Eyespy

A 67 year old man presented with a one month history of headache and one week of decreased visual acuity. Examination showed blood pressure of 180/125 mm Hg and grade three hypertensive retinopathy. Treatment with metoprolol, furosemide, spironolactone, and doxazosin brought his blood pressure to 146/68 mm Hg. Subsequent retinal photography showed complete resolution of the retinal changes. Retinal photography can also be used to show patients that an otherwise asymptomatic condition has improved.¹ (This item was first published in the BMJ, 2007;335:1162 doi: 10.1136/bmj.39412.563426.47.)

Neil McGowan, specialist registrar, James Walker, consultant diabetologist (Email: james.walker@wlt.scot.nhs.uk), St John's Hospital, Livingston, West Lothian EH54 6PP

Doctors are advised to protect their patients from the dangers of ingesting alcohol—alcohol hand rubs that is. The BMJ reports that young or confused patients and people dependent on alcohol are at risk from ingestion of alcohol hand rubs in hospitals or care homes. Researchers do not know the exact amount you need to ingest before having complications, but it is thought that 500 ml or more causes serious effects. The authors suggest placing dispensers in locked, secure holders (BMJ 2007;335:1154-5).

What makes children …