bmj.com: Education

A woman with acute myelopathy in pregnancy: take part in the debate

This case progression is the second of a three part case report where we invite readers to take part in considering the diagnosis and management of a real patient using rapid responses on bmj.com. In three weeks' time we will report the outcome and summarise the responses.

Read part 1, case presentation, and submit rapid response.

Safety alerts from the National Patient Safety Agency

In the opening article of a new BMJ series, Tara Lamont and colleagues from the National Patient Safety Agency (NPSA) explain how the agency attempts to combine the "power of stories" in the individual incident with evidence from the NPSA's error reporting system: "Without numbers, stories are just anecdotes, but without stories, numbers are just dry statistics." But how many doctors see the many rapid response reports sent out by the NPSA to NHS organisations or visit its website and database of nearly four million incidents? Too few, we suspect. Hence this series. The first actual safety alert in the new series is about midazolam, an intravenous drug widely used for conscious sedation of patients for endoscopy, minor surgery, and dentistry.

Diagnosis and management of dengue

In this clinical review, Maria Glória Teixeira and Mauricio L Barreto review the diagnosis and treatment of dengue and discuss the importance of the organisation of healthcare systems in reducing deaths from dengue in areas where the disease is endemic.

More education articles published on 18 November:

Easily missed: Ovarian cancer

Endgames

Endgames is the BMJ's free interactive quiz to help doctors prepare for their postgraduate examinations. Questions are made up of case reports and picture quizzes, providing you with a practical and quick revision tool on common topics rather than clinical rarities.

This week's Endgames articles:

Picture quiz: An unusual cause of acute renal failure

Statistical question: Random allocation I

OnExamination quiz: Acute abdomen

Computed tomography angiograms of the abdomen showing pooling of contrast material in the proximal transverse colon

Acute lower gastrointestinal haemorrhage

In most patients, acute lower gastrointestinal bleeding resolves with conservative management, but when bleeding is especially severe, more invasive investigations and treatment may be needed, say Andrew J Edwards and Giles F Maskell in this rational imaging article. (Image shows computed tomography angiograms (axial, top; coronal, bottom) of the abdomen showing pooling of contrast material (arrows) in the proximal transverse colon, indicating the site of haemorrhage.)

Generalised tetanus in a patient with a chronic ulcerated skin lesion

In developed countries, tetanus is uncommon and cases are usually diagnosed in elderly patients. Levels of tetanus antibodies are progressively lower with increasing age in groups over 50 or 60 years old. Acute injuries and chronic wounds can allow entrance of Clostridium tetani. We report the case of a non-immunised patient with generalised tetanus after biopsy of a chronic ulcerated skin lesion

More education articles published on 13 November:

Should we use bath emollients for atopic eczema?

Diagnosis in general practice: Self diagnosis

A 26 year old student presents with a 12 hour history of a painful left eye. She feels her vision is reduced and her eye is watering more than usual. She has had a previous episode of iritis (anterior uveitis) and she suspects that this is the diagnosis today. Clare Goyder and colleagues agree that some conditions can be diagnosed correctly by the patient, but self diagnosis should always undergo challenge and refinement by the general practitioner.

More education published 11 November: