MinervaBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7274.1480 (Published 09 December 2000) Cite this as: BMJ 2000;321:1480
The received wisdom about ovarian cancer is that symptoms don't develop until the tumour is at an advanced stage, delaying diagnosis and reducing the chances of a cure. Respondents to one survey, however, reported a high incidence of symptoms, mostly related to the abdomen and gut, for months before the diagnosis. Gynaecological symptoms were much less common (Cancer 2000;89:2068-75). Women ignored their symptoms for a median of 2-3 months before finally presenting to a doctor.
An entomologist from California writes that brown recluse spiders are unfairly blamed for inflicting necrotic bites on the state's inhabitants. Only 10 of these spiders have been spotted there since records began (Western Journal of Medicine 2000;173:357-8). Ticks, fleas, and bed bugs are far more likely to bite people than recluse spiders, which are imported by accident from the south eastern states where they live. Doctors should exclude well established causes of skin necrosis, including herpes zoster, staphylococcal skin infections, and syphilitic chancre, before implicating arthropods at all.
Next time you have a few pints and feel like challenging someone to an arm wrestle be sure …
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