Single coronary artery: a familial clustering

A 59 year old man undergoing investigation for chest pain was found at elective coronary angiography to have a single coronary artery; the left coronary had a normal distribution, with the right coronary originating as a continuation of the atrioventricular circumflex. His 30 year old daughter was admitted for elective coronary angiography for further investigation of a dilated cardiomyopathy. She was also found to have a single coronary artery. However, in her case, the right and left coronary arteries arose from the right sinus of Valsalva; the right coronary had a normal distribution, the left coronary passed anterior to the pulmonary trunk and aorta.     

Necrotizing neurosarcoidosis masquerading as a left optic nerve meningioma: case report

Isolated neurosarcoidosis involving the optic nerve meninges is extremely rare and is often indistinguishable from a meningioma in its anatomic site and MR imaging presentation. Characteristic findings include enhanced perineural encasement and thickening of the affected optic nerve on contrast-enhanced T1-weighted cranial MR imaging studies. We present the case report of a patient with isolated necrotizing neurosarcoidosis of the left optic nerve, with clinical and MR imaging findings strongly suggestive of a preoperative diagnosis of a meningioma.     

Selective nerve root blocks

Selective nerve root blocks are an effective way of diagnosing and treating radicular pain in many patients. Although traditionally performed under fluoroscopic guidance, computed tomography (CT) and CT fluoroscopy have been increasingly used to direct needle placement. This article discusses the indications and technique of selective nerve root blocks in the cervical, thoracic, and lumbar spine, as well as the evidence supporting their use in the treatment of patients with radiculopathy and/or back pain. Copyright 2002, Elsevier Science (USA). All rights reserved.     

John Murtagh全科病案研究(五)——7岁男孩24小时内疲乏嗜睡发热呕吐皮疹

1病例简介患儿,男,7岁,突发高热,精神萎靡,嗜睡。发病12h后厌食,呕吐3次后就诊。患儿自诉头痛,在胸部和背部发现细小皮疹。体检结果提示,患儿明显地表现为麻木状态,面色潮红,病态显著。躯干上发现一些细小的斑点状皮疹。四肢末端温度较低,而且毛细血管回流低于正常。生命体征为     

The prevalence of obstructive lung disease in a general population sample: The NICECOPD study

Background: There are little data available on the prevalence of chronic obstructive pulmonary disease (COPD) in the United Kingdom. The Northern Ireland Cost and Epidemiology of Chronic Obstructive Pulmonary Disease (NICECOPD) study is a two-stage survey to examine the prevalence of obstructive lung disease in a general population sample in the Greater Belfast area. Methods: In stage one 4000 subjects aged 40–69 years were selected at random from the general population. They were posted a short screening questionnaire concerning respiratory symptoms. Respondents were divided into ‚symptomatic’ and ‚asymptomatic’ groups according to their responses. In stage two, a sample of symptomatic and asymptomatic subjects completed a more intensive assessment that included a detailed questionnaire on medical history, spirometry, skin allergy testing and serial peak flow measurements. Spirometric criteria for airflow obstruction were FEV1/FVC ratio of <70% with FEV1 < 80% predicted. Subjects were assigned diagnoses according to a pre-arranged protocol. Results: The survey was conducted from May 1999 to May 2001. There was a 67% response rate to the stage 1 screening questionnaire and 1330 responders were identified as being eligible to take part in stage 2. In total, 722 subjects completed a detailed assessment (50.8% Male, symptomatic, n = 326; asymptomatic, n = 396). COPD was diagnosed in 12.3% (8.8, 15.8) of the symptomatic and 2.2% (0.8, 3.6) of the asymptomatic group. The estimated prevalence of obstructive lung disease in the total population age 40–69 years was 14.4%: 6.3% COPD; 7.2% asthma; 0.9% with indeterminate airflow obstruction. In men, the prevalence of COPD varied from 4.9% in those aged 40–49 years to 12.3% in those aged 60–69 years and in women, varied from 1.4% in 40–49 years of age to 4.5% in 60–69 years. Conclusion: The data suggest that COPD and asthma are common conditions in the general population and should inform future plans to address the burden of disease     

Correct procedures and cutting corners: a qualitative study of women's occupational health and safety in a beauty therapy industry

OBJECTIVE: To examine the context of occupational health and safety related to blood-borne communicable diseases practice. METHODS: A case study approach using qualitative semi-structured interviews with five key informants who represented different sectors of the beauty therapy industry in South Australia. RESULTS: Four main themes were identified: (i) exposure to blood and blood-borne communicable diseases; (ii) prevention in practice; (iii) OH&S problems; and (iv) industry needs. CONCLUSION: Key OH&S issues in the beauty therapy industry include: power relationships between employers and employees, equipment costs, the need for more continuing education, and monitoring of practitioners. IMPLICATIONS: Economic constraints, continuing education, and government regulation of the beauty therapy industry are highlighted as significant areas for further consideration in addressing the OH&S needs of practitioners and their clients.