1/53. Telemedical experiences at an Antarctic station.Wintering-over in Antarctica represents a physician's most remote and inaccessible scenario, apart from a space station. Because of the harsh and unpredictable winter weather, Antarctic stations are typically inaccessible for over six months of the year. telephone and fax communication, and recently other forms of telemedicine, have provided vital links to specialists. The author was the sole physician for more than 250 people wintering-over during the 1995 austral winter at McMurdo Station. There were several instances of serious or life-threatening illness where the author relied on teleconsultation. These cases included new-onset coronary artery disease, posterior hip dislocation, complicated colles' fracture and acute appendicitis. There were also numerous consultations for non-emergency clinical presentations normally managed by specialists. telemedicine was a crucial link to specialists from the remote and inaccessible environment of Antarctica.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
2/53. Acute hepatitis induced by greater celandine (chelidonium majus).The hepatotoxic potential of conventional drugs is well known, but herbal medicines are often assumed to be harmless. In the last 2 years, we have observed 10 cases of acute hepatitis induced by preparations of greater celandine (chelidonium majus), which are frequently prescribed to treat gastric and biliary disorders. The course of hepatitis was mild to severe. Marked cholestasis was observed in 5 patients, but liver failure did not occur. Other possible causes of liver disease (viral, autoimmune, hereditary, alcohol, and secondary biliary) were excluded by laboratory tests and imaging procedures, and liver biopsy specimens were consistent with drug-induced damage. After discontinuation of greater celandine, rapid recovery was observed in all patients and liver enzyme levels returned to normal in 2-6 months. Unintentional rechallenge led to a second flare of hepatic inflammation in 1 patient. Greater celandine has to be added to the list of herbs capable of inducing acute (cholestatic) hepatitis. A significant proportion of unexplained cases of hepatitis may be caused by greater celandine.- - - - - - - - - - ranking = 56.846604296944keywords = herbal medicine, medicine (Clic here for more details about this article) |
3/53. Acute hepatitis after ingestion of herbs.Herbal preparations are marketed as natural and safe alternatives to conventional medicines for the prevention and treatment of a variety of ailments. However, consumers may not be fully aware of their potential side effects. We report two cases of acute hepatitis after the ingestion of herbal preparations. One of the mixtures included chaparral and bee pollen; the other was pure bee pollen. Chaparral has been reported to have similar effects in other patients, but we found no reports of acute hepatitis from bee pollen. We discuss chaparral and several other hepatotoxic herbs and review the literature. Our case reports remind primary care physicians to ask their patients about herbal use and discuss their potential toxicities.- - - - - - - - - - ranking = 0.5keywords = medicine (Clic here for more details about this article) |
4/53. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from polygonum multiflorum.Herbal preparations are widely available and generally regarded by the public as harmless remedies for a variety of medical ailments. We report the first case in australia of acute hepatitis associated with the Chinese herbal medicine Shou-Wu-Pian, prepared from polygonum multiflorum. Cholestatic hepatitis developed in a Chinese woman taking this preparation for the greying of her hair, and liver biopsy was consistent with a toxic reaction. Clinical and biochemical resolution occurred following cessation of the drug.- - - - - - - - - - ranking = 56.846604296944keywords = herbal medicine, medicine (Clic here for more details about this article) |
5/53. Effective diagnosis of spinal cord compression using telemedicine.We report the case of a man with an acute cervical cord lesion which was diagnosed after a teleconsultation with a neurologist at a distant neurological centre. We show that the ability to assess patients clinically using real-time videolinks is also of use in detecting those patients who would benefit from specialist neurosurgical intervention, but who might otherwise be denied it because of their location.- - - - - - - - - - ranking = 2keywords = medicine (Clic here for more details about this article) |
6/53. Hepatobiliary scan showing type II choledochal cyst.nuclear medicine hepatobiliary scintigraphy is well established for the evaluation of right upper quadrant pain in cases of possible acute cholecystitis. The authors present a case of type II choledochal cyst shown on a hepatobiliary scan in a patient with possible acute cholecystitis.- - - - - - - - - - ranking = 0.5keywords = medicine (Clic here for more details about this article) |
7/53. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Intra-articular lidocaine for acute anterior shoulder dislocation reduction.A short cut review was carried out to establish how intra-articular lidocaine compared with intravenous analgesia and sedation during reduction of anterior shoulder dislocations. Altogether 146 papers were found using the reported search, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.- - - - - - - - - - ranking = 2keywords = medicine (Clic here for more details about this article) |
8/53. Industrial medicine and acute musculoskeletal rehabilitation. 2. Acute cervical spine and shoulder injuries in the industrial setting.This self-directed learning module highlights the underlying anatomy and biomechanics of the cervical spine and shoulder as a basis for developing a differential diagnosis of contributing pathology in an industrial injury. This includes components of the history, examination, and appropriate diagnostic testing that are necessary to develop an optimal rehabilitation plan. Treatment options are reviewed and include medications, therapy, selective injections, and return-to-work programs in the industrial setting. overall ARTICLE OBJECTIVES: (a) To be able to identify neck and shoulder pathology, (b) to effectively evaluate cervical spine and shoulder injuries, and (c) to rehabilitate acute cervical spine and shoulder injuries in the industrial setting.- - - - - - - - - - ranking = 2keywords = medicine (Clic here for more details about this article) |
9/53. Industrial medicine and acute musculoskeletal rehabilitation. 3. cumulative trauma disorders of the upper limb in computer users.This self-directed learning module highlights various cumulative trauma disorders of the upper limb that may be seen in computer users. The biomechanics and ergonomics of computer users are addressed in relationship to specific neurologic and musculoskeletal conditions within the neck and upper limbs. In addition to a general overview of these conditions, a case presentation is used to show the evaluation and treatment of a computer user who has carpal tunnel syndrome and concomitant de Quervain tenosynovitis. overall ARTICLE OBJECTIVES: (a) To review the important anatomic and ergonomic basis for upper limb cumulative trauma disorders in computer users and (b) to provide an example of evaluation and treatment.- - - - - - - - - - ranking = 2keywords = medicine (Clic here for more details about this article) |
10/53. Industrial medicine and acute musculoskeletal rehabilitation. 4. Evaluation and management of the injured worker with a lower-extremity injury.This self-directed learning module highlights the importance of recognizing the relationships between multiple, concurrent joint injuries in the lower extremity of an injured worker. This chapter focuses on evaluating the lower extremity and devising a rehabilitation program that incorporates the entire kinetic chain. Further recommendations for return to work are discussed. overall ARTICLE OBJECTIVES: (a) To accurately recognize and diagnose coexisting injuries in the lower extremity and (b) to devise an evaluation and treatment program enabling the worker to return to work.- - - - - - - - - - ranking = 2keywords = medicine (Clic here for more details about this article) |
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