British medical bulletin
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British medical bulletin · Jan 2002
ReviewRespiratory infections following haemopoietic stem cell transplantation in children.
Disorders of the respiratory system are well recognised following the administration of chemotherapy schedules; although respiratory complications may occur following less intensive regimens, they are most frequently seen following the administration of high dose chemotherapy with or without radiotherapy which is used in preparation for haemopoietic stem cell transplantation (SCT). In this setting, respiratory complications may occur in up to 50% of patients and account for over 40% of all deaths; those patients who require admission to intensive care (ICU) requiring intubation and mechanical ventilation have a particularly poor prognosis, with less than 10% becoming long-term survivors.
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Antibiotic resistance remains rare in paediatric community-acquired pneumonia in the UK, but is more common in hospital-acquired pneumonia and in patients with chronic lung diseases. It should also be considered in children arriving from countries with a high prevalence of antibiotic resistance, children with previous heavy antibiotic exposure, those who are immunosuppressed, and those who are not responding to conventional therapy. ⋯ Continued vigilance and research is required. The recently introduced pneumococcal conjugate vaccines offer great promise as they are likely to prevent cases of disease due to penicillin-resistant serotypes.
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British medical bulletin · Jan 2002
ReviewUnder-rated neuro-otological symptoms: Hoffman and Brookler 1978 revisited.
In 1978, Hoffman and Brookler published an article in The Laryngoscope to challenge prevailing views on the lack of diagnostic power of certain symptoms often reported by patients to neuro-otologists. Some of these 'under-rated neuro-otological symptoms' include complaints of non-rotational dizziness, blurred and double vision, and the development of visual motion hypersensitivity in patients with balance disorders. In this review, I revisit these visual symptoms in the light of new findings from our laboratory. ⋯ Visual dependence denotes subjects who preferentially use vision, as opposed to vestibular or proprioceptive input, for spatial orientation and postural control. We do not know as yet what makes some vestibular patients become extremely visually dependent. However, we have provided evidence for Hoffman and Brookler's impression that visually triggered complaints should not be summarily dismissed, as they often point to an underlying vestibular disorder.
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British medical bulletin · Jan 2000
ReviewUnderstanding life-style and food use: contributions from the social sciences.
The contribution of social sciences to the study of life-style and food use in Britain is illustrated by drawing on recent evidence of purchasing patterns, reports of the organisation of meals, snacks, eating out and images of the origins of food. Work discussed underlines a considerable degree of empirical complexity, demonstrates that the supply side as well as demand should be taken into account, and illustrates the manner in which even supposedly highly voluntaristic spheres of consumption activity may none the less be circumscribed. The article is prefaced by briefly contrasting the approach to 'life-style' adopted by market researchers, public health professionals and social theorists. It concludes with the proposal that in order to understand the complexity surrounding human food use, we may be advised to consider ensuring that the descriptive and conceptual tools being used can capture that complexity.
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British medical bulletin · Jan 2000
ReviewGenetically modified crops: methodology, benefits, regulation and public concerns.
The genetic modification of crop plants from the methodology involved in their production through to the current debate on their use in agriculture are reviewed. Techniques for plant transformation by Agrobacterium tumefaciens and particle bombardment, and for the selection of transgenic plants using marker genes are described. ⋯ Some of the major concerns of the general public regarding GM crops and food: segregation of GM and non-GM crops and cross-pollination between GM crops and wild species, the use of antibiotic resistance marker genes, the prevention of new allergens being introduced in to the food chain and the relative safety of GM and non-GM foods are considered. Finally, the current debate on the use of GM crops in agriculture and the need for the government, scientists and industry to persevere with the technology in the face of widespread hostility is studied.