BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e4459 (Published 04 July 2012) Cite this as: BMJ 2012;345:e4459

A pilot was diagnosed with bilateral symptomatic pheochromocytomas, for which the optimal treatment is bilateral total adrenalectomy. He refused surgery because he would lose his job; aviation rules stipulate that pilots cannot fly if they have no adrenal glands—although ironically they can command a plane if they have bilateral phaeochromocytomas. After much discussion, he underwent bilateral subtotal adrenalectomy, needed no medication, and continued to fly safely until retirement (Surgery 2012;151:898, doi:10.1016/j.surg.2012.01.001).

In a population based study of nearly 1400 patients with first ever strokes between 2002 and 2010 in a multiethnic south London population, researchers analysed the proportion of patients who presented to hospital within three hours of having a stroke in the period immediately before and after the 2009 FAST stroke awareness campaign (“Face, Arms, Speech and Time”). In the ischaemic stroke group, 11% received thrombolysis in 2002-10, with no differences observed between the periods before and after …

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