Unbounded Medicine

Thrombosed external hemorrhoids often occurs in grade III-IV internal hemorrhoids, and can cause excruciating pain, and patients will often present acutely. In such cases, surgical evacuation of the hemorrhoid can produce immediate relief.
The treatment of choice is hemorrhoidectomy with partial lateral internal sphincterotomy, which consists in incised the mucosa on each side of the hemorrhoid […]

This is a rare complication of subclavian venopuncture:
Inadvertent subclavian arterial puncture

In inexperienced hands it could be a fatal procedure. So, in this case, it was too late when we try to stop that massive bleeding after a surgery interconsultation.
Regards,
Jon Mikel Iñarritu, M.D.

technorati tags: hemomediastinum, subclavian venopuncture, mediastinal hematoma, surgery, medicine, medicina, unbounded […]

50 y/o woman history of respiratory simptoms.

This woman has this cutaneous lesions distributed all over the body. She has history of vitiligo.

Pemphigus and bullous pemphigoid.
These are autoimmune blistering diseases. They are caracterized by the production of antibodies directed against different epitopes, resulting in intraepidermal blistering in pemphigus and subepidermal blistering in pemphigoid. The term pemphigus comes from […]

A friend from the “INER” National Institute for respiratory diseases, show me this image. It was taken after a extraction from bronchoscopy in a man with atelectasis of the lung.

Regards,
Gerardo Morales, M.D.

The patient is a young man with onychocryptosis secondary to overweight. At the images below a matricectomy with remotion of soft tissue are shown. This procedure is performed bedside in few minutes and only need local anesthesia. The goal is to release the nail from the surrounding tissue.

Gerardo Morales, M.D.

CT

At Mexico City The village of Tlalpan at the south of the city concentrates aproximately 80% of specialized medical atention in the country. At the image from a Satellital view are identified some very important hospitals that are at walking distance in a residential zone.

Regards,
Gerardo, M.D.

technorati tags: tlalpan, earthquake, institutos nacionales […]

50 y/o male with a history of one year with respiratory symptoms, he was diagnosed treated at Guatemala where he lives. Now he comes to Mexico City seeking for a second opinion and other options of therapy. At the physical examination he is well, has diminished breath sounds and just sinus tachycardia. […]

Regards,Jon Mikel Iñarritu, M.D.
technorati tags: left bowel obstruction, mechanical obstruction, diverticulitis, intestinal obstruction, surgery, acute abdomen, abdominal, medicine, medicina, unbounded medicine

Via AACE from J Davidson, P Jellinger, L Blonde, H Lebovitz, C Parkin (2005):

The new position statement is this: Even if the initial A1C is from 6 to 7%, you should start pharmacotherapy.
This aggressive treatment has proved that mortality diminishes considerably.

Regards,
Jon Mikel Iñarritu, M.D.

technorati tags: diabetes, diabetes mellitus, A1C, AACE guidelines, guidelines, pharmacotherapy, medicina, […]

Boston Scientific ENTERYX Procedure Kits and Injector Single Packs .
via FDA Safety I nformation Alerts:
For those who haven’t consider endoscopic procdedures for the treatment of GERD, well, at least, you shouldn’t think in Enteryx treatment.
FDA and Boston Scientific notified healthcare professionals and patients about serious adverse events, including death, occurring in patients treated with ENTERYX, […]

This week’s Grand Rounds is hosted by Doc Shazam, she starts with a nice gruop categorization, the conclusion of this roundup is to let us know that in medicine’s blogsphere there is not all about medicine. Here we have the categories.

Specific Diseases
Training
Technology
Ethics
Humor
Delivery
Geek Stuff
Psychology
Medical Trivia, and
Narrative

So please, be sure to visit her site and stay up-to-date […]

via Reuters Health and Headache 2005;45:973-982:

National Headache Foundation guidelines for abortive treatment of migraine aren’t right?
This study states that the combination of acetaminophen, aspirin, and caffeine (AAC) is superior to sumatriptan in migraine’s early treatment.
Goldstein et al, compared the combination treatment with 50mg sumatriptan in 171 subjects treated when the first symptoms ofmigraine occurred. […]