Very interesting case and well written. One could postulate that the hypoxia associated with massive PE might have caused ischaemic changes without infarction or that the death was too soon for changes of infarction to be visible at post mortem examination. Either way, a good learning point, though clearly thrombolysis for either PE or MI […]
Latest articles
Perioperative risk stratification for a patient with severe obstructive sleep apnoea undergoing laparoscopic banding surgery
Surgery on patients with OSA can be problematic, and a preoperative assessment is useful as a predictor of complications and as a means of planning best clinical practice. This proposed assessment takes into account the 3 major areas of concern, namely the severity of OSA, the planned procedure, and the need for perioperative sedation and […]
A not very NICE case of endocarditis
The recommendations of the American Heart Association and European Society for Cardiology on the use of antibiotic prophylaxis for patients considered to be high risk is very relevant in dental practice. The NICE guidelines as described by the author, at times need not be too nice for a high risk patient. Reviewer Dr Peter George […]
Primary prophylaxis of pulmonary embolus with retrievable IVC filter
Announced in the news today was the case of Doreen Carter who had an inferior vena cava filter inserted as an alternative for prophylaxis against thromboembolism. http://www.bbc.co.uk/news/uk-england-berkshire-21655038 She was due to have bowel surgery and, presumably, was deemed too high risk for anticoagulation. The titanium device was also designed to be easily removed. “Dr Carl […]
All tied up in knots
Anything that is linear and remotely flexible may get knotted up. This is well demonstrated in the images accompanying the present case. Murphy’s law applies, and the advice given by the authors is very sound. Reviewer Kirsten Moller All tied up in knots […]
Adenocarcinoma: not all that wheezes is asthma
This is well written case report of a rare presentation of a rare condition. It provides a important reminder to consider a differential diagnosis in patients with asthma. Large airway tumours are rare (0.2%) amongst patients with lung cancer, and amongst tracheal tumours it is thought that adenocarcinomas represent 4-10%.1-5 The majority of tracheal adenocaricinomas […]
Stroke mimic: an interesting case of repetitive conversion disorder
Patients with non-organic or functional disorders do indeed present frequently to stroke services. The hazard for the patient is that they may receive IV thrombolysis – although limited available data.1 Chen et al 2 suggests as the authors here observe, that patients presenting with non-organic or functional disorders are at a relatively low risk of […]
Brain dead or not? CT angiogram yielding false-negative result on brain death confirmation
In this article we are reminded how to confirm brain death and the pitfalls of using CT angiograms for the assessment of cerebral perfusion. Seema Biswas Editor-in-Chief Brain dead or not? CT angiogram yielding false-negative result on brain death confirmation […]
Electrocautery-induced gangrene of the glans penis in a child following circumcision
Circumcision is a routine procedure in some cultures. Different techniques are used as surgical methods. Unfortunately some of them cause tragic and irreversible complications. This article that includes distinct photographs highlights the undesirable consequences clearly and accurately. Because of pointing out the worrying cases in a certain way, I consider that publishing this article in […]
Clinton’s ‘blood clot’ – an MRI and media challenge.
So it turns out that Hillary Clinton, US Secretary of State – who has visited more countries in office than any other – developed a right transverse sinus venous thrombosis. http://www.state.gov/r/pa/prs/ps/2012/12/202419.htm Previously it was just called a ‘blood clot’ requiring ‘hospital’ and ‘blood thinners’. This followed a day of intense speculation in the media which […]