RESUMEN
A 32-year-old man presented to the accident & emergency (A&E) department complaining of an inability to use his left arm and shoulder. The previous day he had injected heroin intravenously into his left antecubital vein. Examination revealed signs of a left-sided brachial plexus lesion. There was no history or sign of trauma. Neurological investigation revealed motor and sensory loss compatible with a complete brachial plexus lesion. He exhibited a very rare condition, asymmetrical atraumatic brachial plexopathy, thought to result from an inflammatory cause, which not only affects the brachial, but also other plexi or individual nerves in the body and thought to be related to repeated intravenous use of heroin. This is a condition for which there is no specific treatment but which usually resolves spontaneously in the absence of continuing heroin misuse.
Asunto(s)
Plexo Braquial , Heroína , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Brazo , Humanos , Masculino , Parálisis/inducido químicamente , Enfermedades del Sistema Nervioso Periférico/inducido químicamenteRESUMEN
It has previously been reported [Davenport & Birtle, 1990] that there is a positive association between nonfatal deliberate self-harm in adolescents and emotionally charged festivals, such as St Valentine's Day and Christmas Day. We studied all cases of nonfatal deliberate self-harm presenting to three Central London hospitals on St Valentine's Day and Christmas Day and on two control dates, between 1983 and 1989. No association was found between cases of deliberate self-harm and St Valentine's Day, but a negative association was found with Christmas Day.
Asunto(s)
Vacaciones y Feriados , Conducta Autodestructiva/epidemiología , Intento de Suicidio/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Incidencia , Londres/epidemiología , Masculino , Persona de Mediana Edad , Estaciones del Año , Conducta Autodestructiva/psicología , Intento de Suicidio/psicologíaRESUMEN
A tape measure, based on 50th centile weight for height and designed to permit easy drug dosage calculation, endotracheal tube size and DC cardioversion current dosages in childrens' emergencies, was tested for reliability by medical and nursing staff with varying paediatric experience. We found that the tape measure gave a reproducible estimate of weight and suggest that its use would facilitate decision making by inexperienced medical and nursing staff in paediatric resuscitation when there is no time to weigh the child.
Asunto(s)
Pediatría/instrumentación , Resucitación/métodos , Pesos y Medidas , Peso Corporal , Niño , Preescolar , Prescripciones de Medicamentos , Humanos , Lactante , Recién Nacido , Intubación Intratraqueal/instrumentación , PrescripcionesRESUMEN
We describe an effective splint for sprains of the metacarpophalangeal joint of the thumb.
Asunto(s)
Traumatismos de los Dedos , Articulación Metacarpofalángica/lesiones , Férulas (Fijadores) , Esguinces y Distensiones/terapia , Pulgar/lesiones , HumanosRESUMEN
The peak acid output to insulin 10-14 days after proximal gastric vagotomy (PGV) for uncomplicated duodenal ulcer in a control group of 11 men was 1.5 mmol/h, and this rose significantly (P less than 0.01) after a mean interval of 26.1 months to 5.3 mmol/h. The rise in the PAOI in 7 male patients undergoing PGV and hepatic interposition for duodenal ulcer was from 1.0 mmol/h to 4.5 mmol/h (P less than 0.05) over a mean interval of 13.1 months. No significant difference between the changes in the PAOI in the two groups of patients could be detected. It is concluded that separation of the lesser curve of the stomach from the cut edge of the lesser omentum by the left lobe of the liver after PGV in an attempt to block vagal regeneration does not alter the postoperative rise in acid secretion.