Five new patients are reported and the pathogenesis of the hypoglycaemia without ketogenesis is discussed. This report extends a recent review.

Predicting recovery following muscle injury can be difficult because it involves consideration of multiple factors. Our objective was to determine if psychological factors, sex, and peak pain and disability ratings could be predictive of delayed recovery following induced muscle injury. Healthy untrained volunteers (n=126; M:F 51:75) underwent a concentric/eccentric isokinetic exercise protocol on their dominant shoulder to induce fatigue, with individuals who reported pain (>0/10) at 96 h being classified as "not recovered". Individuals experiencing pain at 48 h were more likely not to be recovered (O.R.=1.62, p<0.001). Additionally, individuals with higher scores in pain catastrophizing at 48 h were more likely to experience pain at 96 h (O.R.=1.06, p<0.001). Pain duration (in days) was associated with pain scores at 48 h (β=0.385, p<0.001) and baseline anxiety (β=0.220, p=0.007). Fear of movement/re-injury at 96 h was found to be associated with pain catastrophizing at 48 h (β=0.537, p<0.001) and baseline levels of fear of pain (β=0.217, p=0.004). This study provides preliminary evidence that higher pain levels and pain catastrophizing following acute muscle injury are associated with poor recovery, higher fear of movement/re-injury and longer pain duration.

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by contemporary circumstance, by social, economic, artistic, technical and cultural conventions, emphases, inhibitions and restraints". Indeed, the double negative, "not... uninfluenced" is too weak. The acquisition and conveying of anatomical knowledge and the factors behind book production are expressions of the same complex sets of motivations in each era. One does not "influence" the other.The idea that progress in conveying anatomical knowledge is "influenced" by contextual factors does indicate quite accurately that the old triumphalist history still stands at the heart of Roberts' and Tomlinson's enterprise. The heading of chapter 5, "The great leap forward" (Vesalius and co., of course) leaves no doubt on that score. In spite of apposite remarks on the factors that affect the nature of anatomical illustration in the various discursive sections by Roberts, the general tone of the historical narrative (particularly in the commentaries to the plates by Tomlinson) is dismissive of intellectual motivations which lead to illustrations giving expression to concepts which the authors deem to be incompatible with progress in "factual anatomical illustration". Early illustrations thus come in for particularly rough treatment. Medieval representations come into the category "pre-scientific"; early gravida illuminations are said to be "no better than symbolic"; the artist who illustrated Guido da Vigevano's Anathomia "would, of course, have been aware of the ludicrous nature" of his representation of a "miniscule" penis and scrotum. Even later products are censored for not conforming to present notions of representational utility. Thus the obsessively detailed and particularizing obstetrical atlases of the eighteenth century, which illustrate forms life size, are described as "cumbersome and, indeed useless"-but this is a judgement made from the standpoint of the modern structures of anatomical learning. In the production of the great eighteenth-century atlases in Britain, often sold by subscription, the manically detailed representation of an individual specimen, the insistent striving to perfect techniques of engraving, and the regal magnificence of the volumes are all of a piece with the promotion of British science's remorseless progress towards the goal of empirical truth-within a system of noble and institutional patronage.Roberts and Tomlinson have on their own account produced a book which will be of considerable use as an instructive and visually impressive survey. However, its somewhat schizophrenic agenda, which tends to leave social context and empirical knowledge at war with each other, prevents it from providing the great re-alignment in the telling of the conventional story that is really needed.