With the advent of technology in modern medicine, there has been some alteration to the classic ABCs of medicine, which probably means good news, as diagnosis can be made faster, more easily and more accurately. Remember, repeat after me…
Airway
Breathing
CT scan.
bwahahahaha.
President Bush has gotten a colonoscope done, as a screening for colon carcinoma. Apparently, the procedure was performed under sedation, and he had to hand over the presidential power during the duration of the procedure.
A few polyps were removed from the presidential colon, and will be tested, probed, frozen, cut up, microscoped and stained.
Colonoscopy remains the gold-standard for diagnosis of colonic carcinoma. However, screening options include other far less invasive options like screening for faecal occult blood, barium enema studies or even CT colonoscopy.
A new study carried out by researchers from the Johns Hopkins Bloomberg School of Public Health has predicted that the incidence of obesity in American adults is set to rise over the next eight years, with around 75% of Americans overweight by 2015.
The researchers found that obesity rates in America have been steadily increasing at between 0.2% to 0.8% annually over the past three decades. For example, between 1960 to 2004, the percentage of obese adults in the USA increased from 13% to 32%. Also, obesity rates increased at a faster rate among minority and poorer socio-economic groups.
Being overweight is defined as a person having a Body Mass Index (BMI) above 25, while an obese person has a BMI is 30 or over.
Potential morbidities of being obese / overweight ;-
– Premature death. The more you weigh, the greater the risk. If your BMI is greater than 30 you have a 50-100% higher risk of premature death compared to a person with a healthy weight.
– Heart disease. The incidence of heart attack, congestive heart failure, sudden cardiac death, angina and abnormal heart rhythm is greater for people whose BMI is above 25.
– Hypertension. An obese person has twice the risk of having high blood pressure compared to someone of normal weight.
– Dyslipidaemia. If you are obese, your levels of blood fat will be higher and your levels of HDL (good cholesterol) will be lower than those of a person of normal weight.
– Diabetes Mellitus. More than 80% of people with diabetes are overweight/obese.
– Cancer. A person who is overweight/obese has a higher risk of developing the following cancers: colon, gall bladder, kidney, prostate, post-menopausal breast cancer.
– Sleep apnea. A much higher percentage of obese people suffer from interrupted breathing while sleeping than people of normal weight, which can reduce oxygen supply to vital organs and increase the risk of stroke and premature death.
– Arthritis. Your risk of developing arthritis goes up.
– Pregnancy.An obese pregnant mother faces a much higher risk of maternal high blood pressure and gestational diabetes. Obese pregnant women are also at a higher risk of giving birth to babies with birth defects.
While the BRCA 1 and 2 genes are associated with a higher risk of breast cancer, for those who do get breast cancer, it is apparently NOT associated with an increased mortality rate, according to a study publihed in the NEJM. Read more ..
Presenting with generalised bony symptoms,
radiologically -
Thin undulating periosteal reaction, over long bones,
may be associated with COPD / emphysema, carcinoma of the lung, malignant thymoma.
Classic metaphyseal lesion – maybe be associated with subperiosteal haematoma / perosteal reaction
Subdural haemorrhage with long bone fractures
Posterior rib fractures
Multiple injuries of differing ages.
Wormian bones are defined as intrasutural bones.
Risk factor for osteogenesis imperfecta
- more than 10 in number
-Â measuring greater than 6 mm by 4 mm
- arranged in a general mosaic pattern
Â
 Although computed tomography (CT) remains the most frequently used imaging examination in acute cerebral infarction, its sensitivity for early detection of strokes remains limited. In middle cerebral artery (MCA) strokes less than 6 hours old, loss of definition of the gray- white interface in the lateral margins of the insula (”insular ribbon”) was observed. . The insular ribbon is supplied by the insular segment of the MCA and its claustral branches. With cessation of MCA flow, the insular ribbon becomes the region most distal from the anterior and posterior cerebral collateral circulations. Consequently, the insular ribbon effectively becomes a watershed arterial zone. Loss of the insular ribbon is thus a reflection of acute edema due to infarction. Loss of the insular ribbon appears to be another frequent and reliable finding in acute MCA stroke.
One of the most interesting pieces in the news today is that British scientists and doctors may have found a method to cure Type 1 Diabetes Mellitus. This is a type of diabetes that primarily presents in younger patients, often as potentially fatal diabetic ketoacidosis which may lead to coma and death. These patients are almost always on life-long insulin injections.
However, a solution has been found, where doctors harvest islet cells from cadaveric pancreas, meaning, from dead bodies, and then inject these cells into the patient’s liver. An average of 3 injections is required, and some patients have been almost completely cured, not requiring any insulin injections at all.
More research will need to be done, but it appears that there is light at the end of the tunnel for these young patients.