Unbounded Medicine

A woman came to the office because of sharp epigastric pain. On physical examination nothing was wrong except of epigastric pain. An endoscopy was performed and reported as normal. An Upper Gastrointestinal Tract Barium Examination was ordered and we found a cascade stomach, which is a rare finding. We exlude other causes of abdominal pain […]

The best of this week on the Medical Blogsphere is up at HealthyConcers by Elisa.
This week Grand Rounds theme is called “Carnival of the Caregivers”
Take a look at her site, it worths it.
Regards,
Jon Mikel Iñarritu, M.D.

Purpura fulminans
It is a severe condition due to meningococcal sepsis, it occurs in 15 to 25% of those patients with meningococcemia.
The clinical picture is as follows: acute onset of cutaneous hemorrhage and necrosis secondary to vascular thrombosis and disseminated intravascular coagulation. Often there is pain followed by petechiae. Ecchymoses develop and evolve into painful […]

BEWARE! Gory Images

Regards,
Dr. Jon Mikel Iñarritu

Constantly i’m receiving comments to buy some drugs via online, is there a way to stop this? Is there a regulation? I’m getting every week a post with this words on it:
viagra, xanax, XanaX, online alprazolam, Valium, Toradol, morphine, ultram, blackjack, phentermine, poker, Online Casino, Levitra, Fioricet, illegal drugs
Is there any kind of law to […]

Via Diabetes Care Journal.
A cohort study (made by Yaggi, Araujo and McKinlay) who enroll men from 1987-9 to 2004 showed the next results:
Men reporting short sleep duration (< =5 and 6 h of sleep per night) were twice as likely to develop diabetes, and men reporting long sleep duration (>8 h of sleep per […]

I’ve been asked –and consulted- about “rare chest pain” in several times. I could notice that people is always worried about any kind of chest pain because the fear of suffer a heart attack or a pulmonary problem. Chest pain is one of the most common symptoms that require medical attention. You –as physician- should […]

A previously healthy 17 yo woman came in to the ER because she has suffer an automovilistic accident. On the initial evaluation she was with pulse ‘parvus et tardus’ with altered mental status. A chest x-ray was ordered and found an aortic rupture.

Because the bleeding was contained and she has just a little hemodynamic instability, […]

Insulinoma
The classic clinical manifestations are the Whipple’s triad (hypoglycemia, CNS dysfunction & revert of CNS dysfunction due to glucose administration) in 75% of patients.
Its incidence: This tumors are so rare. Probably the best series of insulinomas is from the Olmsted County (Mayo Clinic). This study (cohort) was seen over a sixth decade period (’27 to […]

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 […]

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 […]