The bone scan: where are we now?

The isotope bone scan continues to be the most widely performed nuclear medicine investigation in the UK. The detection of skeletal metastases remains the most common clinical indication. However, the use of the bone scan is changing as it becomes subject to cost pressures, competing imaging modalities, and altering clinical indications.

An analysis of the clinical features of familial schizophrenia.

Clinical features of familial schizophrenia were examined in 169 siblings from 80 families. Factor analysis of symptoms produced a negative symptom factor (affective flattening and negative thought disorder), a disorganization factor (inappropriate affect and positive thought disorder) and a reality distortion factor (delusions and hallucinations). The negative symptom factor correlated positively with duration of illness and poor outcome.

Major incident planning in South East Thames Region: a survey of medical staff awareness and training.

In order to assess awareness and training of medical staff in major incident planning and disaster medicine, a telephone survey was conducted throughout South East Thames Region. Duty consultants and trainees in anaesthesia, general surgery and orthopaedic surgery from a total of 17 hospitals in the region were included. Accident and emergency (A&E) consultants were also interviewed in order to assess administrative aspects of major incident planning.

Assessment of patients' knowledge about their illness and treatment.

One hundred and twenty two patients over the age of 65 were questioned about their knowledge of their illness and treatment. They were unaware of a quarter of both their illnesses and medications. There was a considerable lack of knowledge about certain groups of diseases and medications, while patients were much better informed about others.

A survey of the practice of regional anaesthesia.

A questionnaire designed to elucidate the popularity and practice of regional anaesthesia was circulated to all anaesthetists in the South East Thames Region. Two hundred and eleven completed questionnaires were received and subsequently analysed, a response rate of 65%. Regional anaesthesia was employed at least once per week by 83% of respondents usually in combination with general anaesthesia (77% of respondents).

Risk factors for hydrocortisone myopathy in acute severe asthma.

In one hospital over a 15-month period, four out of nine patients ventilated for acute severe asthma developed acute hydrocortisone myopathy. All patients had received less than 1.0 g day-1 hydrocortisone.

Septic scarlet fever due to Streptococcus pyogenes cellulitis.

We report three cases of septic scarlet fever due to Streptococcus pyogenes Group A (serotype M1/T1/OF-) cellulitis in healthy young adults. Despite prompt treatment two of the patients died. Such cases of cellulitis associated with scarlet fever, severe toxaemia and septicaemia have not been reported in the post-antibiotic era.

The painful heel.

The painful heel syndrome is a common complaint of the middle-aged and elderly. Most patients have no associated disease, except obesity, but young men should be carefully evaluated for ankylosing spondylitis or reactive arthritis. The majority of cases respond to appropriate heel padding, corticosteroid injection or a specially designed insole.