This week in the BMJ
Volume 329, Number 7480, Issue of 18 Dec 2004Cones explain mechanism of embolism
Cones explain mechanism of embolism
Emboli that cause transient ischaemic attacks may move in the bloodstream in the same way that the cones used by Winnie-the-Pooh moved under the Poohsticks bridge. On page 1432 Knight relates how a team of investigators from Guy's Hospital, London, assembled at the bridge where Pooh first played the game of Poohsticks with Rabbit, Piglet, and Roo. After doing a test run, the medical researchers dropped 100 pine cones (painted red for easy identification) into the water at precisely the same point each time, at intervals of one second. They found that 31% of the cones arrived at one destination and 23% at a second (P < 0.0001).
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Doctors could retrain as Polymeal chefs or wine advisers
The Polymeal—an evidence based menu that includes wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds—promises to be an effective, safe, cheap, and tasty solution to reducing cardiovascular morbidity and increasing life expectancy. Calculating the combined effect of the ingredients by multiplying their risk estimates and applying the effects to the cohort from the original Framingham heart study, Franco and colleagues (p 1447) found that the Polymeal could reduce cardiovascular disease by more than 75%. They warn, however, that because of the disturbing adverse effects of garlic, the Polymeal should not be taken before a romantic rendezvous.
Magnetic bracelets may relieve hip and knee pain
Wearing a magnetic bracelet could reduce the pain arising from osteoarthritis of the hip and knee. After randomising 194 people aged 45-80 to wearing a standard strength static bipolar magnetic bracelet, a weak magnetic bracelet, or a non-magnetic (dummy) bracelet for 12 weeks, Harlow and colleagues (p 1450) found that mean pain scores were reduced significantly more in those in the standard magnet group than in the dummy group. Although a few participants allocated to the dummy group did notice the lack of magnetic force, further analysis showed that unblinding did not affect the results.
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Getting to Mars is no picnic
A journey to Mars would take up to two years—more than twice as long as previous space missions—and would be spent largely under conditions of microgravity. On p 1441 Fong considers the effects of prolonged weightlessness on the human body. How best to deliver the crew to Mars in an optimal state for landing and subsequent exploration is a matter of some debate. One avenue that is being explored is the use of artificial gravity during the space flight.
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Sources of diagnostic criteria don't withstand scrutiny
Disagreement over diagnostic criteria can lead to patients not receiving treatment, especially in multi-specialty disorders. One such is polymyositis, and on p 1464 Hengstman and van Engelen detail a dispute over the criteria used by rheumatologists and neurologists. A structured literature search showed that the polymyositis patients in the original source may actually have inclusion body myositis. Further, two thirds of the references were from only two research groups, and one of these groups didn't provide original data, merely referring to their own work in review articles.
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Body donors are respected in Thailand
Medical students' experience in the dissecting room can be fascinating and frightening. Winkelmann and Güldner (p 1455) look to Thailand for a view on the ambiguous status of the cadaver, which carries personal as well as material qualities. Thailand has no shortage of willing body donors, partly because they thus attain the status of great teacher. This status is conferred in an elaborate dedication ceremony. Students know the name, age, and cause of death of the body they are dissecting. A cremation ceremony takes place at the end of the course. These ceremonies define the atmosphere and ethical framework for dissection courses.
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