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Introduction Whether acute pancreatitis can occur in pancreatically insufficient individuals with cystic fibrosis remains a matter of debate. Case presentation We describe a case of acute pancreatitis occurring in a 52-year-old Caucasian Australian man with moderately severe cystic fibrosis lung disease and pancreatic insufficiency. An inflammatory mass within the head of his pancreas was confirmed using computed tomography, magnetic resonance imaging and pancreatic biopsy, but serum amylase and lipase remained normal throughout the acute phase of his illness. His symptoms and the pancreatic mass resolved following the insertion of a biliary stent and the introduction of ursodeoxycholic acid. Conclusion Our case report highlights the potential for acute pancreatitis to occur in patients with pancreatic insufficiency and cystic fibrosis. We further demonstrate that conventional biochemical markers that are normally assessed to confirm the diagnosis may not be of particular use. As patients with cystic fibrosis survive into their fourth and fifth decades of life, atypical presentations of acute pancreatitis may become more common.

Editor—The Child Accident Prevention Trust was interested to read the report of the BMA’s Board of Education and Science on the compulsory use of cycle helmets.1 The trust agrees with the board’s recommendations, in that society is not yet ready to accept legislation in this area, and the other recommendations on the value of educational efforts to increase the use of cycling in general and of helmet wearing. However, we would have liked to see more evidence of the effectiveness of helmets in reducing deaths and brain injury, which seems to be important in deciding to what extent helmets should be worn. In the report this is given a somewhat cursory review of just over one page, whereas standards and their verification, and the purchase and care of helmets, receive eight pages. The Child Accident Prevention Trust is the main organisation in Britian concerned solely with the reduction of accidents and injuries to children, but its work in this area and in particular its association with “Headstart” in the sale of low-cost helmets to schools—which has so far resulted in the sale of approximately 28 000 helmets—is not mentioned at all. The report in the BMJ is also somewhat unbalanced in that in that it tends to take a negative approach to the problem.2 The statement that “a much greater number of lives would be saved if pedestrians and car occupants were encouraged to wear bicycle helmets” is sheer nonsense as it stands, without amplification and qualification. The Child Accident Prevention Trust is strongly in favour of the promotion of cycling by children and of their use of helmets when doing so, both on the road and in off the road activities.

The main part of this excellent book is based on the experience of the National Poisons Information Service, London, and consists of 78 chapters on poisonous drugs or chemicals, or groups of substances. Plants, fungi, and snakes are also included. Each chapter is similarly structured, with key points of presentation and management, followed by a description of the substance and its use, its toxicity, clinical effects and case reports, treatment, and references etc. There are 29 …

Many years ago a baby of about 18 months was admitted to hospital under my care having taken 10 of his mother's imipramine tablets prescribed for her depression at becoming pregnant against her wishes. This was before the days of child resistant containers. Imipramine was then a relatively new drug, and the baby had convulsions and cardiac irregularities, which are recognised side effects. I got the fits under control, but the cardiac irregularities were beyond me. My paediatric cardiology colleague and later an adult cardiologist came to help. But it was to no avail and the baby died after about 10 hours. He was the only child under my care who died from medicinal poisoning. All …

Jackson Hugh. The Late Victorian Decline in Churchgoing Some New Zealand Evidence / Le Déclin de la pratique religieuse à la fin de l'ère victorienne. Le cas néo-zélandais.. In: Archives de sciences sociales des religions, n°56/1, 1983. pp. 97-106.

My purpose in this paper is to take a fresh look at the possibility that the belief in the resurrection of Jesus had its origins in a failure of prophecy. I shall argue that the crucifixion of Jesus cut across his disciples' expectations of the coming of the kingdom and placed their faith in jeopardy. I shall further suggest that the belief in the resurrection of Jesus might be explicable as a creative response to the disconfirming event of the crucifixion, whereby the disciples were able to maintain their faith in a modified form.

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