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“Mr Robert Tucker at the age of seventeen discovered that he was unable to distinguish several of the primitive colors from each other. Yellow is the only one known by him to a certainty. A difference in the shade of green he can distinguish, though not the green color itself from the orange. In comparing, says Dr B, Mr Robert Tucker’s cranium with casts, and with the plates in Dr Spurzheim’s book, I was forcibly struck with a flatness of his os Frontis, at the place of the orbitary ridge, where the organ of coloring is said to be situated—and this flatness it is well known indicates a small development of the organ. (

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The risks of cardiovascular disease and osteoporosis drastically increases for women at the onset of menopause. It has been suggested that phyto-oestrogens may inhibit bone loss and protect the cardiovascular system by improving lipid profiles. In a double blind randomised study from Okalahoma State University flaxseed supplements were associated with an improvement in lipid profiles in post-menopausal women. However, flaxseed supplementation did not seem to have any effect on bone metabolism in these women. (

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Evidence exists from clinical trials that coffee drinking is associated with increased blood pressure. However, it has not been determined whether coffee drinking is associated with an increased incidence of clinically significant hypertension. In a cohort study of white male former medical students, consumption of one cup of coffee a day was associated with a small increase in both systolic and diastolic blood pressure. However, over many years of follow up, coffee drinking appeared to have a very small role in the development of clinically significant hypertension. (

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Vasectomy is the safest method of surgical sterilisation. Over the past three decades it has become an increasingly common procedure in many countries. Concerns have been raised about the safety of vasectomy as a result of reports that suggested an increased risk of prostate cancer in men who had undergone vasectomy. In a national population based case-controlled study of 923 new cases of prostate cancer from the New Zealand Cancer Registry vasectomy did not appear to increase the risk of prostate cancer even after 25 years or more. (

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Tuberous sclerosis is an autosomal dominant disorder associated with the development of benign neoplasms of the brain, kidney, skin, and retina. In a study from Emory University brain, kidney, and skin tumours from patients with tuberous sclerosis were stained with CD31, a specific marker of vascular endothelium. The results of this study demonstrate that the brain, kidney, and skin neoplasms from patients with tuberous sclerosis are highly angiogenic. These results suggest that anti-angiogenic therapy may be effective in the treatment and prevention of tuberous sclerosis associated neoplasms. (

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There has been a suggestion that oxidative stress may have an important role in the pathogenesis of Alzheimer’s disease. A population based, prospective cohort study conducted in the Netherlands suggests that a diet high in vitamin C and vitamin E may lower the risk of Alzheimer’s disease. This effect was most pronounced among current smokers. (

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There are few successful treatment options for patients with ankylosing spondylitis. In a 12 week placebo controlled multicentre study from Germany, patients with ankylosing spondylitis were either treated with a placebo or infliximab. 53% of patients treated with infliximab had regression of disease activity by week 12 compared to 9% in the placebo group. Although treatment with infliximab was generally well tolerated three patients had to discontinue therapy because of systemic tuberculosis, allergic granulomatosis of the lung, or mild leucopenia. (

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Changes in cerebral white matter are commonly detected on MRI scans in elderly people. It has been hypothesised that these are of a microvascular aetiology. As part of the Atherosclerosis Risk in Communities Study (ARIC), a total of 1684 patients aged 51–72 years who had cerebral MRI and retinal photography were evaluated. In this study with cerebral white matter, people with lesions were more likely to have retinal microvascular abnormalities and to have an increased risk of stroke than people without similar white matter lesions. The risk of stroke was higher when retinopathy accompanied the white matter lesions. (

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Patients with vertebrobasilar disease are frequently seen by ophthalmologists because of the complaints associated with ocular motor disabilities, especially diplopia and nystagmus. Vertebrobasilar disease has generally considered to be a condition with poor prognosis because of high mortality and associated severe disability. In a study of 407 patients entered in the New England Medical Center Posterior Circulation Registry vertebrobasilar occlusive disease was found to consist of a variety of different stroke mechanisms and vascular lesions. Many of these were associated with a good prognosis. The prognosis for patients with vertebrobasilar disease may be better than previously reported. (

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Malpractice claims, once thought to be a unique American problem, have become an increasing problem for physicians in many countries. It is usually said that a physician’s malpractice experience is related to caseload and unpredictable circumstances. However, in a study from Vanderbilt University it would appear that malpractice risk is related in large measure to factors such as patient dissatisfaction with interpersonal behaviours. In this retrospective longitudinal cohort study of general and specialist physicians there was a direct correlation between unsolicited patient complaints recorded by the medical centre and each physician’s risk of malpractice claims. By identifying and intervening with physicians who generate a high number of complaints medical systems may be able to reduce the risk of malpractice claims. (

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