Nstrict, to choke). {People|Individuals|Folks|Men and women|Persons|People
Nstrict, to choke). Persons taking a clinical history will know that a range of descriptions is made use of, like tightening, a lump inside the throat, stress, indigestion, wind, along with a want to help keep swallowing. Frequently a series of phrases for example “I mean” or “you know” is used because the GSK2256098 site patient struggles to seek out words for a sensation for PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20085829 which no shared language exists. Other types of angina (Ludwig’s and Vincent’s) have now correctly disappeared so the qualification “pectoris” is largely redundant. TheBMJ VOLUME 317 29 AUGUST 1998 www.bmj.comExtra expense of subcutaneous apomorphine would pay for personal nursesEditor–In their editorial Chaudhuri and Clough advocate a higher use of subcutaneous apomorphine in patients with Parkinson’s disease and point out that a prefilled variable dose pen injector has lately grow to be readily available.1 My local pharmacist informed me of the boost in price when a patient is switched towards the use of these pens. My patient’s dose of apomorphine supplied in traditional vials expenses 200 monthly; exactly the same dose supplied in injector pens expenses 225 a month. I telephoned the manufacturer, Britannia Pharmaceuticals, to discover if there had been some error inside the pricing structure. I was told that the difference in price was correct and justified as the business was hoping to recoup the charges incurred in establishing the pen injection technique. This can be surprising given that the technologies has already been well developed for insulin, at an increase of only 50 more than the cost of insulin in vials.Enhancing pay and working conditions is greater than merely rewarding healthcare teamsEditor–I read with admiration, interest, amusement, and some sadness the editorial on rewarding healthcare teams by Bloor and Maynard.1 My admiration is for Maynard’s persistence. He has for many years advocated the replacement of physicians by other healthcare experts and also the abolition of distinction awards. He manages to mount a range of exciting alternative procedures to justify this. The only issue that he forgot to introduce in this editorial was his current (and equally damaging and superficial) suggestion that not only should really we replace doctors with nurse practitioners but that we need to make up for any remaining shortageLetterssensation of infarction is comparable but unrelieved by rest or vasodilators. The authors note the power of television drama in conveying the wrong image of a heart attack, that is of a fat, red faced man abruptly gasping and clutching at his tie. Surely the answer has to be to supply the media with superior descriptions. Real depictions of the onset and evolution of myocardial infarction in EastEnders and also the Archers will be considerably more valuable than pamphlets that wrongly, it seems, instruct the public to look out for 15 minutes of central chest discomfort because the hallmark of heart attack.Tom Treasure Professor of cardiothoracic surgery St George’s Hospital, London SW17 0QT1 Ruston A, Clayton J, Calnan M. Patients’ action throughout their cardiac occasion: qualitative study exploring differences and modifiable things. [With commentary by J Green.] BMJ 1998;316:1060-5. (four April.)in six months in accident and emergency. Much less than a third of those senior residence officers intend to pursue a profession in surgery or accident and emergency.five The shortening of working hours and training of junior doctors tends to make it more important than ever that coaching is effective; each clinical expertise and formal teaching have to be relevant. Priority of places on advanc.