18 Aug, 07 | by BMJ Group
The initials RLS are forever associated with the great Scottish teller of tales who died on Samoa at the age of 44. He certainly had restless legs, and rarely remained in one place for very long; and his nocturnal wakefulness brings us some of the most haunting passages in Travels with a Donkey. Whether he kicked his wife Fanny in his sleep, we are not (so far as I know) told, but she certainly deserved it. Nor do we know whether he carried the common variant of an intron of BTBD9 on chromosome 6p21.2 which this study asserts to be associated with susceptibility to periodic limb movements in sleep. But hey, let’s pick a dark foggy night in Samoa, climb up to his grave, and take a tissue sample. He would rather like that.
Opponents of abortion are always trying to find evidence that it does physical harm to women so that they won’t enter into mortal sin by having such procedures. But this study of subsequent pregnancies after medical abortion in Denmark shows no increased risk of ectopic pregnancy, miscarriage or preterm birth.
If you have extensive small-cell lung cancer, you will die, probably within six months. You may wish to spend one or more of these months receiving chemotherapy and then one or more receiving prophylactic cranial irradiation, which will raise your mean survival from 5.4 months to 6.7 months, and your chance of reaching a year from 13% to 27%. The investigators suggest that it should therefore “be part of standard care for all patients with small-cell lung cancer who have a response to initial chemotherapy.” Care? For me, that would be an Italian hillside and a good choice of music.
Treating psoriasis is tiresome; as this review of psoralen and ultraviolet A light therapy points out, most patients find their treatment unsatisfactory. They can’t forget their disease, especially when they take their clothes off; and doctors can’t explain it or do more than control it. Still, old-fashioned PUVA does work, a bit better in most patients than narrow-band UVB. If you want to understand how, there is some classic artwork on p.685 featuring colour combinations you may wish to avoid in your living room.