Severe acute mitral valve regurgitation in a COVID-19-infected patient.

The ongoing SARS-CoV-2 (COVID-19) pandemic has presented many difficult and unique challenges to the medical community. We describe a case of a middle-aged COVID-19-positive man who presented with pulmonary oedema and acute respiratory failure. He was initially diagnosed with acute respiratory distress syndrome.

Lessons learned from a subsidised spectacles scheme aiming to improve eye health in Aboriginal people in Victoria, Australia.

The Victorian Aboriginal Spectacles Subsidy Scheme (VASSS) aimed to improve access to visual aids and eye care for Aboriginal and Torres Strait Islander Victorians. The VASSS started in July 2010 and has operated continually since. In 2016, we explored the collaborations, planning, adaptations and performance of the VASSS over the first 6 years by reviewing and analysing service data, as well as data from semistructured interviews, focus groups and surveys.

Progressive myeloneuropathy with symptomatic anaemia.

Hypocupremia is a rare and under-recognised cause of bone marrow dysplasia and myeloneuropathy. A 47-year-old Caucasian woman had progressive ascending peripheral neuropathy and gait ataxia over 3 months and fatigue, dyspnoea and unintentional weight loss over 8 months. She had profound macrocytic anaemia and neutropenia.

Antibody-Negative Relapse of Goodpasture Syndrome with Pulmonary Hemorrhage.

Goodpasture syndrome is a rare autoimmune disease comprising antiglomerular basement membrane (anti-GBM) crescentic glomerulonephritis and pulmonary capillaritis with circulating anti-GBM antibodies. Rarely, antibody-negative cases have been described. We report a young, African American adult woman admitted with flank pain and hematuria with laboratory testing and kidney biopsy demonstrating anti-GBM crescentic glomerulonephritis with elevated anti-GBM antibody levels.

"Fitter families for future firesides": Florence Sherbon and popular eugenics.

In the 1920s, eugenicists adapted public health contests to create "Fitter Family for Future Firesides" contests. Designed by Mary T. Watts and Dr.

Thomas Bakewell (1761-1835): madhouse keeper and moral therapist.

Thomas Bakewell, a non-medical asylum keeper, published in 1805 a family guide on the management of the insane, based on his experience of mental illness. He consolidated his humane approach at Spring Vale Asylum near Stone in Staffordshire that he ran for 27 years along moral therapy lines. This paper relates Bakewell's work to the philosophical and scientific influences of the preceding century and describes his practice through analysis of case studies he presented to a Parliamentary Select Committee in 1815.

Bovine tuberculosis in cattle: reduced risk on wildlife-friendly farms.

The associations between habitat and other factors that lead to the risk of bovine tuberculosis (bTB) in diary cattle were examined in an unmatched case-control study. Data from 60 herds with recent history of bTB and 60 controls were analysed using logistic regression. The predictors included farmland habitat, topography, indices of badger density and herd size.

Lymphocytic interstitial pneumonitis (LIP) in Sjögren's syndrome: a case report and a review of the literature.

Sjõgren's disease is one of the most common rheumatological diseases and can present with a variety of extra-glandular manifestations. Lymphocytic Interstitial Pneumonitis (LIP) is the most common lung pathology in these patients. It is important to know and recognize this condition because it is potentially treatable.

The Popeye principle: selling child health in the first nutrition crisis.

The cartoon character Popeye the Sailor was capable of superhuman feats of strength after eating a can of spinach. Popeye ate spinach because the association of spinach with strength was a product of the first national nutrition crisis in the United States: the 1920s fight against child malnutrition. Spanning the first three decades of the twentieth century, the malnutrition crisis arose from the confluence of many different events including the invention of nutrition science and new standards for height and weight; international food crises created by world war; the rise of consumerism, advertising, and new forms of mass media; and Progressive reformers' conviction that education was a key component of any solution.

Evaluating the accuracy of technicians and pharmacists in checking unit dose medication cassettes.

The accuracy rates of board-registered pharmacy technicians and pharmacists in checking unit dose medication cassettes in the inpatient setting at two separate institutions were examined. Cedars-Sinai Medical Center and Long Beach Memorial Medical Center, both in Los Angeles county, petitioned the California State Board of Pharmacy to approve a waiver of the California Code of Regulations to conduct an experimental program to compare the accuracy of unit dose medication cassettes checked by pharmacists with that of cassettes checked by trained, certified pharmacy technicians. The study consisted of three parts: assessing pharmacist baseline checking accuracy (Phase I), developing a technician-training program and certifying technicians who completed the didactic and practical training (Phase II), and evaluating the accuracy of certified technicians checking unit dose medication cassettes as a daily function (Phase III).

