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Archive for January, 2015

Quiescent infective endocarditis in a patient with bronchopneumonia

30 Jan, 15 | by Kristy Ebanks

Splenic abscess

We have a very interesting image for you but, can you answer the questions below?

Nayak_July_2014_Figure_1

1. What would be your differential diagnosis in Figure 1?
2. What factors would determine whether you perform a splenectomy?
3. What is the latest evidence in terms of post-splenectomy sepsis?

If you don’t know the answers or want to know more read ’Splenic abscess as a potential initial manifestation of quiescent infective endocarditis in a patient with bronchopneumonia

Australian boy is first to receive ‘artificial pancreas’ insulin pump

26 Jan, 15 | by Dr Dean Jenkins

Xavier Hames is a four year old boy with Type 1 diabetes and he has been fitted with an insulin pump that senses glucose levels and stops insulin – a step closer to an ‘artificial pancreas’. An artificial pancreas adds a glucose sensor to an insulin pump so that it can sense when to reduce or stop insulin to avoid hypoglycaemia. More sophisticated devices are being developed to improve the management of people requiring insulin.

Xavier’s story has been widely reported in the news:

“Diabetes breakthrough hailed as Australian boy given artificial pancreas” http://www.theguardian.com/society/2015/jan/21/australian-boy-given-artificial-pancreas-to-help-manage-type-1-diabetes

“World-first insulin pump for diabetic Perth boy Xavier Hames” http://www.abc.net.au/news/2015-01-21/perth-boy-becomes-first-patient-fitted-with-artifical-pancreas/6032388

“Four-year-old Perth boy Xavier Hames has become the first patient in the world to receive an artificial pancreas as part of his routine diabetic care.” https://lockerdome.com/biosolutionscorp/7346894150058004

“A four-year-old Australian boy has been fitted with an artificial pancreas in what researchers said was a world first treatment for managing type 1 diabetes.” http://medicalobserverph.com/features-australian-boy-4-gets-world-first-artificial-pancreas/

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A word from the Editor In Chief – 10,000+ cases!

21 Jan, 15 | by Kristy Ebanks

What would you do if you woke up one morning and found that you could not stand, your legs simply won’t move.

This was exactly what the patient in this, our 10 000th case at BMJ Case Reports, discovered.

He presented to the Accident and Emergency Department with sudden bilateral lower limb paralysis and urinary retention. How would you manage his care? What would you do? He needs urgent attention. Is this trauma? Is there cord compression? Could this be Guillain – Barre? Could the paralysis become generalized? Will he stop breathing?

Put yourself in this patient’s position. How would you feel? Put yourself in the admitting doctor’s position. There is a need to act fast. Multiple disciplines will need to consult. The patient may need intensive care.

What is your working diagnosis? What do you need to exclude? How will you investigate?

Read on and tell us what you would do. How would discover what is wrong? How would you discuss this with the patient? What about his family?

Read on and find out whether the symptoms improve…. Sudden flaccid paralysis

The 10,000th BMJ Case Report

8 Jan, 15 | by Kristy Ebanks

Sudden flaccid paralysis

We have reached a milestone with this case but, can you answer the questions below?

F2.medium F1.medium

1. What may precipitate sudden onset paralysis?
2. What is seen in these two MRI figures?
3. What is the differential diagnosis?

If you don’t know the answers or want to know more read ’Sudden flaccid paralysis

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