Medical Mysteries, Bizarre Cases

Shady

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I really need to hear more! Were they worms then? They don't usually give you food poisoning straight off from pork. Something much worse was going on there!
All i remember is they were black and thickish and just floating, by thickish i mean bout quarter of an inchish, my hubby was not one of those peeps who moaned when he was ill, this really knocked him back all that from a pork pie, it was from a shop when we lived in Skeggy, we should have told them, god knows how many more was ill.


Oooo just got my FT 387
 

EnolaGaia

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This woman's severe rheumatoid arthritis escalated to include a rare condition in which the bones in the hands and wrists shrink, resulting in the fingers "telescoping" (as in collapsing a segmented telescope).
Woman's Bones Shrank in Rare Case of 'Telescoping Fingers'

A rare condition caused a woman's fingers to scrunch back into her hands as the bones of her hand and wrist steadily disappeared, according to a report of the case.

The bone loss caused the 69-year-old woman's fingers to buckle back into her hand like segments of a collapsing telescope, a distinct symptom that explains the unusual condition's nickname: "telescoping fingers."

An estimated 3.7% to 6.7% of people with a condition called psoriatic arthritis develop "telescoping fingers," according to a 2013 report in the journal Reumatología Clínica; the condition also occurs in people with rheumatoid arthritis, but even more rarely. When clinicians originally described the condition, in 1913, they called it "la main en lorgnette," or "the opera-glass hand." That term referenced the telescoping action of magnifying glasses used by theatergoers to enhance their view of the stage, according to a 1938 report in the Journal of Bone and Joint Surgery.

In the recent case, described in a report published today (Dec. 11) in The New England Journal of Medicine, the woman's hands appeared severely deformed and swollen when she went to a rheumatology clinic in Turkey for treatment. The patient had been diagnosed with rheumatoid arthritis 18 years earlier, and over time, her knuckles had grown so swollen that her fingers skewed to one side, toward her pinky fingers, her doctors noted. Upon examining the patient's hands, the doctors discovered that the bones of her displaced digits seemed unusually short — far too short for the woman to properly flex her fingers or make a fist.

Radiographs of the patient's wrists and hands revealed the extent of the damage: The bones of the woman's fingers, hand, wrist and lower forearm appeared worn down, as if substantial amounts of tissue had disappeared. The doctors diagnosed the woman with telescoping fingers, medically known as arthritis mutilans, and attributed the tissue loss to a process called osteolysis, which causes bones to be "reabsorbed" by cells called osteoclasts. ...
FULL STORY: https://www.livescience.com/woman-with-rare-case-of-telescoping-fingers.html
 

EnolaGaia

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A physician passenger on an airline flight diagnosed and resolved what appeared to be another passenger's stroke. It turns out that the paralysis on one side of the victim's face was caused by pressure effects rather than a true stroke event.
Doc on plane diagnoses man's unusual condition midair

A few minutes after his flight reached cruising altitude, Dr. Alan Hunter responded to a flight attendant's call for a doctor on board. A passenger was having a stroke, or so it seemed, the attendant said. This was certainly urgent — a passenger having a stroke could be one reason for an emergency landing.

But the passenger, whose face was drooping on one side, wasn't having a stroke after all, Hunter determined. Rather, the passenger had an unusual yet typically temporary condition, resulting in part from pressure changes in the airplane. No emergency landing was needed, and with Hunter's help, the patient was soon feeling fine. ...

Hunter, who is an internal medicine doctor at Oregon Health & Science University, said he had never seen a case like this before. To alert other doctors about this condition, Hunter described the case in a report published Monday (Jan. 27) in the journal Annals of Internal Medicine. ...

When Hunter responded to the call, the patient told Hunter that he'd had a sudden headache and pain and a sense of fullness in his ears, as well as slurred speech and drooling. But the case didn't look like a stroke, Hunter said. When people's faces droop on one side during a stroke, usually either the top or the bottom of the face is affected. In this case, the entire right side of the patient's face was drooping. And the patient was young and healthy looking, making stroke less likely, Hunter said. The patient also mentioned that he'd just recovered from a cold.

"Ultimately, it just made sense that it was a pressure-related phenomenon" rather than a stroke, Hunter said. ...

Because Hunter suspected that the patient's symptoms might be due to a clogged eustachian tube, he had the patient swallow a few times. He also gave the patient some extra oxygen. Within minutes, the patient was back to normal.

