Intended for healthcare professionals



BMJ 1998; 317 doi: (Published 07 November 1998) Cite this as: BMJ 1998;317:1330

Those bold spirits who first suggested that aggressive treatment should be given to patients newly diagnosed as having rheumatoid arthritis have had their strategy confirmed in clinical trials,says a leader in Annals of the Rheumatic Diseases (1998;57:511-2). Treatment withdisease modifying drugs is less unpleasant with the newer drugs. The conclusion is that patients suspected of having rheumatoid arthritis should be seen without delay by a consultant rheumatologist. In the NHS of 1998 that may be a pretty forlorn hope.

Current media interest in the problems of farmers has given the impression of a sudden crisis, but a paper in Occupational and Environmental Medicine (1998;55:729-34) shows that the problems go back for at least four years. A questionnaire sent to 1000 farmers in 1995-6 found that nearly one quarter had financial problems and 79% worried about money. Very few, however, said that they felt socially isolated. Sixteen per cent of the sheep farmers reported symptoms which they attributed to organophosphate poisoning.

Further evidence of structural abnormalities in the brains of patients with schizophrenia has come from a necropsy study reported in the Journal of Neurology, Neurosurgery and Psychiatry (1998;65:446-53. A defect was found in the fine structure of dendrites of the pyramidal neurons; …

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