What's new this month in BMJ Journals
http://www.100md.com
《英国医生杂志》
Patients use rural A&E departments appropriately
More than 9 out of 10 "walking wounded" who attended four rural Welsh accident and emergency departments did so for conditions with recent acute onset or exacerbation. Only 6% had a chronic condition. Overwhelmingly, patients used their own transport; only three travelled by ambulance—all at a general practitioner's suggestion. The main reason for attending was that the GP service could not meet their needs. Most patients were content with their care, the determining feature of discontent being a doctor seen as rude, abrupt, or unsympathetic. The authors conclude that stories of unreasonable patient behaviour or expectations have the status of an "urban legend."
Emerg Med J 2005;22: 165-170
Smokers are unrealistic about their risks
Current smokers incorrectly judge their own risk of lung cancer as lower than that of other smokers and they substantially underestimate their excess risk over that of non-smokers. More than half of current smokers believe myths, such as the one about exercise reversing the ill effects of smoking. A similar number have an unrealistic expectation of the chance of curing lung cancer. These findings come from a survey of 1245 current smokers in New Jersey, which confirms that smokers have a poor understanding of the risks they face. The argument that people begin or continue smoking with adequate knowledge of what it might mean to them is indefensible, say the authors.
Tobacco Control 2005;14: 55-9
Multiplanar reconstruction of contrast enhanced computed tomography images of a patient with Takayasu's arteritis shows occlusion of the abdominal aorta with abnormal collaterals arising from enlarged inferior epigastric arteries (IEA) and deep iliac circumflex arteries (DICA). These feed into the common iliac arteries (CIA).
Heart 2005;91: 392
Footballers claim illicit drug use goes undetected
Credit: MASAKATSU YAMAZAKI
One in three professional footballers in a British survey told researchers they believed up to 1 in 20 players used performance enhancing drugs. Thirty nine respondents, across all four English divisions, said they personally knew players who did so. Many players admitted to using permitted supplements such as vitamins, minerals, protein powders, and creatine, mostly on advice from a trainer, nutritionist, or physiotherapist—but 18% did so without advice. Nearly half of players stated they knew colleagues who took recreational drugs, but as only about 6 of the 1100 players checked each year test positive for these, it seems to be easy to avoid detection. Sixty per cent of those surveyed did not expect to be tested for illicit drugs in the next 12 months, suggesting to the authors that the Football Association's system is not likely to command respect. The authors recommend increasing drug testing at least to the level used in elite track and field events, and they say that clubs should provide expert advice on the use of legal supplements.
Br J Sports Med 2005;39: e18
Minor head injury may predict premature death
People admitted to hospital in Edinburgh with a minor head injury have an increased risk of dying over the subsequent 20 years. The excess mortality is mostly from substance abuse (particularly alcohol), suicide, and unintentional injury. Of 1573 people who had had minor head injury in 1981, 340 died within 20 years, 48% of them before the age of 70. The death certificate of 28 gave a code related to alcohol use, and six to drug abuse. Sixteen had committed suicide, more than 80 times the rate in the general Scottish population. A further 18 died from unintentional injuries without evidence of alcohol being associated. Epilepsy was reported as a cause of death in eight men. A cohort with head injury differs from the normal population in being younger, of lower socioeconomic status, and more likely to be substance misusers. The authors recommend a prospective study of suicide risk in those sustaining head injury and targeting this group for suicide prevention initiatives.
More than 9 out of 10 "walking wounded" who attended four rural Welsh accident and emergency departments did so for conditions with recent acute onset or exacerbation. Only 6% had a chronic condition. Overwhelmingly, patients used their own transport; only three travelled by ambulance—all at a general practitioner's suggestion. The main reason for attending was that the GP service could not meet their needs. Most patients were content with their care, the determining feature of discontent being a doctor seen as rude, abrupt, or unsympathetic. The authors conclude that stories of unreasonable patient behaviour or expectations have the status of an "urban legend."
Emerg Med J 2005;22: 165-170
Smokers are unrealistic about their risks
Current smokers incorrectly judge their own risk of lung cancer as lower than that of other smokers and they substantially underestimate their excess risk over that of non-smokers. More than half of current smokers believe myths, such as the one about exercise reversing the ill effects of smoking. A similar number have an unrealistic expectation of the chance of curing lung cancer. These findings come from a survey of 1245 current smokers in New Jersey, which confirms that smokers have a poor understanding of the risks they face. The argument that people begin or continue smoking with adequate knowledge of what it might mean to them is indefensible, say the authors.
Tobacco Control 2005;14: 55-9
Multiplanar reconstruction of contrast enhanced computed tomography images of a patient with Takayasu's arteritis shows occlusion of the abdominal aorta with abnormal collaterals arising from enlarged inferior epigastric arteries (IEA) and deep iliac circumflex arteries (DICA). These feed into the common iliac arteries (CIA).
Heart 2005;91: 392
Footballers claim illicit drug use goes undetected
Credit: MASAKATSU YAMAZAKI
One in three professional footballers in a British survey told researchers they believed up to 1 in 20 players used performance enhancing drugs. Thirty nine respondents, across all four English divisions, said they personally knew players who did so. Many players admitted to using permitted supplements such as vitamins, minerals, protein powders, and creatine, mostly on advice from a trainer, nutritionist, or physiotherapist—but 18% did so without advice. Nearly half of players stated they knew colleagues who took recreational drugs, but as only about 6 of the 1100 players checked each year test positive for these, it seems to be easy to avoid detection. Sixty per cent of those surveyed did not expect to be tested for illicit drugs in the next 12 months, suggesting to the authors that the Football Association's system is not likely to command respect. The authors recommend increasing drug testing at least to the level used in elite track and field events, and they say that clubs should provide expert advice on the use of legal supplements.
Br J Sports Med 2005;39: e18
Minor head injury may predict premature death
People admitted to hospital in Edinburgh with a minor head injury have an increased risk of dying over the subsequent 20 years. The excess mortality is mostly from substance abuse (particularly alcohol), suicide, and unintentional injury. Of 1573 people who had had minor head injury in 1981, 340 died within 20 years, 48% of them before the age of 70. The death certificate of 28 gave a code related to alcohol use, and six to drug abuse. Sixteen had committed suicide, more than 80 times the rate in the general Scottish population. A further 18 died from unintentional injuries without evidence of alcohol being associated. Epilepsy was reported as a cause of death in eight men. A cohort with head injury differs from the normal population in being younger, of lower socioeconomic status, and more likely to be substance misusers. The authors recommend a prospective study of suicide risk in those sustaining head injury and targeting this group for suicide prevention initiatives.