How informative is the print media coverage of colorectal cancer?

AIM: To date there has been no assessment of the educational content of colorectal newspaper articles. We aimed to analyse articles in the print media concerning colorectal cancer for their public health content. METHOD: Articles mentioning colorectal cancer in the top 10 UK newspapers were analysed over a 1-year period for their educational content. The number of articles mentioning 'red flag' symptoms, celebrity connections or specific cancer charities was recorded. RESULTS: Of the 349 articles identified, 146 were not relevant. Of the remaining 203 articles, 62 (30%) were concerned with celebrities with colon cancer, 13 (6.4%) made reference to red flag symptoms and 14 (6.9%) mentioned cancer charities by name. CONCLUSION: About 13% of newspaper articles have any educational content. If this increased, the general public might benefit.

Informed consent and patient understanding of blood transfusion.

BACKGROUND: Obtaining separate informed consent for blood transfusion is mandatory in some countries. Although patients should be informed about risks and benefits of transfusion, studies suggest this does not happen routinely in the UK and the patient perspective is lacking in the current literature. AIM: To explore provision of information and the consent process for patients receiving blood transfusions at our hospital. OBJECTIVES: To assess patient recall of the consent process, information conveyed, ease in understanding discussions and perceived knowledge of transfusion afterwards. METHODS: All 342 adult patients for whom blood was cross-matched between 1 March 2008 and 30 April 2008 were sent postal questionnaires. RESULTS: One hundred and sixty-four questionnaires were returned. Overall, 59·1% of patients said someone explained they might need a transfusion; of those 86·7% felt the reason had been explained. Only 58·8% of patients felt informed of what transfusion involves, with 67·0% told of the benefits and 27·8% informed of risks. Overall, 51·5% of patients said this information was easy to understand, but only 26·8% were aware of a transfusion information leaflet. Of those receiving leaflets, all said they read it and had no questions. Despite this, 61·9% were satisfied overall with the information received. CONCLUSION: Information leaflets could increase the information available to patients, with minimal impact on health care professionals' time. Leaflets are available, free of charge, from the National Health Service Blood and Transplant website. These have been introduced at each bedside, in pre-op packs and in outpatient clinics, with re-assessment planned in 6 months.

Assessing the internet prevalence of cancer.

INTRODUCTION: The internet is one of the most frequently accessed sources of information by patients. There is a variety of cancer-related information provided by the internet, aimed at both the general public (from official sites and non-regulated sites) and health care professionals. Little is known about whether the information provided reflects the prevalence of disease. METHODS: Searches for the 10 most common UK cancers were performed using five internet search engines. The number of relevant webpages was recorded and compared to the prevalence of each cancer according to Cancer Research UK. RESULTS: Of the 985,687,623 webpages identified, the majority were related to breast cancer (37.2%), followed by lung (16.2%) and prostate cancer (12.5%). Colorectal cancer, Oesophageal cancer and non-Hodgkin's lymphoma had the least number of websites (4.1%, 0.3% and 0.9%, respectively). There was over-representation of breast, kidney and stomach cancer with ratios of prevalence to number of websites of 1.7, 2.6 and 2.5 to 1, respectively. There was under-representation of colorectal cancer, non-Hodgkin's lymphoma and oesophageal cancer (ratios 0.2, 0.2 and 0.1, respectively). CONCLUSION: This data highlights the enormity of information available on the internet. However, there is over-representation of certain cancers (and under-representation of others) which may influence how patients perceive their illness. Healthcare professionals should be aware of the nature of information available on the internet and known when and how to direct patients to reputable sites that provide high quality information.

Death and illness as depicted in the media.

INTRODUCTION: The media may affect how illness is perceived, in terms of its prevalence, severity and outcomes. The media also influences our perception of death and leads to an overestimation of incidence of some causes of mortality. Articles depicting medical subjects may not be in-depth and are often influenced by non-medical issues. The media has both a positive impact on the population, in providing opportunistic health information, and a negative impact, causing an overestimation of severity and incidence of certain diseases. This article aims to assess if media reporting of illness and death represents national statistics. METHOD: The 10 most common daily read UK newspapers were assessed for articles relating to the most common causes of UK mortality. The searches were performed via each newspaper's online search facility over a 12-month period. Where appropriate, media friendly terms were used as search terms. RESULTS: A total of 18,482 pertinent articles were found relating to the most common causes of death in the UK. When the reportage of illness was compared with the actual incidence cerebrovascular accidents and chronic obstructive pulmonary disease were under-represented in the media, with ratios 0.31 and 0.01 to 1, respectively. Flu/pneumonia, prostate cancer, dementia and breast cancer all have a large media profile, with ratios of 5.52, 3.06, 4.09 and 4.9 to 1, respectively. CONCLUSION: The media has a significant impact on our perceptions of illness and death. This may influence how patients seek medical attention and their concerns at consultation. Strategies to improve the educational content of the media may enhance the dissemination of health information via this resource.

Elastofibroma of the hand.

A 69-year-old man presented with a 20-year history of a slowly enlarging mass of the left index finger dating from a hammer injury. The mass was excised, and seen to have the characteristic histological appearance of an elastofibroma, a benign tumour-like growth usually found in the soft tissue of the back. Such a lesion has not previously been documented in the hand, which we consider surprising in view of the generally accepted traumatic aetiology of this entity and the susceptibility of the hand to injury.

