Heart failure is a disease of epidemic proportions with three quarters of patients afflicted dying within 3 years. Aside from the appalling prognosis of the condition patients suffer greatly, as does the purse of the national health budget. These patients are admitted time and time again for prolonged periods for worsening heart failure, have multiple co-morbidities and often lack social suppor...

There was a request recently to categorise aspects of postgraduate medical education as either "academic" or "vocational." This raises a question about the meaning of words and about the logic behind such a distinction. In common parlance "academic" means impracticable and irrelevant to the real business of living. A "vocation" was once a calling to the higher rungs of a profession but now "voc...

Fun is functional: play is evolution's way of making sure animals acquire and perfect valuable skills in circumstances of relative safety. Yet precisely what animals find fun has seldom been examined for what it can potentially reveal about how they represent and think about the world.

A 68-year-old man with a history of ulcer disease and mild renal insuffi ciency comes to your offi ce complaining of severe pain in his right foot. You note swelling and redness around the base of the big toe and diagnose acute gout. Wishing to avoid nonsteroidal anti-infl ammatory drugs (NSAIDs) and colchicine because of the patient’s medical history, you wonder what you can safely prescribe f...