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Polygeia: students shaping global health

On 15th November a new Cambridge-based organisation, Polygeia, held their inaugural conference on global health policy. Polygeia’s mission is to empower students to participate in global health discussions through policy research and discussion. Already, work has been produced on neglected tropical diseases, mental health, global health partnerships, sexual and reproductive health and pharmaceuticals. The type of work done ranges from literature reviews to opinion pieces to project evaluations. Through undertaking a wide range of work with support from academics and professionals from around the world, the second aspect to Polygeia’s mission is to develop the skills of those students involved.

3rd EUNS National Conference 2015; From Neuroscience to Neurology

Image credit: aboutmodafinil.com

We are happy to once again be supporting the Edinburgh University Neurological Society (EUNS) for their 3rd Annual conference, to be held on Saturday 7th February, 2015. The conference will involve keynote speakers specialising in ageing, CJD and paediatric neurosurgery, along with workshops on Surgery and Neurotrauma, Careers in Neurology and Neurosurgery, Neuroscience Lab Skills and Science Communication. There is also a poster and oral presentation session

The Future of Neurology: Announcing the winning essay of the 2014 “Neuroscience to Neurology” essay competition

Image credit: ZEISS Microscopy

The World Health Organization estimates that neurological disorders currently affect one billion people worldwide, a number which is predicted to increase considerably as a result of an ageing population. The need to further understand the brain and make progress in the field of neurology has therefore never been greater. However, with over 100 million neurons each making over 1000 synapses, the human brain is undoubtedly the most complex organ in the human body, and it is this complexity that has meant that advances in neuroscience have been comparatively slow.

The Medicalisation of Criminal Behaviour: A Unifying Approach

J. Rogers
Phèdre is a tragedy which explores the relationship between moral culpability and responsibility for one’s actions by examining the incestuous love of a queen for her step-son, a passion that is apparently imputed to her by a vengeful deity. What is fascinating for the purposes of our discussion is the dynamic interplay between the portrayals of Phèdre’s infatuation both as an illness and simultaneously as a crime, for this is essentially the same question we must consider in deciding to what extent a malady excuses behaviour that contravenes society’s judicial expectations. While this was doubtless an intriguing consideration for a seventeenth century French dramatist, it is all the more pertinent for us today given the extent of medicalisation that has occurred in recent decades across many spheres of society.

Detection of Coeliac Patients at Risk of an Osteoporotic Fracture: A Two-Cycle Clinical Audit

A. Nunn, D. Patterson
Patients diagnosed with Coeliac disease are known to be at higher risk of suffering a low-impact fracture, and even as children it is important to detect and correct malabsorption due to Coeliac since this may have a lasting impact on their lifelong fracture risk. The British Society of Gastroenterologists recommends that those Coeliac patients with two or more additional risk factors for osteoporotic fracture undergo a dual X-ray absorptiometry (DEXA) scan to determine their bone density. This audit addressed the question of whether this standard was being adhered to in a general practice setting in the south-east of England. The capture of cases represented a prevalence of 1:275 (similar to previously reported figures for the prevalence of this condition). The rate of DEXA scanning in this population was disappointingly low (only 37%), and since many of those Coeliac patients who should have been scanned, and were not, possessed ‘minor’ risk factors such as smoking or female gender, the low pick-up rate may be attributable to a lack of awareness of the small but significant risk that these factors pose. Of those DEXA scans performed, the bone mineral densities of the patients concerned was inversely proportional to the number of risk factors they possessed, supporting the stance of the BSG. Practitioner education alone was not sufficient to improve the rate of scanning, which actually declined following a period of raising awareness of the need for such scans.

An Anaesthetic Muse(um)

Image credit: Garrett Coakley

Jonathan Dauncey
Proclaiming it possesses the historical magnitude of the Natural History Museum or the g-forces created by the Typhoon Jet simulator in the Science Museum is perhaps overstepping the mark. However, the Anaesthesia Museum in London is certainly worth an hour of your time if you ever find yourself shimmying the droves of wide-eyed cash-flashers on Oxford Street. Equidistant between Oxford Circus and Regent’s Park tube stations, the museum boasts over 3000 anaesthetic items from throughout the anaesthetic ages. It is a must-visit for those curious about the origins of a speciality that was conceived by plucky medics taking turns at inhaling mystical concoctions of unidentified gases that lined their 19th century labs in a quest to eliminate pain [1]

A case of a single coronary artery arising from the right coronary cusp

Coronary artery anomalies (CAAs) are present in 1-1.96% of the population [1,2]. The clinical significance of single CAAs differs depending on the course of the artery. Those that take an inter-arterial (malignant) course, between the aorta and pulmonary artery, can present with syncope or sudden death [1,3]. This is attributed to the myocardial ischaemia that ensues when the single coronary artery is compressed between high-flow structures in systole. Whereas, those that traverse benign, inter-ventricular paths do not predispose to myocardial ischaemia, hence, patients are often asymptomatic [1,3]

Jacksonian seizure: A trembling thought

Case presentation: A 22 year old male with a 3-year history of impaired left ventricular function and a past medical history of anthracycline-treated acute myeloid leukaemia was admitted with symptoms of worsening cardiac failure. The patient’s symptoms progressed over 3 months, and included diminished exercise tolerance, orthopnoea, paroxysmal nocturnal dyspnoea, nausea, abdominal pain and diarrhoea. He also described an acute nocturnal episode of severe chest pain, shortness of breath, and involuntary twitching, beginning in the left hand and progressing proximally. The patient was diagnosed with dilated cardiomyopathy – a well-documented side effect of anthracycline therapy.

It’s all in the Head?

Mr F, a Maltese 69 year old retired electrician living at home with his wife, presented to the Emergency Department with a referral from his ophthalmologist. Mr F presented with a two month history of headaches that had worsened the last two weeks accompanied by a deterioration in peripheral vision over the last week. The headache was described as continuous and generalised, had suddenly increased in severity from 2/10 to 7/10 over the last 2 weeks, and was not affected by posture, movement or time of day. Mr F denied any associated vomiting, drowsiness, neck stiffness, photophobia or rhinorrhoea. Other clinical features noted were fatigue, cold intolerance, decreased need for shaving and decreased libido for the past month. No other constitutional symptoms including weight loss, change in appetite, fevers, or night sweats were reported. No changes in bladder or bowel function.

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