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The use of continuous subcutaneous infusions of midazolam in six patients is described. These patients were all suffering from advanced cancer and cared for at home by a hospice-based team. The drug was used to control restlessness in the last stages of life and in all cases produced a beneficial therapeutic effect. In these cases it provided a desirable alternative to other benzodiazepines or phenothiazines, was convenient to administer and no side effects arising from its use were noted. [ABSTRACT FROM PUBLISHER]

A 55-year-old man, without evident sexual risk, presented with symptoms of a urethritis and balanitis. This followed directly from exposure to organic residue from a domestic plant, the Euphorbia or Garden Spurge, found on his fingers after gardening. A review of relevant medical literature reveals little putative association between exposure to this plant and genital symptomatology. However, historical sources are presented suggesting the effect may previously have been well recognised.

When treating contacts of patients with sexually transmitted infections (STIs), health professionals may face conflicting ethical imperatives. We surveyed middle grade doctors in genitourinary (GU) medicine and asked how they would manage a hypothetical clinical scenario. This was analysed on the basis of principles of respect for autonomy and beneficence/non-maleficence to assess how they weigh up duties of informed consent (autonomy of patient), partner confidentiality (autonomy of partner) and the need to achieve a good medical outcome. Responses indicated that the strategies that they employ in practice - what they actually say to patients (and what they leave unsaid) - balance the conflicting requirements of these ethical principles in quite different ways, some of which appear ethically problematic.

Recent child protection reports and changes in sexual offences laws in England and Wales have altered the ethical and legal landscape for health professionals working with sexually active young people. This study aimed to identify the educational needs of a sample of those professionals. A true/false questionnaire was developed comprising statements concerning sexual activity in young people. We sent it to a sample of Family Planning staff, genitourinary (GU) medicine nurses and doctors in 102 Family Planning and 261 GU-medicine clinics throughout England and Wales. A total of 168 completed questionnaires were returned. The range of correct responses for the whole group was between 2 and 10 out of 10, with a median of 6. We identified some misunderstanding concerning the term 'Fraser' competence and the legal basis on which contraception can be provided to under 16-year olds, as well as some lack of awareness concerning present advice on child protection. In free text responses, many people volunteered educational needs.