Progressive multiple cranial neuropathies presenting as a delayed complication of radiotherapy in infancy.

A 38 year old woman who had undergone irradiation during infancy for a left facial cutaneous arteriovenous malformation sequentially developed complete palsies of the ipsilateral VII, V, XI, IX, X, XII and VI cranial nerves. Apart from optic and olfactory nerve damage there are few reports of radiotherapy causing cranial nerve injury. We link the unusually extensive and progressive neural damage and the prolonged latency to the patient''s age at time of irradiation.     

A randomized controlled trial of electromagnetic therapy in the primary care management of venous leg ulceration

OBJECTIVE: The aim was to establish the potential efficacy, tolerabilityand side-effect profile of electromagnetic therapy as an adjunctto conventional dressings in the treatment of venous leg ulcers. METHOD: A prospective, randomized, double blind controlled clinicaltrial was carried out in a dedicated leg ulcer clinic basedin one urban general practice. Nineteen patients with leg ulcersof confirmed venous aetiology were assessed. The main outcomemeasures were rate and scale of venous leg ulcer healing, changesin patient-reported pain levels, quality of life, degree ofmobility, side effect profile and acceptability to patientsand staff. RESULTS: Sixty-eight per cent of patients attending this dedicated clinicachieved improvements in the size of their ulcer (4, 21%, healedfully) and in reduced pain levels (P < 0.05) during the trial,despite the chronicity of ulcer histories. Patients treatedwith electromagnetic therapy at 800 Hz were found at day 50to have significantly greater healing (P < 0.05) and paincontrol (P < 0.05) than placebo therapy or treatment with600 Hz. All patients reported improved mobility at the end ofthe study. The electromagnetic therapy was well tolerated bypatients, with no differences between groups in reporting adverseevents, and proved acceptable to staff. CONCLUSION: Despite the small numbers in this pilot study, electromagnetictherapy provided significant gains in the healing of venousleg ulcers and reduction in pain. Keywords. Electromagnetic therapy, RCT, leg ulcers, primary care.     

A model for assessing information retrieval and application skills of medical students.

PURPOSE: To develop and evaluate a model for assessing information retrieval and application skills, and to compare the performances on the assessment exercises of students who were and were not instructed in these skills. METHOD: The authors developed a set of four examination stations, each with multiple subtasks, and administered the exams to students at two medical schools. Students at one school had intensive instruction in literature searching and filtering skills for information quality (instructed group), and those at the other school had minimal instruction in these areas (uninstructed group). The stations addressed pediatrics content and the skills of searching Medline and the World Wide Web, evaluating research articles, evaluating the accuracy of information from the Web, and using the information to make recommendations to patients. The authors determined the psychometric characteristics of the stations and compared the performances of the two groups of students. RESULTS: Students in the instructed group performed significantly better and with less variability than the uninstructed group on four tasks and no differently on seven tasks. There was no task on which the uninstructed group performed significantly better than the instructed group. CONCLUSION: The prototype stations showed predictable differences across curricula, indicating that they have promise as assessment tools for the essential skills of information retrieval and application.