Prevalence and characteristics of aquagenic pruritus in a young African population

Background

The internet is an increasingly important tool for physicians, but the extent to which it is used by dermatologists is unknown. We aimed to investigate the utilization of the internet by dermatologists in Saudi Arabia for medical purposes during their daily practice and to clarify the reasons for its use and non-use.

Methods

A self-administered questionnaire was distributed to all 160 dermatologists attending the National Dermatology conference in 2007.

Results

A total of 107 questionnaires were completed. Sixty-two percent of respondents had access to the internet in the workplace. The use of the internet to update medical knowledge was reported by 91%. Only 27% had internet access in consultation rooms. The majority of information retrieval occurred outside patient consultation hours (91%). Only 13% reported using the internet during patient consultation. Possible reasons included: lack of access (54%), time pressure (37%), possible interference with the physician-patient relationship (30%), and that use of the internet was too time-consuming (10%). The mean searching time used to solve a clinical problem was 34 ± 3 minutes. Fifty-eight percent used Pubmed; however, 77% of the dermatologists had no training at all in how to use this tool.

Conclusion

Professional medical use of the internet is widespread among dermatologists in Saudi Arabia. Providing access to the internet in the workplace and training of dermatologists to perform effective electronic searches are badly needed to improve the professional medical use of internet, which is expected to lead to better delivery of patient care.     

选择外科导航系统的参考要素

外科导航系统可提供外科手术过程中的实时指导，是一种极具应用前景的互动式工具。它可以在术中为外科医生提供实时信息，从而有利于手术的进程，改善手术效果，减少并发症。该系统的运用可降低手术创伤。该系统中计算机的运用有助于术前计划的制定和术后资料的收集。计算机辅助外科手术导航系统的应用已有十多年历史。随着近年来技术的发展，该技术得以进一步改良，并精确化了手术程序。虽然外科导航系统是一门相对较新的技术．但由于其显的优点，将会在临床上越来越广泛地应用。我们调研了五个外科导航系统的生产商，旨在介绍目前临床上可选择的外科导航系统和注意事项。     

Lung cancer in association with human immunodeficiency virus infection.

The association of lung cancer and infection by the human immunodeficiency virus (HIV) is uncommon. This report and critical review of the medical literature defines a clinical profile of 22 patients affected with this uncommon association. This clinical profile includes young age (median, 38 years), intravenous drug abuse (14 of 22 patients), preponderance of adenocarcinoma over other cell subtypes (11 of 22 patients), and advanced clinical stage at presentation (10 of 15 patients with staging data had Stage III or IV disease). This study also examines a possible increased risk for lung cancer in patients infected by HIV. Continued surveillance and reporting of lung tumors (other than lymphomas and Kaposi sarcomas) in patients infected by HIV should help to define the frequency of the association and the validity of the clinical profile.     

PRIMARY PERITONITIS IN A PARAPLEGIC PATIENT

SUMMARY This report of a paraplegic patient with a primary peritonitis illustrates the difficulty in diagnosis and management these patients pose.     

Evaluation of the anti-diabetic property of Morinda lucida leaves in streptozotocin-diabetic rats

The hypoglycaemic and anti-hyperglycaemic activities of a methanol extract of Morinda lucida Benth. (Rubiaceae) leaves were studied in normal and streptozotocin-diabetic rats. In normal rats, the extract demonstrated a significant (P < 0.05) and dose-dependent hypoglycaemic activity within 4 h after oral administration. The plasma glucose level of 400 mg kg(-1) of the extract at 4 h was 42.5 +/- 0.4 mg/100 mL (control 67.4 +/- 1.2 mg/100 mL). After 12 h, the plasma glucose level of rats administered 50, 100, 200 or 400 mg kg(-1) extract fell to 51.9 +/- 1.2, 47.3 +/- 0.8, 43.1 +/- 0.4 and 40.0 +/- 0.5 mg/100 mL, respectively. In hyperglycaemic rats, the extract produced a significant (P < 0.05) anti-diabetic effect from day 3 after oral administration, with 400 mg kg(-1) extract-treated animals having a plasma glucose level of 248.7 +/- 5.3 mg/100 mL compared with glibenclamide (10 mg kg(-1))-treated animals with a plasma glucose level of 251.5 +/- 5.8 mg/100 mL. These results suggest that the leaves of Morinda lucida have a strong glucose lowering property when administered to streptozotocin-treated rats.     

Häusliche Gewalt

Background

The consequences of domestic violence are often life-threatening injuries. In order to protect the victim and ensure sufficient prosecution, forensic assessments, thorough documentation of injuries and correct securing of biological traces are of eminent importance.

Objective

The complexity, extent and characteristics of domestic violence and its consequences were assessed and evaluated to illustrate the indispensable importance of forensic medical expertise.

Material and methods

A retrospective statistical analysis of forensic physical examinations at the Institute of Forensic Medicine at the Hanover Medical School (MHH) in the years 2001–2010 was conducted. Cases that were investigated as part of criminal proceedings following domestic violence were scientifically analyzed.

Results

From 1 January 2001 to 31 December 2010 a total of 3098 forensic physical examinations were conducted. In 216 cases the victim had been physically and/or sexually assaulted by the partner (7?%). Of the victims 25?% had a medical background, indications of alcohol consumption, drugs or medication abuse. Women (92.1?%) were disproportionately overrepresented in comparison to men (7.9?%) and repeatedly subjected to violence by the partner (41?%). In 80.6?% of cases the forensic physical examination was conducted within 48 h of the incident. In 91.7?% of the patients the detected injuries were predominantly located on the upper extremities (67.1?%), head (55.1?%) and neck (45.8?%) and were often caused by life-threatening actions (50.5?%). These were mostly due to blunt force (70.8?%), sexual assault (31?%) and violence to the neck. Of the victims 82.8?% expressed subjective complaints during and/or after having been subjected to violence on the neck and in 74.7?% visible injuries to the neck or petechiae in the facial region could be detected. As a result of sexual violence by the partner only unspecific, insignificant anogenital findings could be detected.

Conclusion

A forensic physical examination of the victim shortly after the incident is of eminent importance to ensure correct documentation of injuries and collection of biological traces, which can be used as evidence in court. Apart from the forensic physical examination for the police/public prosecution department, the Institute of Forensic Medicine of the MMH provides victims with a documentation of injuries and securing of evidence free of charge with the project “Netzwerk ProBeweis”, thereby closing a gap in the healthcare system.