Childhood hyperkinetic disorder/attention deficit disorder grown up.

There is growing evidence for the validity of the diagnosis of Attention Deficit Hyperkinetic Disorder (ADHD) in adults, as well as evidence that conduct disorder in adolescents and dissocial personality disorder in adult life are linked to ADHD in childhood. Methylphenidate is an effective treatment of ADHD in adolescents and young adults and it is possible that dissocial personality disorder will respond to methylphenidate. There is no evidence that methylphenidate reduces symptoms of conduct disorder in adolescents or of dissocial personality disorder in young adults, because no studies have evaluated methylphenidate in these conditions.

Cardiff puerperal mood and hormone study. III. Postnatal depression at 5 to 6 weeks postpartum, and its hormonal correlates across the peripartum period.

Background: We assessed associations of mood at 5-6 weeks postpartum with peripartum saliva cortisol and progesterone profiles.

Method: A prospective study involved 120 primiparous women free of major marital, socioeconomic and health problems, who collected saliva twice daily from 2 weeks before delivery to day 35 postpartum. This allowed intensive characterisation of cortisol and progesterone profiles.

Variables related to increased mortality following out-patient pulmonary rehabilitation.

Although patients with advanced pulmonary diseases have significant improvement in exercise ability and functional status following comprehensive out-patient pulmonary rehabilitation (OPR), their long-term prognosis once they have reached this stage of their diseases remains poor. To further evaluate predictors of increased mortality in these patients, we related patient characteristics and short-term outcome obtained during OPR assessment of 158 patients to subsequent survival. The time period from OPR to death or collection of survival data was 40.

Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II.

Objectives: To define relation between mood and concentrations of progesterone and cortisol during perinatal period to test hypothesis that rapid physiological withdrawal of steroid hormones after delivery is associated with depression.

Design: Prospective study of primiparous women from two weeks before expected date of delivery to 35 days postpartum.

Setting: Antenatal clinic in university hospital, obstetric inpatient unit, patients' homes.

Cardiff puerperal mood and hormone study. 1. Saliva steroid hormone profiles in late pregnancy and the puerperium: endocrine factors and parturition.

Participants were 120 primiparous women who had vaginal delivery of a non-handicapped child. Saliva was collected twice daily through parturition to day 35 post-partum. In the prepartum, a highly significant circadian rhythm was seen in cortisol, with a lower-amplitude rhythm in progesterone (AM/PM = 1.

Group therapeutic factors on an alcohol in-patient unit.

Seventy consecutive patients admitted to an alcohol unit were given a modified version of Yalom's therapeutic factor questionnaire at various points during the therapeutic programme. This programme consists of a two-week introductory programme, followed by a treatment programme, which includes psychodynamic groups, life-history reviews and intensive cognitive-therapy sessions. Internal agreement of ranking order of therapeutic factors was high among all patients and was independent of time spent in group therapy.

Teaching psychiatric interview skills to medical students.

A teaching package is described for teaching interview skills to large blocks of medical students whilst on their psychiatric attachment. The aims of this package are to reduce students' concerns about interviewing psychiatric patients, to reinforce students' knowledge of basic interviewing skills and to introduce students to the particular skills required in taking a psychiatric history and mental state examination. The package emphasizes the following teaching methods: 'hands-on' experience of interviewing a patient in front of small groups of peers; peer feedback using check-lists which focus on three major aspects of interviewing; elicitation of facts, elicitation of feelings and control of the interview; facilitation of small-group discussions in the presence of senior psychiatrist.

An innovation in teaching ethics to medical students.

There is growing agreement among the medical profession that medical ethics should be taught at undergraduate level. We present a model which can be taught in a way which is lively and entertaining, and which allows students to discuss ethical problems freely in small groups. This brief teaching package maximizes the learning experience.

Outcome in bipolar affective disorder after stereotactic tractotomy.

Nine patients have been treated by subcaudate stereotactic tractotomy for bipolar affective disorder resistant to drug treatments. In the majority, after the operation there was a reduction in frequency and severity of depressive and manic episodes. There was a trend for the operation to have more effect on the manic than on the depressive phases.