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BMJ. 2007 June 16; 334(7606): 1280.
PMCID: PMC1892456

Minerva

An Australian doctor has received an email offer from South Africa which suggests he is being considered for an award as a “distinguished contributor to medical knowledge.” Part of the award is said to involve naming a wing in a new oncology centre after him. As much as he'd like to think he was worthy of such recognition, the doctor in question describes himself as a “minor player in radiation oncology” and warns others that this is likely to be another version of the notorious Nigerian money laundering scam and should be ignored.

Patients with newly diagnosed type 2 diabetes are at high risk of stroke in the first five years after diagnosis compared with the general public. Researchers in Canada estimate the risk is more than double the rate for the general population, which confirms the need for aggressive management of cardiovascular risk in these patients right from the start (Stroke 2007;38:1739, doi: 10.1161/STROKEAHA.106.481390)

Children born with insufficient numbers of neutrophils are prone to sepsis, but they can be treated successfully with G-CSF (granulocyte colony stimulating factor) to reverse the neutropenia. What's interesting is that, although G-CSF can improve the cell count, it does not correct the underlying functional deficiency of the neutrophils in defending against micro-organisms. Scientists report that the expression of the polypeptides responsible for the antimicrobial machinery of these cells is almost absent in those children who carry the mutant gene even when they are subsequently treated with G-CSF (Blood 2007;109:4716-23, doi: 10.1182/blood-2006-09-045427).

Toilet trained children who need to provide midstream urine samples should be cleaned around the perineum with soap beforehand to reduce contamination rates (resulting in unnecessary treatment with antibiotics), according to a study in Pediatrics (2007;119:e1288-93, doi: 10.1542/peds.2006-2392). Children randomised to the cleaning group were less likely to have a positive urine analysis result than those in the non-cleaning group (21% v 37%).

When medical students present cases they're often interrupted by their teachers. An observational study carried out in one teaching centre found that the number of interruptions and duration of presentations decreased with the level of the student's training. But the frequency of interruptions (per minute) did not vary according to the level of the learner. In 40% of trainees' presentations, the teacher interrupted in order to give an assessment and sometimes a plan before the trainee had done so. Only 8.3% of learners said they found the interruptions disruptive (Academic Emergency Medicine 2007;14:521-5, doi: 10.1197/j.aem.2006.11.035).

There may be personality traits that can help doctors distinguish between people who are developing dementia with Lewy bodies and those with Alzheimer's disease (Neurology 2007;68:1895-901, doi: 10.1212/01.wnl.0000263131.80945.ad). The most important traits are diminished emotional responsiveness, relinquishing hobbies, growing apathy, and hyperactivity with no purpose. Identifying these, together with the presence of visual hallucinations, should improve the identification of people with dementia with Lewy bodies.

A GP educationalist recently re-entered the world of hospital medicine. He was shocked to discover that, while GP education has been dramatically transformed over the past quarter of a century, the development of medical training in hospitals seems to have stood still. Consultants, he says, find themselves in training roles by force of circumstance rather than through choice, aptitude, or relevant training, and hospital juniors remain unsupervised for much of their clinical work. In contrast, GP registrars are in effect supernumerary in their practices and have access to constant supervision (QJM 2007;100:393-4, doi: 10.1093/qjmed/hcm029).

The quality of drinking water in many developing countries remains poor. A community based longitudinal study conducted over two years in India found that 47.7% of hand pumps and 15.9% of taps were supplying contaminated water (Bahrain Medical Bulletin 2007;27:53-6). The situation was worse in the pre-monsoon and monsoon seasons. Education about methods of household disinfection is critical.

A study of more than 12 000 grandparents in the United States concludes that looking after grandchildren is perfectly safe and may even benefit the grandparents' health (Washington Times, 1 June, www.washingtontimes.com). Whether it's a full time occupation or just occasional duty, grandparents suffer no ills. Grandmothers, in fact, reported “modest improvements” in their health, tended to exercise more, and had less depression. These findings fly in the face of a media barrage that, over the years, has focused on the alleged problems for grandparents who take care of their grandchildren.


Articles from The BMJ are provided here courtesy of BMJ Publishing Group