Eyespy

>> A 7 month old girl presented with an indurated, erythematous, scaling plaque on her left little finger. First noticed at birth, every few weeks it seemed more prominent and blistered. At the time of blistering, a flush would develop all over the body and would last two hours. She was otherwise well and was developing normally. This was thought to be a solitary mastocytoma with no evidence of systemic involvement. Mast cell infiltration of the skin and histamine release induces symptoms such as pruritus and flushing. Mast cell release can be precipitated by physical touch. It’s usually self limiting: this child is now 2 years old and the lesion has almost completely resolved.¹ (This item was first published in the BMJ, 2008;336:676; doi: 10.1136/bmj.39521.451053.47.)

Ella Seccombe F1 dermatology
Justine Hextall consultant dermatologist Worthing Hospital, Worthing BN11 2DH
ellaseccombe@gmail.com
Student BMJ 2008;16:220 | 17

>> Medical students become less empathetic as they progress through medical school. These worrying findings are based on a survey of 419 medical students from the University of Arkansas (Academic Medicine 2008;83:244-9). The authors suggest a possible reason is the mismatch between the reality of being a doctor and how the media portray the career. They also propose that another contributing factor is the “high degree of student stress and anxiety caused by students’ competitiveness and desire to overachieve on examinations.”

>> Diesel fumes may cause long term changes to the brain. A double blind randomised crossover study in the Netherlands, in which patients were exposed either to diluted diesel exhaust or to filtered air for one hour, showed altered electroencephalographic activity between the two groups (Particle and Fibre Toxicology 2008;5:4). Exhaust fumes caused a general cortical stress response in the brain within 30 minutes, which lasted for at least one hour after the patient left the room. The chemicals responsible are thought to be nanoparticles in the fumes, which have already been implicated in cardiovascular and respiratory disorders.

>> A Hawaiian hospital’s policy for visits by pets was breached when a horse came to see a patient recovering from surgery. A relative escorted the pet horse through the hospital building in the hope of cheering up the patient. However, hospital staff were not amused, and security finally managed to stop the pair as the lift doors opened on the third floor. The patient was still allowed to leave his room to greet his visitors, but unfortunately it turned out that the wrong horse had been brought. Luckily “there were just a few scuff marks,” claimed the hospital’s spokeswoman (http://news.bbc.co.uk, 24 Mar 2008, “Hospital bridles at horse in lift”).

>> Older blood given during operations leads to a higher complication rate and more deaths. These are the findings of an eight year study that investigated data from 2872 patients who underwent cardiac surgery (New England Journal of Medicine 2008;358:1229-39). Patients who had received transfusions of blood that had been stored for more than two weeks were found to have more complications after operation and reduced short and long term survival compared with patients who received blood that had been stored for less than two weeks.

>> Cardiac pacemaker hackers may be the criminals of the future. Implanted cardiac devices such as pacemakers maintain a regular heartbeat and are equipped with technology that allows doctors to adjust the settings wirelessly. But researchers at US universities have shown that a radio can be used to intercept these therapeutic signals and instead induce fatal changes such as ventricular fibrillation. To date such a case has not been reported (www.telegraph.co.uk, 13 Mar 2008, “Hacking fears over wireless pacemakers”).

>> Money can buy happiness, according to a Canadian research group (Science 2008;319:1687-8). Surprisingly though, it is not the amount of money you have but the amount you have given away that brings happiness. A study that looked at 632 US residents showed that almost 10% of their spending was “prosocial”—that is, it was spent on other people either in the form of gifts or charitable donations. People with a greater proportion of prosocial expenditure were found to be happier.

>> Already tried diet, exercise, drugs, and surgery to decrease your risk of a myocardial infarction? What next? Buy a cat! In a study of almost 4500 adults in the United States, cat owners were shown to have a 40% lower risk of dying from a myocardial infarction compared with their cat-free counterparts, in a 20 year follow-up period (Stroke 2008;39:642-3). The study adjusted for age, sex, ethnicity, blood pressure, smoking, diabetes, cholesterol, and body mass index. Previous studies have shown that domestic pets are associated with lower stress and blood pressure, both risk factors for cardiovascular disease.

>> “All you can eat” seating at baseball games in the United States is attracting criticism from health specialists. Many major league baseball teams now offer seats that include unlimited snacks in the price of a ticket to watch a game. This has proved popular with many fans, but dieticians say it is a “symbol of binge eating, supersized fast food, and poor nutrition.” Concerns arise because there is already an obesity epidemic, with the Centers for Disease Control and Prevention reporting that one in three US adults is obese (www.usatoday.com, 6 Mar 2008, “Eating away the innings in baseball’s cheap seats”).

Provenance and peer review: Commissioned; not externally peer reviewed.

   

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