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BMJ. 2007 November 10; 335(7627): 1000.
PMCID: PMC2072006

Minerva

The European Doctors' Orchestra will be performing their 2007 London extravaganza on Sunday 18 November at 3 pm at the Dukes Hall, Royal Academy of Music, Marylebone Road, in central London. Come and support Save the Children and enjoy the buzz of over 100 musical doctors from all over Europe playing Vaughan Williams' The Wasps, Schubert's ninth symphony, and Dvorak's cello concerto. For information and tickets please email Stephen Brearley at vascusurg@btconnect.com.

The Royal Northern Hospital was “loved and respected” by the citizens of a somewhat deprived part of north London from 1856 to 1992. Hamilton Bailey and Robert McNeill Love, who made medical publishing history with their surgical textbooks, both worked there. A new history by Albert Rinsler (ISBN 9780955520204) says the architects proposed the rather novel idea of three circular block wards with 20 beds in each, and the Whittington Hospital, which serves the same part of London, incorporated some of these curvy features in its recent redesign.

Pathologists in Lancaster say that transient bacteraemia occurring in otherwise completely healthy people can occasionally cause acute, life threatening events due to the bacterial toxins, even though the circulating bacteria can be rapidly cleared in less than 20 minutes (Medical Hypotheses 2007;69:1032-9; doi: 10.1016/j.mehy.2007.02.039). Infants aged 2-3 months are most at risk: antitoxin immunoglobulin G is at its lowest level, and sudden unexpected death in infancy, haemorrhagic shock, and encephalopathy could all be caused in this way. Similar profound physiological dysfunction in later life, such as epilepsy, migraine, stroke, and cardiac arrhythmias, could all be triggered by a similar mechanism, suggest the authors.

Sarcopenia is the loss of muscle mass and strength that happens with age, and in particular in people with type 2 diabetes. A cross sectional study in the Quarterly Journal of Medicine (2007;100:707-13; doi: 10.1093/qjmed/hcm095) aimed to discover if grip strength and features of the metabolic syndrome are related. The authors report that impaired grip is associated with some individual features (such as fasting triglyceride concentrations, blood pressure, and waist circumference), and lower grip strength was significantly associated with having the metabolic syndrome (odds ratio 1.18, 95% confidence interval 1.07 to 1.30). Whether grip strength will prove useful in the clinic remains to be seen.

Hackney, east London, may have an “outbreak” of unwanted pregnancies and sexually transmitted infections after the discovery of seven different types of counterfeit condoms that don't conform to the appropriate British or European standards ( www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary=true&ssDocName=CON2032868&ssTargetNodeId=365). Customers who think they may have bought any of the suspect condoms have been urged to contact a 24 hour consumer helpline or their local trading standards office. Minerva thinks they should be advised to see a doctor.

A non-profit organisation called Rx Laughter uses humour for healing and has recently collaborated with the University of California, Los Angeles. It has collected preliminary data on a sample of 18 children aged 7-16 years who watched funny video tapes before, during, and after a standardised pain task, which involved placing a hand in cold water. Indicators of humour—the number of laughs and smiles—were not significantly associated with severity of pain or submersion time, but the group did show significantly greater tolerance of pain while watching the funny videos than when they watched them immediately before or after the cold water task (eCAM published online 5 October 2007; doi: 10.1093/ecam/nem097).

Karl Marx made no secret of having recurrent boils. According to a paper in the British Journal of Dermatology (published online 6 November 2007; doi: 10.1111/j.1365-2133.2007.08282.x) the underlying condition was hidradenitis suppurativa, in which the large sweat glands under the arms and in the groin become blocked and inflamed, and the skin eventually becomes thickened and scarred. Marx often complained in his letters that his skin affected the output and quality of his work. Hidradenitis suppurativa probably contributed to his poverty and to his frankly admitted low self esteem and self loathing.

It's the waiting and the aftermath of undergoing electroconvulsive therapy (ECT) that upsets patients, rather than the actual treatment itself (Psychiatric Bulletin (2007;31:414-17; doi: 10.1192/pb.bp.107.014860). Over 65% of the 389 patients surveyed at centres accredited for ECT said that they found the staff friendly and reassuring, and many commented that this put them at their ease before receiving treatment. But many reported that the waiting and post-recovery areas left a lot to be desired.

The patients' information page in Clinical Diabetes (2007;25:144; doi: 10.2337/diaclin.25.4.144) offers an aspect of living with diabetes that is often forgotten. Doctors focus in on diet, HbA1c, and cholesterol levels and blood pressure; patients are left with all the emotions: “Diabetes creates many feelings—sadness, anger, fear, and frustration, to name just a few. Although these feelings can affect your diabetes and how you care for it, you may not know how to talk with your doctor about these feelings.” Whether doctors know how to listen is another question altogether.


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