Intended for healthcare professionals

Minerva Minerva


BMJ 2000; 321 doi: (Published 08 July 2000) Cite this as: BMJ 2000;321:124

Acute appendicitis is the commonest extrauterine indication for laparotomy in pregnancy, and it can occur in any trimester. Diagnosis can be difficult, not least because conventional wisdom has been that the site of the pain migrates upwards with the growing uterus. A case series in the American Journal of Obstetrics and Gynecology (2000;182:1027-9) refutes this belief: right lower quadrant pain was the commonest presenting symptom in all trimesters.

Class differences in health status are well recognised and, although many explanatory variables (such as differing rates of smoking) are well understood, they by no means explain all observed differences. Lack of job control is a principal suspect, and a recent study (Journal of Epidemiology and Community Health 2000;54:484-93) reports a natural experiment that occurred when cutbacks changed the nature of Finnish local authority workers' jobs. The results show that reducing job control increases time lost to sickness by a factor of around 1.3.

Anticonvulsants of all types are known to influence visual function, presumably through their direct effects on GABAergic neurons of retinal cells. However, a study that compared the effects of carbamazepine and vigabatrin found that carbamazepine had no effect on contrast sensitivity but vigabatrin did (British Journal of Ophthalmology 2000;84:622-5). Contrast …

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