At the time, Hunter didn't know exactly what condition he had just treated. But after he got off the plane, he did some research and found something called facial barotrauma, a condition that seemed to fit the current case. Most often described in scuba divers coming up from the deep, facial barotrauma occurs when a patient experiences a drop in pressure, and a blocked eustachian tube reduces blood and oxygen flow to one of the facial nerves. In the case of a diver, that pressure drop occurs as the patient swims toward the surface and water pressure lessens; in the case of an airplane passenger, it happens as the plane rises and atmospheric pressure drops.

According to Hunter's research, this phenomenon happens only if the eustachian tube is somehow dysfunctional. ...
FULL STORY: https://www.livescience.com/in-flight-diagnosis-facial-barotrauma.html

==========================

Published letter (report) on the incident:

Annals of Internal Medicine
28 January 2020

Unilateral Facial Paralysis During an Airline Flight
Alan J. Hunter, MD

Background: A medical emergency during a commercial airline flight may require an unplanned landing, which disrupts travel plans and is expensive.

Objective: To alert clinicians to a condition that can mimic acute stroke but does not require an unplanned aircraft landing. ...

https://annals.org/aim/article-abstract/2759790/unilateral-facial-paralysis-during-airline-flight#
 

Ermintruder

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Published letter (report) on the incident:

Annals of Internal Medicine
28 January 2020
So to be clear on this, please: is it the case that in the USA, a medical doctor who is an "internist" is not an 'intern'? Ie they are NOT in the process of receiving training in a specialism, but have arrived at a professional destination, or level of vocational capability? And: an ''internist'' is not an 'internalisist'(sic) despite being a specialist in internal medicine? (US terms)

Because I'm not really helped by this definition:
Wikipedia said:
Internal medicine or general internal medicine (in Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists, or physicians (without a modifier) in Commonwealth nations
I've never head the term "general internal medicine" used in the UK, but have (of course) always heard the term 'general practise', or "general practitioner" (which is the term used in the UK for a family/community doctor (cf someone "seeing their GP") I've also always known that this term was unrecognised in the US, but had assumed it was in general use across the Commonwealth (it certainly is, in India, but I'm now unsure re Canada).

I'm now puzzling over whether I would've forgivably-presumed that 'Internal Medicine' refers to biological ailments internal to the sufferer: but surely that starts to get into a strange tautology....also might that mean that 'external medicine' (as it were, if it definably-existed?) might be looking at disease and pathological situations, rather than the victims?

I'm now really puzzling over this: and (because I've started to think too much about it)....is there a parallel between someone in medicine being an "intern" (ie 'practicing' in the British-not-US strict sense of the word, ie almost an apprentice-under-training, the status of what we'd now call in the UK a "foundation doctor); and someone 'practising' medicine (this in the British/Commonweath/semi-deprecated sense of the word, and probably not recognised as a differentiated word in the US at all) a state of being where they have already-mastered their discipline....
viz
'intern' to 'internist'

versus
'practice' into 'practise'
 
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EnolaGaia

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So to be clear on this, please: is it the case that in the USA, a medical doctor who is an "internist" is not an 'intern'? Ie they are NOT in the process of receiving training in a specialism, but have arrived at a professional destination, or level of vocational capability? And: an ''internist'' is not an 'internalisist'(sic) despite being a specialist in internal medicine? (US terms) ...
One refers to the stage of professional development, whereas the other refers to the focus of professional interest and expertise.

As I understand it ...

Intern (as used in medicine): Someone in a professional field who is near or beyond the completion of their professional (book-learning) education and who is serving a period of supervised practical experience before being finally certified as a journeyman professional.
(Not to be confused with "a student or non-professional serving as a junior grade helper" - e.g., "office intern".)

Internist: A medical sub-field or area of specialization focusing on diagnosis / treatment of problems (including diseases) "internal" to the body, but not encompassing direct participation in treatment involving surgical intervention. Internists analyze and treat, but they don't "cut."

Crudely stated: All licensed internists will have been interns at some point, but not all interns will become internists.
 

ramonmercado

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Some more background to the Yosemite cases.
Oh dear! Hantavirus is back!


Even when the world is trying to find a cure for the dreaded coronavirus pandemic, a report in Global Times said that a man from China's Yunnan province died from Hantavirus while on a bus to the Shandong province.

All the fellow passengers on the bus have been tested for the virus.

What is Hantavirus?

The Centre for Disease Control says that the virus is spread mainly from rodents. It goes on to say that infection with any of the hantavirus can cause hantavirus disease in people. "Hantaviruses in the Americas are known as “New World” hantaviruses and may cause hantavirus pulmonary syndrome (HPS). Other hantaviruses, known as “Old World” hantaviruses, are found mostly in Europe and Asia and may cause hemorrhagic fever with renal syndrome (HFRS)," the CDC website said.

https://m.economictimes.com/news/in...leshow/74793841.cms?__twitter_impression=true
 
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