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It is a little known fact that if you remove the pineal gland from newborn chickens they develop a spinal deformity similar to that of human adolescent idiopathic scoliosis. So could pineal insufficiency be a cause of idiopathic scoliosis? Unfortunately for the theory, a Viennese study (Journal of Bone and Joint Surgery2000;82-B:399–403) has shown no difference in circadian serum concentrations of melatonin between adolescents with idiopathic scoliosis and controls.

Workers in St Mary's Hospital, London (Journal of Bone and Joint Surgery 2000;82-B:387–91) have described their experience in managing 14 children with meningococcal septicaemia and limb ischaemia. Eight of the nine survivors had 14 limb segment amputations. They recommend that all ischaemic limbs should have Doppler and Duplex studies and compartment pressures should be measured. Fasciotomy should be done only in the lower limbs and only in the first 24 hours and if there is no contraindication such as excessive bleeding. Amputation should be delayed and elective.

Data from the 1946 Medical Research Council British birth cohort study have been used in an attempt to define the childhood antecedents of medically unexplained symptoms in adults (British Journal of Psychiatry2000;176:273–80). The risk of hospital admission for such symptoms was increased if the father was reported to be in poor health during the patient's childhood. Maternal ill health had no such effect. Recurrent abdominal pain in childhood increased the risk of admission for unexplained symptoms as an adult more than …

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