1/8. Atrophia maculosa varioliformis cutis: a pediatric case.Atrophia maculosa varioliformis cutis was described in 1918 by Heidingsfeld as a type of idiopathic noninflammatory macular atrophy typically occurring in young individuals. Only 13 cases have been reported since the first description. Considering that atrophia maculosa varioliformis cutis can be mistaken for a scarring and artifact dermatitis, it is important for physicians to distinguish this condition. We report a new case in a 5-year-old boy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. epilepsy--doctor's dilemma, lawyer's delight? Medico-legal consequences of practising in the field of epilepsy report of an International League against epilepsy British Branch meeting--Edinburgh, April 2000.Six cases are described where the medical management of a person's epilepsy was brought under legal scrutiny. Lessons learnt from this educational exercise include improving doctor patient communication, the function of a Coroner's Court, when is misdiagnosis negligent, the vagaries of expert witnesses, should failure to diagnose a tumour be blamed on the physician or the service when facilities are inadequate, is failure to recognise a rare drug interaction, failure to warn against an interaction, or failure to take a proper history, negligent? The conference also examined the legal ramifications of the nurse/doctor relationship in epilepsy care, the place of epilepsy guidelines and, due to its interactive nature, reflected on the audience's epilepsy knowledge, which, in places seemed significantly deficient. It was a gripping educational exercise.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/8. Hemiatrophy and hemiparesis in a patient with congenital cytomegalovirus infection.A 3-year-old girl with congenital cytomegalovirus (CMV) infection has been followed up since birth. Hemiatrophy and hemiparesis occurred at 9 months of age. These unusual sequels of congenital CMV infection should encourage physicians to do longitudinal studies on infants with congenital CMV infection, as well as to examine children with hemiatrophy and hemiparesis for CMV infection.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/8. Updates on the diagnosis and management of posttraumatic hydrocephalus.Posttraumatic hydrocephalus is a vital subject for the practitioner caring for patients with traumatic encephalopathy, as a large number of brain trauma patients develop ventricular enlargement. The managing physician should understand which ventriculomegalic patients are suffering from hydrocephalus, which have cerebral atrophy and which stand a reasonable chance of improvement on surgical placement of a ventricular shunt. This paper highlights this decision process in two patients, and offers the physician a practical overview of posttraumatic hydrocephalus and its management.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
5/8. Neurologic complications in oral polio vaccine recipients.Between April 1982 and June 1983 four children 3 to 24 months of age were referred for evaluation of neurologic abnormalities found to be compatible with vaccine-related poliovirus infection, which had not been suspected by referring physicians. patients were epidemiologically unrelated residents of indiana, and none had prior symptoms suggestive of immunodeficiency. All had received poliovirus vaccine orally (first dose in three, fourth dose in one) and a diphtheria-tetanus-pertussis injection in the left anterior thigh within 30 days of symptoms. A vaccine-like strain of poliovirus was isolated from each patient, and each had symptoms (left leg paralysis in three; developmental regression, spasticity, and progressive fatal cerebral atrophy in one) persisting for at least 6 months. Immune function was normal in two with poliovirus type 3 infection, and abnormal (hypogammaglobulinemia, combined immunodeficiency) in two with type 1 and type 2 infection, respectively. The incidence of observed vaccine-related poliovirus infection in indiana recipients of orally administered poliovirus vaccine was 0.058 per 100,000 per year, significantly greater (P less than 0.001) than predicted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/8. Atrophia maculosa varioliformis cutis.We describe a case of atrophia maculosa varioliformis cutis (AMVC), a rare form of idiopathic facial macular atrophy. A biopsy revealed only a depression in the epidermis, probably caused by loss of dermal collagen. Because AMVC may be confused with scarring, and factitial disease may be suggested, it is important that this condition be recognized by the physician.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/8. An office laboratory panel to assess vaginal problems.In determining the cause of vaginal complaints, the routine use of four simple tests ("the vagina panel") enables the physician to identify pathogens (candida, gardnerella, trichomonas), pathologic processes (inflammation, estrogen deficiency) and, in most instances, a healthy vagina. time and money are saved. The specimens can be collected in one minute during a pelvic examination. The panel can provide the answers to eight essential questions in two minutes of observer time, with supplies costing about $2.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/8. Interdigital neuroma. Local cutaneous changes after corticosteroid injection.Interdigital neuroma was diagnosed in a patient who was treated subsequently with a local corticosteroid injection. Two to 3 weeks after injection, a 2.5 x 1.5-cm area of hyperpigmentation, thinning of the skin, and subcutaneous fat atrophy developed at the site of the injection. Occurrence of these side effects depends on the solubility of the steroid preparation, the dosage, and the anatomic site and depth of the injection. When using local corticosteroid injections to treat interdigital neuromas, the physician should be familiar with the properties and recommended dosage of the given steroid. The injection should be deep enough so that the cortisone solution does not leak into the subcutaneous area. The possibility of skin atrophy and altered pigmentation should be discussed with all patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |