WEMJ Volume 111 No. 2 - June 2012

West of England Medical Journal (online)  ISSN 2050-8530 


Welcome to the June 2012  issue of the West Of England Medical Journal which is now available open access.

This issue includes some interesting articles. Reducing exacerbations of COPD addresses a common problem. This is a well thought out and thoroughly referenced review article. There is an a book review on the Treatment of Obesity and the editor has managed to find the same topic in in our journal in 1885 (see From The Archives).  It is interesting to work out what has changed and what has not with regard to our views on diet and obesity.

There is an excellent series of cases describing the role of Repeat Subtraction Angiography and this has helped prompt an editorial on Discrepancy and Error in Radiology written by the WEMJ editor with the assistance of guest editor Dr Judy Holt.

Paul Goddard

1. Reducing Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A review of current pharmacological strategies

West of England Medical Journal Volume 111, Number 2, Article 1,  2012

Sonya M Hessey and Nabil A Jarad

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterised by the presence of chronic airflow obstruction that is not fully reversible. The disease involves degeneration and destruction of lung tissues, hypertrophy of mucous glands, and airway narrowing and inflammation.  These pathological changes result in symptoms of chronic cough, regular sputum production, wheeze and dyspnoea. Nearly 900, 000 individuals in the United Kingdom are diagnosed as having COPD, and approximately 2 million more have COPD which remains undiagnosed and unmanaged. COPD is complicated by acute exacerbations. This article reviews the strategies for reducing exacerbations including bronchodilators, corticosteroids, antibiotics and phosphodiesterase inhibitors.

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2. The Obesity Epidemic by Zoë Harcombe

Columbus Publishing Ltd 328 pp £20

West of England Medical Journal Volume 111, Number 2, Article 2,  2012

Reviewed by Dr Alick Dowling (Author of ENJOY EATING LESS – Letters to a Grandchild (Reviewed in WEMJ Vol 110 no 1)

Abstract from Book Review: The Obesity Epidemic by Zoë Harcombe

This masterly fully-referenced comprehensive survey of the field in 136,000 words demolishes current advice. Those who absorb her message reject misguided policy from World Health Authorities.

The author, an experienced nutritionist is brave to challenge, not only the current ‘consensus’ of the medical establishment, but also that shared by her fellow nutritionists and dieticians, that ‘cholesterol’ is responsible for heart attacks and strokes. ‘I regularly attend obesity conferences where I am a lone and unwelcome voice in amongst an overwhelming majority of dieticians.’ 

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3. Role of repeat digital subtraction angiography in non traumatic subarachnoid hemorrhage: Early detection of recanalisation of the spontaneously thrombosed aneurysm

West of England Medical Journal Volume 111, Number 2, Article 3 June 2012

Anand Alurkar, 

Lakshmi Sudha Prasanna Karanam,  Suresh Nayak,  

Sagar Oak, KEM, Pune, 



Ruptured intracranial aneurysms accounts for major cause of non traumatic subarachnoid haemorrhage (SAH). Digital subtraction angiography (DSA) is the gold standard for detection of the aneurysm. There were several reports that described about the rate of false negative findings on the angiography.

One of the main causes described in the literature is false negative angiography in aneurismal SAH was spontaneous thrombosis.(6) Hence repeat angiography is mandatory in all the cases of initially angiographically negative nontraumatic SAH.

We present three patients of aneurismal SAH with an initial negative angiogram, where subsequent repeat angiography done after 3 weeks in all the three patients revealed the presence of an aneurysm. 

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4. Editorial: Discrepancy and Error in Radiology: Judy Holt and Paul Goddard

West of England Medical Journal Volume 111, Number 2, Article 4 June 2012

Medical error is perceived by the public as being of great importance. This article concentrates on discrepancy and error in radiology but the points made are relevant to medical practice in general.  The value of discrepancy meetings is stressed

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5. From the Archives of the Journal 1885

Treatment of Whooping Cough with Cocaine,  

Treatment of Obesity "..... Fluids far from being suppressed should be increased'
Cholera  "...above all the bad habit of throwing human evacuations anywhere..."
Obituary: William Michell Clarke

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Welcome to the West of England Medical Journal. This is the online journal of the Bristol Medico Chirurgical Society. The journal was formerly known as the Bristol Medico Chirurgical Journal and was first published in 1883.

This is a general medical journal and is available for everybody to read online. To access the issue please click on the link in the column to the left of this introduction.

Please see the Instruction for Authors if you wish to submit an article or send a letter.

View details of the WEMJ Editoral Board