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This hospital-based cross-sectional cohort study examines the clinical and demographic features of neck pain, disability (using the Northwick Park neck pain questionnaire) and relationships to handicap in employment.Of 173 consecutive referrals to a rheumatology clinic with neck pain, 70% had neck/arm pain without neurological involvement, 13% other conditions, 11% nerve involvement and 5% other spinal pain. 141 patients (mean age 50 years) had mechanical or degenerative neck pain, of which 13% was probably work-related and 13% was trauma-related. 44 had taken sickness absence for an average of 30 weeks. Comorbidities were frequent (lumbar pain 51%).Those in work were significantly less disabled than those not working (p = 0.001) and those off sick (p < 0.01). Those reporting sleep disturbance, tearfulness and crying were significantly more disabled (p = 0.0001) than those who did not.Neck pain in secondary care is complicated by physical and emotional comorbidities. Comprehensive management requires a biopsychosocial model of care. [ABSTRACT FROM AUTHOR]

Objective: To determine problems associated with electric-powered indoor/outdoor wheelchairs (EPIOCs) and the benefits perceived by their users. Design: Hospital-based cohort study of all patients referred over a 19-month period. Setting: Regional Wheelchair Service for North West London serving nine district wheelchair services. Subjects: Of the 174 subjects referred, 10 withdrew their application or were found to be unsuitable at screening, 164 were assessed and 124 were prescribed chairs. One hundred and thirteen subjects were interviewed by telephone four months after provision of the chair. Main measures: Demographic and diagnostic data; current chair usage; self-reported accidents and component faults were compared with those recorded in the unit records; new activities embarked on since delivery; and benefits reported for main carers. Results: Seventeen ‘mishaps’ were reported by 15 users including tipping from chairs (6) and falls during transfers (3). Three probably reflected mechanical failure. Component failure was found in 39% of EPIOCs, mostly affecting control boxes (22), frames (10) and footrests (10). New activities were undertaken by 56 (50%) users, usually shopping and visits to friends/family. Eighty-five per cent of users felt that the chairs made life easier for their informal carers through increased independence, reducing transfers and reduced need for ‘pushing’. Conclusions: The component failures and self-reported accidents (some potentially dangerous) have implications for the NHS, manufacturers, prescribers and users. EPIOCs enhance the independence of severely physically disabled individuals in the community and assist carers by lessening dependence and enhancing social interaction. This study demonstrated the need for follow-up of EPIOC users and chairs. [ABSTRACT FROM AUTHOR]

Comments on several medical related topics in Great Britain. Chance of survival of patients with prostate cancer treated with neutron therapy; Role of general practitioners in caring for psychiatrically disabled people; Treatment of venous leg ulcers with oxpentifylline.

Presents several letters related to medicine in Great Britain. Management of parental leaves among medical personnel; Complications of artificial ultraviolet radiation exposures; Examination of skin reactions on diphosphonate drugs.

Focuses on health related issues. Responsibilities of general practitioners in disabling disorders; Use of doxycycline in the treatment of chlamydial infections; Derivation of intravenous beta-agonist in severe acute asthma.

Compares the community support scheme for hospital readmission of elderly patients in Great Britain. Maintenance of care attendants on randomized study of patients; Efforts included on the support for elderly patients; Evaluation on the results of the implemented schemes.

Presents issues related to medicine in Great Britain. Accounts on the doctor that died of the Acquired Immune Deficiency Syndrome disease; Implications of calcitonin for patients with malignant metastatic islet cell tumors; Importance of rubella virus immunization for the medical profession.