WEMJ Volume 116 No 2 June 2017

Six new articles and one corrected article (a change in layout).

We start with a couple of articles about tuberculosis. Despite our best efforts the disease is still plaguing the world and the first article, the editorial, gives a brief overview of the history of TB. This is followed by an article from the Bristol Medico Historical Society. This emanated from a poster presented by John Powell and detailing a patient's biography of life in Ham Green isolation hospital when he had tuberculous meningitis. It is, perhaps, fitting that this article should be published just as the society celebrates its summer party at Ham Green.

Peter Dunn has once again contributed magnificently with two articles, the first is on congential dislocation of the hip and the second on the importance of umbilical circulation in preventing RDS.

There is also a book review of Baskett's excellent work on Caesarean birth and an abstract of Alice James superb paper on hospital nutrition...we hope to publish the full paper in the future.



1. Editorial: A short history of Tuberculosis With a particular reference to Bristol, Paul R Goddard, WEMJ Volume 116 No.2  Article 1 June  2017

Tuberculosis has plagued the human race for millennia. It is possible that Mycobacterium tuberculosis has killed more human beings than any other microbial pathogen and its devastations has been at least on a par with malaria, smallpox and bubonic plague. Researchers (1) have concluded that the early versions of Mycobacterium tuberculosis go back three million years and evolved in East Africa along with early hominins. The present strains are a few thousand years old with the present diversity originating between 250 and a thousand years ago

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2. Tuberculous Meningitis A PATIENT’S STORY, HAM GREEN HOSPITAL 1951-52 Roy Crabbe 2012 WEMJ Vol 116 No 2 Article 2

This paper by Roy Crabbe formed the basis of a poster and handout prepared by John Powell and displayed at the Bristol Medico-Historical Society meeting in December 2012. My involvement with Ham Green really starts in July of 1951 after my mother had been diagnosed with Pulmonary TB after two years of treatment for chronic bronchitis (!) and two months after my sixteenth birthday. For several months I had not been too well myself and in the beginning of August I was admitted to the Lyme Regis Cottage hospital with pulmonary TB

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3. Pitfalls in the early diagnosis of congenital dislocation of the hip  Peter M. Dunn, MA, MD, FRCP, FRCOG, FRCPCH WEMJ Volume 116 No.2 Article 3 June 2017

Congenital dislocation of the hip has been a major interest for more than fifty years during which time I have studied more than 1,500 cases.  While treatment of the hips with light abduction splinting at birth is extremely effective, delayed diagnosis frequently leads to operative intervention and lifelong problems.  

In this brief paper I plan to draw attention to some of the reasons for missing the early diagnosis.

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4. A history of Caesarean Birth. T F Baskett Book Review, Reviewed by Professor David Cahill WEMJ Volume 116 No.2  Article  4 June  2017

I enjoyed reading this book - it is very well referenced and researched, and while it only has just under 200 pages, it encompasses a wide range of the history of Caesarean section delivery

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5. Childhood Obesity: Adapting the Hospital Nutrition Environment, Abstract. Alice James 5th Year UoB Medical Student WEMJ Volume 116 No.2  Article 5 June  2017

I have always been surprised at the wide availability and deliberate promotion of unhealthy food and drink items within hospitals – even within or in the near vicinity of paediatric departments. This led me to consider whether improving the quality of the hospital nutritional environment could help to reduce childhood obesity.

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6. The importance of the umbilical circulation  in preventing respiratory distress syndrome, Peter Dunn  WEMJ Volume 116 No.2  Article 6 June  2017

I became convinced of the importance of achieving alveolar ventilation prior to imposing circulatory change on the baby by clamping the pulsating umbilical cord.

“At delivery the baby’s cardio-respiratory haemodynamics may be seriously compromised by premature occlusion of the umbilical cord and also by resuscitation in the head-down position.  An understanding of the pathophysiology of maladaptation at birth has led to a method of management that attempts to avoid these iatrogenic factors.  This includes delivery of the preterm Caesarean section infant with umbilical circulation intact, and the use of gentle positive pressure ventilation with the infant in a head-up position and the placenta lying alongside the baby.”  

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7. Re-publication with corrected layout: Bronchoscopic lung volume reduction using endobronchial valves for the symptomatic improvement of severe emphysema Saveria Di Gerlando, Bethannie McIntyre, Nabil Jarad WEMJ Volume 115 No 4  Article 5 December 2016

Endobronchial valve insertion is more likely to be radiologically and clinically successful in patients with intact fissures, negative collateral ventilation and an absence of a paraseptal bullous component

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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