Sixty-one successive patients undergoing routine cholecystectomy together with all the registered nursing staff and junior doctors working on the surgical wards in a major teaching hospital were studied by means of questionnaires. These were designed to identify beliefs and attitudes to postoperative analgesia in the hospital. The survey revealed that there is a continuing prevalence among medical and nursing staff of attitudes and practices likely to contribute to poor postoperative analgesia. Patients had low expectations of pain relief and displayed reluctance to request analgesia. Injections were generally effective when given, but dosing intervals were often too long for good analgesia. With this knowledge it has been possible to devise strategies to counteract those attitudes leading to poor analgesia and these have formed the basis of a new Acute Pain Service. It is intended to repeat this survey at 3 yearly intervals in order to monitor progress.

No abstract

Twelve patients with chronic migraine recruited from a neurology clinic or a self-help group were randomly allocated to receive either 6 weeks active laser acupuncture or 6 weeks dummy laser acupuncture. Patients completed headache diaries for the 6 weeks prior to treatment and for 6 weeks following. They were then crossed over to receive the alternative treatment for a further 6 weeks. Neither patients nor operator knew which unit was the active one. There was a reduction in mean total headache score (combining duration and severity) of 18% in the active group and 43% in the control group following the first treatment period. This difference was not significant. Following the second treatment period, mean scores increased by 50% in the active group and 5% in the control group but again this difference was not significant due to inconsistent responses by some patients. When active and placebo treatments were computed for all patients, there were still no significant differences. It is concluded that laser acupuncture does not have an important clinical effect in migraine over and above the expected placebo response.

No abstract

No abstract

No abstract

No abstract

psoriasis NS; Student's t test). At present a sex and smoking matched control group is not available for comparison with the patients with palmoplantar pustulosis, but there was no difference between results for smokers and non-smokers within the three groups of subjects. Our study has shown similar results of assessment of neutrophil morphology in palmoplantar pustulosis and psoriasis. Abnormalities of neutrophil C3b receptor function in the two disorders have also been reported to be similar,6 although this may not be the case for intralesional neutrophils.7 Although our preliminary results suggest that peripheral blood neutrophil morphology is not changed by cigarette smoking, further studies of the relation between psoriasis, palmoplantar pustulosis, smoking, chemoattractant production, and neutrophil function are certainly warranted to explain the epidemiological findings reported by