Journal of the Royal Society of Medicine
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Painful bone metastases are a common problem for cancer patients. Although current evidence supports the use of a single fraction of radiotherapy as the treatment of choice, many radiotherapists, for a variety of reasons, continue to use fractionated regimens. Over one six month period 105 patients received external beam irradiation for painful bone metastases at the Royal London Hospital (RLH). ⋯ Fractionation did not appear to influence this. Ten patients received large field irradiation. Fifteen patients had five or more sites irradiated, of whom only one received hemibody irradiation.
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One-third of accident and emergency (A & E) patients who deliberately take an overdose are not admitted to hospital, and this proportion is increasing. We conducted an audit of 300 case records of such patients from two different district health authorities in London. We found that only 4% of patients were assessed in the manner recommended by the Department of Health and 10% had no psychosocial assessment whatsoever. We recommend specific training, an assessment form, regular audit, and communication with the general practitioner.
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The aim of this study was to compare and contrast the views of general practitioners (GPs), hospital doctors and medical students to alternative medicine. A questionnaire was sent to a random sample of 100 GPs and 100 hospital doctors in the South West Thames Regional Health Authority (SWTRHA). A convenience sample of 237 pre-clinical medical students at St George's Hospital Medical School was also given a questionnaire. ⋯ Twelve per cent of hospital doctors and 20% of GPs were practising alternative medicine. The majority of the respondents felt that alternative medicine should be available on the National Health Service (NHS) and that medical students should receive some tuition about alternative therapies. A considerable proportion of those doctors referring patients to alternative practitioners were ignorant of their official qualifications.
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The present study examined the prevalence and severity of anxiety and depression among people with migraine. To obtain a spectrum of migraine experience two potentially different samples were identified: over 600 patients attending migraine clinics and 87 migraine sufferers in the general population. International Headache Society criteria were used to establish the diagnosis of migraine. ⋯ There is no evidence that it is correlated with frequency of migraine attacks. Anxiety and depression are common among people with migraine and remain largely unrecognized. Future studies should identify contributory factors.