No laughing matter: subacute degeneration of the spinal cord due to nitrous oxide inhalation.

Background: Whilst the dangers of 'legal highs' have been widely publicised in the media, very few cases of the neurological syndrome associated with the inhalation of nitrous oxide (NO) have been reported. Here we set out to raise awareness of subacute degeneration of the spinal cord arising from recreational NO use so that formal surveillance programs and public health interventions can be designed.

Methods: Case series documenting the clinical and investigational features of ten consecutive cases of subacute degeneration of the spinal cord presenting to a hospital with a tertiary neurosciences service in East London.

Is preparedness for CBRN incidents important to general practitioners in East London?

General practitioners (GPs) have an important role in public health response to CBRN incidents, including disseminating information to worried patients and undertaking risk assessments of patients. The authors undertook the first known UK survey of GPs' CBRN preparedness to assess knowledge and attitudes towards CBRN preparedness among GPs in East London, in the area of the Olympic Park. A questionnaire was developed, focusing on GPs' self-preparedness for, and perceived roles in CBRN incidents, and GPs' access to resources and policies for dealing with such incidents.

Addressing the inverse care law in cardiac services.

Background: Wide variation in rates of angiography and revascularization exist that are not explained by the level of need for these services. The National Service Framework for Coronary Heart Disease has set out a number of standards with the aim of increasing the number of revascularizations and reducing inequalities in access to care. In this study we aimed to investigate inequity in angiography and revascularization rates between the four Primary Care Group (PCG) areas in Camden and Islington Health Authority and to put in place measures to address the problems identified.