How much do patients know about everyday matters that can affect their health? A study of 200 patients attending a rural G.P. surgery was undertaken to find out. It revealed some ignorance about the link between smoking and heart disease especially among female smokers (22% for this group). It showed a great deal of ignorance about alcohol in relation to health. Patients had a poor understanding of the relative alcohol content of different beverages, diseases related to excessive drinking and safe limits of alcohol consumption.
General practitioner attitude questionnaires were sent in May 1987 to 525 general practitioners (GPs) within Avon. A year later a section dealing with the management of clinical situations was sent to 198 Avon consultants, to determine how they would ideally expect a GP to respond to these situations. The majority of both the GPs and consultants held a common viewpoint, but significant differences were noted between the consultants and GPs in six out of the ten situations. Consultants with more than six months' GP experience had fewer significantly different views than their colleagues with little or no GP experience. GPs and specialists under the age of 45 years also had fewer significant differences in management than older GPs and specialists. The differences seem to reflect the clinical focus and interests of each professional group. We believe vocational training is a contributory factor to the differences and support the General Medical Council's proposal of a broader post registration training for all doctors.
In the 11 years 1977 to 1987, 36 confirmed cases of tracheobronchial foreign body were seen in the Bristol Children's Hospital. The distribution of ages, sites, and natures of the objects inhaled are similar to those in other reviews. Complications of removal of the foreign body once diagnosed were few, and have been absent since the Storz rod lens system was introduced in 1982. Eleven patients experienced delay of at least 7 days between the beginning of the symptoms and diagnosis, of whom 3 subsequently required open thoracotomy. Six of these had sought medical advice during this period, of whom 4 had a positive history of choking or inhalation. Inhaled foreign bodies remain a source of diagnostic difficulty, although this should be improved by greater attention to history and appropriate investigation. Technical advances have ensured their safe bronchoscopic removal in most cases.
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