The US Food and Drug Administration (FDA) is requiring the manufacturers of Tumour Necrosis Factor (TNF) blockers to update the Boxed Warning in the prescribing information to alert healthcare professionals of an increased risk of lymphoma and other malignancies in children and adolescents treated with TNF blockers. FDA ALERT [8/4/2009] The FDA analysed 48 cases […]
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Plant sterol enriched margarines increase cardiovascular risk?
Maybe the assumption that natural substances can do no harm has again been shown to be wrong. Are these margarines good or bad for you? A case published in BMJ Case Reports this week raises an interesting question about plant sterol-enriched margarines and cardiovascular risk. They reduce LDL cholesterol but do not seem to reduce […]
Aggressive Infantile Fibromatosis in an Iraqi child treated in the UK
The case of three-year-old Saif Basim with Agressive Infantile Fibromatosis is in the news this week. The young boy was flown from Iraq to be treated by British surgeons since the appropriate facilities were not available in Baghdad. http://www.dailymail.co.uk/health/article-1204230/Iraqi-boy-smile-life-saving-surgery-UK-remove-tumour-face.html http://news.bbc.co.uk/1/hi/england/london/8188149.stm http://www.thesun.co.uk/sol/homepage/news/2571657/Iraqui-tumour-boys-first-smile.html Royal Jordanian airlines paid for the family’s flight to the UK but the British […]
An unusual neurological presentation after exposure to snails.
http://casereports.bmj.com/cgi/content/short/2009/aug03_1/bcr1020081075?q=w_casereports The reviewer (Dr Marion Woods, Royal Brisbane and Women’s Hospital, Australia) commented: “The case of Angiostrongylus cantonensis infection with the clinical manifestations of eosinophilic meningo-encephalitis and myeloradiculitis that caused lower limb weakness and bladder dysfunction described in this issue of the journal is the likely consequence of ingestion of a very high worm burden […]
Swine flu help line misses other serious conditions
A teenager was told he had swine flu after phoning the national helpline only to discover a few days later that his condition was a severe urinary tract infection. http://news.bbc.co.uk/1/hi/england/bristol/8184506.stm Whilst alarming this is a predictable drawback of telephone helplines in that it is more difficult to make a correct diagnosis over the telephone especially […]
The co-existence of CHARGE and myelodysplastic syndrome in a child
The authors of this case report highlight the unusual association of CHARGE and MDS in a child. It is a well written short report that may be an early indication of an association and interesting pathological link. However, as the authors point out, the association in this particular patient may simply be coincidence. The co-existence […]
Side effects of evidence-based medicine
This case highlights the challenge of implementing evidence-based medicine and guidelines. Each patient is an individual and may not fit within the group that has helped define the evidence for a particular clinical procedure. In this article the authors discuss two cases of pre-operative patients that did not fit the ‘healthy’ group they were thought […]
The wonders of brain plasticity
A German girl born with a missing right hemisphere of her brain has baffled her doctors by having normal vision. http://news.bbc.co.uk/1/hi/health/8159631.stm “[MRI] Scans on the girl showed that the retinal nerve fibres carrying visual information from the back of the eye which should have gone to the right hemisphere of the brain diverted to the […]
Orthopaedic surgeons move young woman’s heart
The BBC are carrying an interesting case report of a young woman with severe scoliosis. The deformity had shifted her mediastinum and heart to the right but, after corrective surgery, her symptoms of back pain and the heart shift have resolved. http://news.bbc.co.uk/1/hi/health/8160522.stm “A spokeswoman for the Scoliosis Association said: ‘If scoliosis goes untreated, it will […]
Gastric outlet obstruction from a caecal volvulus, herniated through epiploic foramen: a case report
This is an unusual, and we think first reported, case of gastric outlet obstruction due to herniation of the caecum and ileum through the epiploic foramen. It demonstrates the usefulness of contrast CT in the pre-operative evaluation of such patients presenting with acute abdomen. What I particularly like is the hand drawn operative findings by […]