Minerva

New, more relaxed guidelines have been published in the British Journal of Dermatology on the follow up of patients with conditions such as lupus erythematosus treated with antimalarial drugs. Dermatologists and rheumatologists need no longer attempt funduscopy to judge whether retinal damage is developing: simple checks of visual acuity at intervals of a year will give adequate warning of deterioration in vision that needs referral to an ophthalmologist.

Many patients with peripheral vascular disease of the legs do not have classic intermittent claudication. They may be asymptomatic or report a range of atypical symptoms, sometimes brought on by exercise, including numbness, discomfort, and pain in muscles other than the calves (Archives of Internal Medicine 1999:159:387-92). In a comparative study of patients recruited from different settings, more than half of those diagnosed in general medical outpatients were asymptomatic. Being older, male, and diabetic was also linked to having no symptoms.

Self help groups can be a valuable source of information and support to patients, but only if they know about them. Help! is a comprehensive guide to over 800 British self help groups and support organisations that was originally compiled by a teacher in Blackburn. The sixth edition is now available for less than the price of a week's coffee and …