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Should Lucina put down her pen on the grounds that “the more you know the worse...”? For that is the face value message of a Florida study of family physicians (Journal of Family Practice1999;48:23–30; abstracted and discussed inEvidence-Based Medicine1999;4:158). Those who were assessed as better educated, both at medical school and subsequently, were significantly more prone to being sued for malpractice. Lucina's meme machine keeps flashing up “confounding factors” and “measurement difficulties”; she does not yet feel able to devote herself wholeheartedly to the pursuit of ignorance.
Both hand, foot, and mouth disease and herpangina are usually ascribed to infection with group A coxsackieviruses. In Taiwan in 1998 over 100 000 people, mostly children, developed one or other of these two conditions (New England Journal of Medicine1999;341: 929–35) and the predominant cause was enterovirus 71. Neurological complications were common (Ibid: 936–42) and pulmonary oedema often followed and was invariably fatal. The strongest predictor of pulmonary oedema was hyperglycaemia (Lancet1999;354:1682–6).
Almost two thirds of respondent adult members of a large Californian health maintenance organisation admitted to at least one of eight categories of childhood adverse experience (Journal of the American Medical Association1999;282:1652–8). There was a direct, quantifiable relationship between the number of adverse childhood experiences and tobacco smoking in adolescence and adult life. The authors make no attempt to relate smoking behaviour to the current life experiences of their respondents.
Do people with mild to …