Rectal examination in general practice.

OBJECTIVE: To investigate factors influencing a general practitioner's decision to do a rectal examination in patients with anorectal or urinary symptoms. DESIGN: Postal questionnaire survey. SETTING: General practices in inner London and Devon. SUBJECTS: 859 General practitioners, 609 (71%) of whom returned the questionnaire. MAIN OUTCOME MEASURES: Number of rectal examinations done each month; the indication score, derived from answers to a question asking whether the respondent would do a rectal examination for various symptoms; and the confidence score, which indicated the respondent's confidence in the diagnosis made on rectal examination. RESULTS: 279 General practitioners did five or fewer rectal examinations each month and 96 did more than 10 each month. Factors significantly associated with doing fewer rectal examinations were a small partnership and being a female general practitioner, and the expectation that the examination would be repeated. Lack of time in the surgery, and a waiting time of less than two weeks for an urgent outpatient appointment were also important. General practitioners were deterred from doing rectal examinations by reluctance of the patient (278), the expectation that the examination would be repeated (141), and lack of time (123) or a chaperone (39). Confidence in diagnosis was significantly associated with doing more rectal examinations, the perception of having been well taught to do a rectal examination at medical school, and being a male general practitioner. CONCLUSIONS: Factors other than clinical judgment influence the frequency of rectal examination in general practice. Rectal examination may become commoner with the trend towards larger group practices and if diagnostic confidence is increased and greater emphasis put on rectal examination in undergraduate and postgraduate teaching.

How does the media profile of cancer compare with prevalence?

INTRODUCTION: Knowledge and understanding of disease can influence time to presentation and potentially, therefore, cancer survival rates. The media is one of the most important sources of public health information and it influences the awareness and perception of cancer. It is not known if the reportage of cancer by the media is representative to the true incidence of disease. MATERIALS AND METHODS: The top 10 UK daily newspapers were assessed over a 1-year period for the 10 most common UK cancers via their on-line search facilities. RESULTS: Of the 5832 articles identified, there was marked over-representation of breast, kidney and stomach cancer with ratios of prevalence to reporting of 1.4, 1.9 and 3.2 to 1, respectively. Colorectal, non-Hodgkin lymphoma, bladder and oesophageal cancers are all markedly under-represented with ratios of 0.4, 0.2, 0.6 and 0.4 to 1, respectively. CONCLUSIONS: A policy of media advocacy by health professionals could enhance the information provided by the media and thus reflect the true extent of disease. A partnership between health professionals and journalists could result in articles that are relevant to the population, informative and in a style and format that is easily comprehendible. Targeted public health information could highlight the 'red-flag' symptoms and break down any stigma associated with cancer. This enhanced awareness could improve the health-seeking behaviour of the general population and reduce the delay from symptoms to diagnosis.

Infective aneurysm of the inferior pancreaticoduodenal artery.

INTRODUCTION: Pancreaticoduodenal (PD) artery aneurysms account for less than 2% of all splanchnic aneurysms. A mycotic aetiology is extremely uncommon. INTRODUCTION: Two weeks following an episode of sepsis related to a prostatic biopsy, a 59-year-old man presented with abdominal pain and anaemia. Ultrasonography and computed tomography revealed an inferior PD artery pseudoaneurysm with an associated mesenteric root haematoma. This was treated successfully by transcatheter embolisation. INTRODUCTION: Infective pseudoaneurysms of the PD artery are rare but can be associated with rupture into the gastrointestinal tract or retroperitoneum. Transcatheter embolisation remains the most effective therapy as it is associated with low morbidity and mortality rates and recurrence is very unlikely provided the aneurysm is completely excluded from the circulation.

Patients' perspectives on how doctors dress.

Infection in hospitals is a serious problem. Attempting to address the spread of infection, many UK National Health Service trusts have adopted a 'bare-below-the-elbows' and tie-less dress-code policy. This followed publication of Department of Health guidelines on staff uniforms in September 2007. Although the potential for colonisation of clothing with pathogens has been investigated, patients' opinions on dress-code and policy change have not. This survey of 75 patients in Great Western Hospital, Swindon, UK, used questionnaires to address this. The survey showed that, although patients did feel that doctors' dress was important, neckties and white coats were not expected. Moreover, surgical scrubs were considered acceptable forms of attire. Problems of identifying doctors and determining their grade were repeatedly raised. Patients were generally unaware of the new dress-code, and few knew anything of its relationship to infection control. This work demonstrates that more 'traditional' dress is not expected. Given the problems of identification and perception of surgical scrubs as suitable, their introduction as a 'uniform for doctors' should be considered. Furthermore, work needs to be done to advertise policy change and increase patient awareness of infection control.

Streptococcus milleri as a cause of pleural empyema.

Review of an annual series of cases of empyema seen at a regional cardiothoracic unit showed that six out of 25 were due to Streptococcus milleri. The details of the cases are summarised. This organism is now an important cause of empyema, occurring much more commonly in men than in women; but since it is highly sensitive to penicillins permanent resolution can be achieved with antibiotic treatment combined with open or closed drainage.

Use of the Denver pleuroperitoneal shunt in the treatment of chylothorax secondary to filariasis.

A 57 year old woman developed a chylothorax as a result of having had filariasis as a child. This failed to respond to conservative measures but was successfully managed by means of a Denver pleuroperitoneal shunt.