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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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Pop goes the O2: a case of popper-induced methaemoglobinamia

This is a well written case report of a common presentation in emergency departments (altered mental state associated with alcohol intoxication and a possible head injury). It highlights the importance of a good history and maintaining a high index of suspicion for relatively uncommon diagnoses in patients with this common emergency department presentation. Can the […]

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The importance of challenging your diagnosis even in straightforward cases

A useful approach to all patients with non-healing wounds can be summarised by the following concept: “Wounds do not heal for no reason.” The development of an ulcer is a priori evidence of some pathological process (e.g. unrelieved pressure). For a wound or an ulcer to persist, there must be a disruption in the elegant […]

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