Bipolar Disorder

Mood fluctuations are common during normal daily life as a result of either stressful or pleasant events. However, severe and persistent mood swings that result in psychological distress and behavioral impairment may be symptomatic of an underlying affective disorder. Affective

Salicylate Toxicity

On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the

Bedbugs

Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. Stage.

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Sepia In the pre-internet era, in the days of non-digital photography, most families owned and treasured their albums of pictures. Often arranged chronologically by year, each series of collections defined lives. Unlike today’s ubiquitous smart phone compilations hung out to

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Heads above parapets Putting one’s head above the parapet is a term synonymous with ‘guts’: risking exposure, opprobrium and exclusion it is particularly germane in the scientific world when the middle of the road approach (‘more research is needed’) is

Milk and Health

Milk products from cows and other nonhuman mammals are major components of traditional Western diets, especially in cold climates. The recommended intake of milk or equivalent portions of cheese, yogurt, or other dairy products in the United States is three

Milk and Health

Milk products from cows and other nonhuman mammals are major components of traditional Western diets, especially in cold climates. The recommended intake of milk or equivalent portions of cheese, yogurt, or other dairy products in the United States is three

Defeating Schistosomiasis

Schistosomiasis is an ancient, neglected parasitic disease caused by blood flukes (trematode worms) of the genus schistosoma. Affecting an estimated 200 million persons in 78 countries, the disease is intimately associated with poverty and is grossly debilitating, leading to chronic

Defeating Schistosomiasis

Schistosomiasis is an ancient, neglected parasitic disease caused by blood flukes (trematode worms) of the genus schistosoma. Affecting an estimated 200 million persons in 78 countries, the disease is intimately associated with poverty and is grossly debilitating, leading to chronic

Care of Transgender Persons

Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. Stage.

Penicillin Allergy

In 1928, Sir Alexander Fleming discovered that the active component of a penicillium fungus had the capacity to kill bacteria in a petri dish, and he named it penicillin. In 1945, Fleming, Florey, and Chain were jointly awarded the Nobel

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Real life: just fantasy? Lest anyone risks seducing themselves to the contrary, we should remind ourselves constantly how little (if anything) we genuinely know. Time gives us more familiarity with exposure outcome phenotype pattern recognition but do we get closer

Acute Upper Airway Obstruction

Acute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error, making it a constant challenge for clinicians. Substantial advances have been made in preventive medicine, our understanding of the pathophysiology of…

Schizophrenia

Schizophrenia is a psychiatric syndrome characterized by psychotic symptoms of hallucinations, delusions, and disorganized speech, by negative symptoms such as decreased motivation and diminished expressiveness, and by cognitive deficits involving impaired executive functions, memory, and speed of…

Schizophrenia

Schizophrenia is a psychiatric syndrome characterized by psychotic symptoms of hallucinations, delusions, and disorganized speech, by negative symptoms such as decreased motivation and diminished expressiveness, and by cognitive deficits involving impaired executive functions, memory, and speed of…

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Pulseless electrical activity Deandra Luong and colleagues report a series of infants where ECG monitoring was used to monitor the heart rate during initial stabilisation after birth and there was no clinically detectable cardiac output despite ECG traces showing heart

Measles

Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. Stage.

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Global health: Charges to migrant children’s families In a hard-hitting salvo, Russell and colleagues argue that recent changes to charging regulations in the NHS, both undermine child health and represent a departure from the founding principles of the organisation. The

Heatstroke

Heatstroke is the most hazardous condition in a spectrum of illnesses progressing from heat exhaustion to heatstroke, in which a shared finding is hyperthermia (i.e. the rise in core body temperature when heat accumulation overrides heat dissipation during exercise or

Heatstroke

Heatstroke is the most hazardous condition in a spectrum of illnesses progressing from heat exhaustion to heatstroke, in which a shared finding is hyperthermia (i.e. the rise in core body temperature when heat accumulation overrides heat dissipation during exercise or

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Global health: tuberculosisDiagnosis Though the WHO endorsed gold standard for diagnosing tuberculosis in all age groups is positive microbiology, this is notoriously difficult to achieve in children. If all else fails and the infrastructure allows, bronchoscopy is an option, but

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Automated FiO2 adjustment In an issue bursting with great content the Editor’s choice this month is closed-loop automated FiO2 control. The potential for this technology to improve clinical outcomes of high-risk preterm infants is obvious and most manufacturers are working

[Editorial] The lost boys

The gravity of gender inequality seems to have, at last, reached all sectors of society. A watershed on dangerously permissive attitudes to sexual assaults, outrage at gender-oriented discrimination, and a refusal to accept socially constructed gender roles are aired daily

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Global child healthAntibiotics in non-bloody diarrhoea Managing infectious diarrhoea is essentially uncomplicated. In only a small proportion of children, those with bloody diarrhoea (shigella, cholera amoebiasis) and associated toxicity or sepsis are antibiotics indicated. In other situations, they can prolong

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Milestones Like many words with an implicit sense of drama, ‘milestones’ has become something of an overused term, a ‘millstone’, if you will. There are occasions, though, where it is fully justified and, by chance, this month’s issue describes events

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In Kipling’s seminal novel ‘Kim’, the central premise (literal and metaphorical) is the wresting for power in fin de (19th) siècle South Asia. This attritional confrontation became popularly known as the Great Game and, though ostensibly a children’s book, is really

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Parsimony Parsimony, ‘the quality of frugality in the use of resources’, is an unusual term. Unusual in that it has both pejorative (personal—meanness) and complimentary connotations. A parsimonious statistical model, for example, makes fewer assumptions, has fewer variables and has

Hip hip: no hurray

Twenty-first century parents want to be assured that their newborn infant is ‘normal’. But how reliable is the routine newborn examination procedure? Should parents trust us as health professionals when we say, or imply, that they have a normal, healthy

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World Cup winners… Hugo Lagercrantz’s editorial (see page 1005) based on the recent Lancet paper by Zylberszteyn examining relative child mortality in Sweden and England reinforces some home truths. Unsurprisingly, as the largest contributor to the numerator, the greatest difference

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Postnatal steroids for bronchopulmonary dysplasia While there are many strategies for reducing the risk of BPD, the place of corticosteroids remains uncertain in spite of its long history. This month we publish a network meta-analysis by Zhang et al which

Acne Vulgaris

Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations. Stage.

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