In the context of mediastinal emphysema/pneumomediastinum,the main aetiologies are associated with oesophageal perforation,lung pathology or post head and neck surgery related.The main way to differentiate the patholo...In the context of mediastinal emphysema/pneumomediastinum,the main aetiologies are associated with oesophageal perforation,lung pathology or post head and neck surgery related.The main way to differentiate the pathologies would be through Computed Tomographic Imaging of the Thorax and abdomen with oral and intravenous contrast in the context of triple phase imaging.The causes of pneumomediastinum should be differentiated between traumatic and non-traumatic.Oesophageal perforation(Boerhaave syndrome)is associated with Mackler’s triad in upto 50%of patients(severe retrosternal chest pain,pneumomediastinum,mediastinitis).Whereas in cases of lung pathology this can be associated with pneumothorax and pleural effusion.展开更多
The importance of performing an early primary survey in‘silver trauma’patients in the detection of injuries has been well documented in reducing the associated morbidity and mortality.[1]In the past,when whole body ...The importance of performing an early primary survey in‘silver trauma’patients in the detection of injuries has been well documented in reducing the associated morbidity and mortality.[1]In the past,when whole body computed tomography(WBCT)was not commonly available,following initial examination patients would undergo chest radiograph and pelvic X-ray and then proceed to selective computed tomography(CT).With the relatively widespread availability of CT,the use of these X-rays has diminished.The reliance on clinical examination alone for the detection of underlying injuries is another matter of debate.展开更多
Dear editor,A young lady in her early 20s presented acutely with shortness of breath with her oxygen saturations on room noted to be mid to 70%with normal respiratory rate,and blue discolouration of the lips(Figure 1)...Dear editor,A young lady in her early 20s presented acutely with shortness of breath with her oxygen saturations on room noted to be mid to 70%with normal respiratory rate,and blue discolouration of the lips(Figure 1).The relevant past medical history and surgical history included well controlled asthma and a laparoscopic salpingectomy for ectopic pregnancy approximately 3 weeks previously.The only relevant recent history was use of cocaine over the preceding 48 hours.展开更多
Dear editor,Iatrogenic hypoglycaemia is a common acute presentation;either because of misuse,self-harm or criminal intent.The most common culprits are insulin and oral hypoglycaemics(sulfonylurea,biguanides)although a...Dear editor,Iatrogenic hypoglycaemia is a common acute presentation;either because of misuse,self-harm or criminal intent.The most common culprits are insulin and oral hypoglycaemics(sulfonylurea,biguanides)although aspirin,fluoroquinolone and beta blockers can be causative agents.Common symptoms include sweating,anxiety,tremors,and palpitations.Neuroglycopenic symptoms usually arise at serum glucose concentrations of<2.8 mmol/L and include dizziness,confusion,blurred vision,somnolence and more serious symptoms can be convulsions,coma and potentially death.展开更多
文摘In the context of mediastinal emphysema/pneumomediastinum,the main aetiologies are associated with oesophageal perforation,lung pathology or post head and neck surgery related.The main way to differentiate the pathologies would be through Computed Tomographic Imaging of the Thorax and abdomen with oral and intravenous contrast in the context of triple phase imaging.The causes of pneumomediastinum should be differentiated between traumatic and non-traumatic.Oesophageal perforation(Boerhaave syndrome)is associated with Mackler’s triad in upto 50%of patients(severe retrosternal chest pain,pneumomediastinum,mediastinitis).Whereas in cases of lung pathology this can be associated with pneumothorax and pleural effusion.
文摘The importance of performing an early primary survey in‘silver trauma’patients in the detection of injuries has been well documented in reducing the associated morbidity and mortality.[1]In the past,when whole body computed tomography(WBCT)was not commonly available,following initial examination patients would undergo chest radiograph and pelvic X-ray and then proceed to selective computed tomography(CT).With the relatively widespread availability of CT,the use of these X-rays has diminished.The reliance on clinical examination alone for the detection of underlying injuries is another matter of debate.
文摘Dear editor,A young lady in her early 20s presented acutely with shortness of breath with her oxygen saturations on room noted to be mid to 70%with normal respiratory rate,and blue discolouration of the lips(Figure 1).The relevant past medical history and surgical history included well controlled asthma and a laparoscopic salpingectomy for ectopic pregnancy approximately 3 weeks previously.The only relevant recent history was use of cocaine over the preceding 48 hours.
文摘Dear editor,Iatrogenic hypoglycaemia is a common acute presentation;either because of misuse,self-harm or criminal intent.The most common culprits are insulin and oral hypoglycaemics(sulfonylurea,biguanides)although aspirin,fluoroquinolone and beta blockers can be causative agents.Common symptoms include sweating,anxiety,tremors,and palpitations.Neuroglycopenic symptoms usually arise at serum glucose concentrations of<2.8 mmol/L and include dizziness,confusion,blurred vision,somnolence and more serious symptoms can be convulsions,coma and potentially death.
