibrillation with an...

A diagnostic conundrum.(Infection)
September 1, 2003... A 37 year old man with learning difficulties presented to our hospital in 1999 with anorexia, 12 kg weight loss, swelling of the legs, and night sweats. On examination he had a dusky generalised pigmentation but no rash and slight hepatomegaly....

Progressive furrowing of skin with digital clubbing.(Digital Clubbing)
September 1, 2003... A 27 year old man presented with gradual coarsening of his facial features noticed for the past two years. It was associated with marked oiliness of the facial skin and excessive sweating from the palms and soles. He had also noticed gradual...

Red eyes, reduced vision, and vomiting.(Ophthalmology)(Brief Article)
September 1, 2003... A 67 year old woman was referred by her general practitioner to our accident and emergency department with a two day history of nausea, vomiting, and blurred vision in both eyes. Her drug history included that of taking atenolol and...

An odd case of multiple "cannonball metastases".(ResPiratory Medicine)
September 1, 2003... An 84 year old woman was admitted to our acute stroke unit with sudden onset of slurred speech and right sided weakness of six hours' duration. She gave a history of a previous myocardial infarct, chronic obstructive lung disease, and...

A rare cause of wheeze in a young adult.(Respiratory Medicine)(lung defect causes wheezing)
September 1, 2003... A 16 year old Irish girl was referred by her general practitioner to the respiratory outpatient clinic with a nine year history of wheeze on exertion, which was getting progressively worse. She had a minimal response to regular inhaled low dose...

Deep jaundice in an adolescent.(Jaundice)
September 1, 2003... A 16 year old girl, previously healthy, presented with a four day history of 39[degrees]C fever with chills, loss of appetite, and fatigue. During the past 24 hours, she had dark urine and became progressively jaundiced. She had never smoked or...

An unusual electrocardiographic abnormality.(Self Assessment Answers)
September 1, 2003... Q1: What is shown in fig 1 (see p 539), and what is its significance? Figure I shows a prolonged QT interval (corrected QT 520 milliseconds) and macroscopic T wave alternans. T wave alternans is defined as a beat to beat variation in the...

A diagnostic conundrum.(Self Assessment Answers)
September 1, 2003... Q1: What is the diagnosis in this case? The diagnosis is Whipple's disease. This is a rare multisystem disorder characterised by weight loss, diarrhoea, abdominal pain, arthralgia and lymphadenopathy, though presentation may be very...

Progressive furrowing of skin with digital clubbing.(Self Assessment Answers)
September 1, 2003... Q1: What is the diagnosis? The diagnosis is primary hypertrophic osteoarthropathy or pachydermoperiostitis or Touraine-Solente-Gole syndrome. The presence of characteristic facial features with cutis verticis gyrata and advanced clubbing...

Red eyes, reduced vision, and vomiting.(Self Assessment Answers)
September 1, 2003... Q1: Describe the anterior segment photographs Both eyes reveal ciliary injection, corneal oedema, and shallow anterior chambers. Both pupils are oval and mid-dilated along with patches of iris atrophy more prominent in the left eye (figs 1...

An odd case of multiple "cannonball metastases".(Self Assessment Answers)
September 1, 2003... Q1: What abnormalities are seen on the radiograph? The chest radiograph (see p 542) shows evidence of a raised left hemidiaphragm and a small left pleural effusion. Two pulmonary nodules, which have no visible calcification or cavitation...

A rare cause of wheeze in a young adult.(Self Assessment Answers)
September 1, 2003... Q1: Describe the findings on radiography and computed tomography The plain radiograph and computed tomogram of the chest (see p 543) demonstrated considerable reduction in the volume of her right lung with hyperlucency, a paucity of...

Deep jaundice in an adolescent.(Self Assessment Answers)
September 1, 2003... Q1: What is the main differential diagnosis of this patient's initial syndrome? In this young girl a syndrome of fever, lymphadenopathy, and hepatosplenomegaly were accompanied by intrahepatic cholestasis with high bilirubin and acute...

Sneddon's syndrome: additional neurological feature in antiphospholipid (Hughes') syndrome.(Letter)
September 1, 2003... I was interested to read the article by Hughes on the antiphospholipid syndrome. (1) I agree that primary antiphospholipid syndrome (APS) is a major neurological disease. Disease conditions other than deep vein thrombosis, recurrent fetal loss,...

The Mnopause in Pactice.(Book Review)
September 1, 2003... The Menopause in Practice. Catrina Bain, Mary Ann Lumsden, Naveed Sattar, and Ian A Greer. (Pp 71; [pounds sterling]14.95.) Royal Society of Medicine Press, 2002. ISBN 1-85315-516-0. *** The field of the management of the menopause is...

Conservative Srgery for Mnorrhagia.(Brief Article)(Book Review)
September 1, 2003... Conservative Surgery for Menorrhagia. Edited by Peter O'Donovan, Paul McGurgan, and Walter Prendiville. (Pp 251; [pounds sterling]65.) Greenwich Medical Media, 2003. ISBN 1-84110-097-8. *** During the last decade many techniques for...

Online.
September 1, 2003... Contains everything available in the paper version of the journal and more... * Browse the archive PMJ online has an archive dating back to 1965. Full text from January 1999, abstracts from 1976 and table of contents back to 1965. ...