Clin Med
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This questionnaire-based study assessed the attitudes of the general public to the symptoms of a transient ischaemic attack (TIA) and determined the current level of knowledge about the management of TIA among doctors. The public chose to wait for symptom recurrence before seeking medical advice for amaurosis (41%) and upper limb (UL) monoparesis (51%), sensory loss (68%), or paraesthesia (95%). However, medical advice would be sought most often for slurred speech alone (89%) or combined with UL monoparesis (99%). ⋯ In conclusion, the general public does not recognise the importance of TIA symptoms and the need for rapid assessment. This is compounded by deficiencies in the medical management of TIA. Stroke guidelines will remain ineffective without public awareness campaigns and physician education.
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In 2003, occasional military patients with hyponatraemia, hypokalaemia and alkalosis were encountered in Iraq. Development of central pontine myelinolysis in one patient indicated treatment should be cautious. Two years later, heat illness continued to occur during the very hot summer months and 23 cases were admitted to a British military field hospital near Basra, Iraq. ⋯ These electrolyte changes were compatible with secondary hyperaldosteronism but field conditions constrained further investigation. Hyponatraemia was probably due to salt deficiency rather than overhydration. In some military personnel summer salt supplementation could be essential during operations in hot countries.
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Biography Historical Article
Shostakovich versus the Central Committee: the power of music.
The centenary of Shostakovich's birth, celebrated in 2006, generated considerable interest in his life and music. During the Cold War his music was rarely played in the West, and it was not until after his death in 1975 that it re-emerged. ⋯ Much debate has focused on whether Shostakovich was a victim or mouthpiece of Communism. In order to fully appreciate his music, it is essential to understand his personal and professional life under Josef Stalin--in particular his public humiliation by the Central Committee, and by professional musicians who were Communist Party members.
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Hubris syndrome is associated with power, more likely to manifest itself the longer the person exercises power and the greater the power they exercise. A syndrome not to be applied to anyone with existing mental illness or brain damage. ⋯ It is less likely to develop in people who retain a personal modesty, remain open to criticism, have a degree of cynicism or well developed sense of humour. Four heads of government in the last 100 years are singled out as having developed hubris syndrome: David Lloyd George, Margaret Thatcher, George W Bush and Tony Blair.
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Performing music at a professional level requires the integration of multimodal sensory and motor information and precise monitoring of the performance via auditory feedback. In the context of Western classical music, musicians are forced to reproduce highly controlled movements almost perfectly with a high reliability. These specialised sensorimotor skills are acquired during extensive training periods over many years. ⋯ Auditory-sensorimotor integration, for example, is accompanied by rapid modulations of neuronal connectivity in the time range of 20 minutes. Finally, dysfunctional plasticity in musicians, known as musician's dystonia, leads to deterioration of extensively trained fine motor skills. Musician's dystonia may be caused by training induced dysplasticity with pathological fusion of central nervous representations in sensorimotor cortical and subcortical brain regions.