“Bring sac close to peritoneum, drain its purulent liquid content, and have the shrunken pouch squeezed through this tiny hole.” Such was the senior surgeon’s instruction at the conclusion of a gallbladder removal operation. […]
Tom Nolan: New pandemic flu guidelines – don’t forget your oximeter
New guidelines on the management of pandemic H1N1 influenza were published recently by the Department of Health. They include guidelines on when to refer patients to hospital (see below) and an update on the epidemiology of the disease: fewer than 1% of cases are admitted to hospital; 12-15% of patients admitted to hospital go on […]
Peter Lapsley: Please tick the box!
Some things never seem to change. I spent much of the ten years during which I ran the Skin Care Campaign (SCC) explaining patiently to the government and to pharmacists that, where topical treatments for skin diseases are concerned, generic substitution can present serious problems. That was not only the view of the 35 patient […]
Louise Kenny on paraquat poisoning
The night before last, one of the other doctors admitted a 22 year old male who had ingested concentrated paraquat whilst intoxicated. At the time of admission he was 24 hours post ingestion and his presenting complaint was pain in his mouth and throat due to chemical burns. The night shift doctor handed over the case, […]
Liz Wager on Einstein, David Nutt, and academic freedom
I’m just back from Washington DC, where we held the first US meeting of COPE (the Committee on Publication Ethics). Engraved onto the building housing part of the National Academy of Sciences is a quote from Einstein which could serve as the COPE motto if we had one. It reads: “The right to search for […]
Richard Smith on assessing health technology assessment
The budget of Britain’s Health Technology Assessment programme has grown from £13m in 2006 to £88m in 2010, and it has conducted a swathe of trials on new technologies, published dozens of papers, and supported a study that won the BMJ paper of the year. But could it do even better? This was the question addressed […]
Richard Smith: Rethinking priorities in global health
Last week’s conference to launch Edinburgh University’s Global Health Academy left me thinking that priorities in global health may be very wrong. David Molyneaux from Liverpool said that an alien observing earth for the first time would think that it had only three diseases: AIDS, TB, and malaria. He is one of the “three dinosaurs […]
Emily Spry on ER in the Pikin Hospital
I am happy and exhausted at the end of the first week of the new Triage system and Emergency Room at the Children’s Hospital. Around 80 children present to the hospital each day and Triage nurses now briefly assess them and rush those with Emergency signs to the new 3-bedded ER. There they are assessed […]
Carmi Z Margolis on global health education
When he first entered the spacious great room, a colleague exclaimed: “What an amazing place! I’ve always wanted to come to Bellagio! How did you do it?” I imagine most of our conference participants had similar thoughts. The Rockefeller Foundation Bellagio Conference Centre, situated on the grounds of an ancient villa that belonged to the […]
Domhnall MacAuley: Excellence in Practice. RCGP Annual National Primary Care Conference.
Are you an apple, a pear, or even a melon? Metabolic risk is less if you have the body profile of a pear rather than an apple. If you are shaped like a melon, it is definitely time for a serious diet. You may not have noticed, however, that you are now one of the […]