Res Medica (E-Journal)
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The Diving Casualty, Aetiology and Management
Get PDFAdapted and revised from a dissertation read before the Society on Wednesday 1st February 1978AbstractThe logarithmic increase in diving, both professional and amateur, is paralleled by an unprecedented rise in related morbidity and morality. Improved breathing apparatus and protective clothing are enabling man to remain in water longer and to dive deeper than ever before. Many diving accidents are untreatable owing tothe circumstances in which they occur: in a modern saturation diving system it may be impossible to bring a diver back to atmospheric pressure in less than several days — whatever the medical emergency. However, an increasing number of fatalities are occurring due to lack of knowledge of the basic signs and symptoms which a diver, surfacing obviously with great difficulty, may present.This dissertation is an attempt to review and collate current work and knowledge of the medical problems presented by the underwater environment
The Diagnosis of Knee Pain
Get PDFThe knee is open to injury because it is designed for rapid action, not simply during its large excursion from extension to full flexion, but also lesser accommodative movements of rotation, tilt and glide. As if that were not enough, that highly developed but sometimes temperamental sesamoid, the patella, adds its own unique problems. The complexities of these movements are reflected in the subtleties of the structure of the knee. Regrettably they have also led to a proliferation of clinical tests and surgical repairs whose sophistication confuses rather than enlightens.Before enquiring about the characteristics of the painful knee the general characteristics of the patient should be assessed quickly. In children problems usually relate to patellar malalignment syndromes, possibly a discoid meniscus, and the aching discomfort produced by traction apophysitis such as Osgood-Schlatter\u27s disease of the tibial tuberosity. After puberty girls are particularly likely to develop patellar pain, which may be associated with lateral subluxation of that bone. In the young woman the sources of such pain may be so prolix that the surgeon may do more harm than good if he operates. During adolescence and early adult life males are most likely to suffer from meniscal and ligamentous tears, often brought on by exertion or accidents during sport. A patient with an endomorphic physique usually has associated genu valgum and may present with medial ligament sprains and patello-femoral pain. Those with ligamentous laxity are also prone to sprains and patellar subluxation. The mesomorphic athlete is likely to injure the menisci, or may come in with significant tears of the ligaments and synovium
Management of the HIV-infected patient before the Development of AIDS
Get PDF19th century and early 20th century physicians taught their students: “Know syphilis and you will know medicine.” In this last decade of the 20th century, physicians could justifiably substitute the word ‘AIDS’ for ‘syphilis’. Every aspect of human immunodeficiency virus (HIV) infection - whether the epidemiology, immunology, pathogenesis, diagnosis, management or prevention - presents an intellectual challenge to our profession. Politicians, educationalists, doctors and the lay public ignore this disease at their peril. We all have a duty to ourselves and to future generations to do everything possible to control and ultimately to eliminate HIV infection
Journal scan
Get PDFThis is a short collection of interesting items pertinent to medicine and science in general. It gives a taste of some of the current work in hand around the world. We would welcome any contributions of this nature, just a short chatty narrative of an interesting or amusing article that you have seen or read.CoffeeA recent study1 of ‘healthy’ moderate drinkers (consuming 4-6 cups per day; moderate? I call that low.) showed that on switching to decaffeinated (in a blind trial) many developed headaches for 2-3 days.One good reason not to stop? Need another good reason? Here goes ...A report(2) from Sheffield states that coffee induces a desire to defaecate (by increasing activity in the rectosigmoid) in nearly 30% of people. For some unexplained reason this predominately affects women! - a cheap cure for constipation? Unfortunately the effects of the evil brew doesn’t end there; about the same number of people (30% of the population) find that coffee aggravates their symptoms of irritable bowel syndrome.Will the coffee saga never end?
The Drife Diaries
Get PDFAs readers will be aware, Teviot Row is alive with rumours that an ex-Edinburgh medical student is threatening to publish the diaries he kept during his undergraduate days in the "Swinging Sixties". His former colleagues, now distinguished medical men, are said to have offered large sums as "hush money" to "Doctor X", and several Edinburgh Publishing Houses have experienced burglaries and arson attacks, as well as telephone calls hinting at complications should the publisher ever need medical treatment. Undaunted, in what must be journalism\u27s coup of the decade, Res Medica has secured exclusive rights to these manuscripts, and after consultation with our lawyers (who advise us that their authorship must remain a closely guarded secret) we now present the final instalment of the first extracts from The Drife Diaries. Previous issues available from the RMS office
The Loneliest GP
Get PDFTristan da Cunha, the lonely Island with the exotic name, forms the setting for Dr Digby Thomas\u27 reflective and retrospective look at his time \u27castaway\u27 In the South Atlantic.Tristan da Cunha is the most remote permanently inhabited place on the planet. Easter Island in the Pacific, the runner-up, has a long runway bringing two jetloads of tourists each week; Tristan, having no airstrip, is reached from Cape Town after five or six days at sea with up to three months between sailings and there is little casual tourism
Update on CJD
Get PDFIn March 1996 the discovery of a new form of Creutzfeldt-Jakob disease (CJD) was announced to a shocked world. In order to understand why this news took the headlines by storm, it is necessary to trace the history of this rare disease and in particular its links with bovine spongiform encephalopathy (BSE), or “mad cow disease”. By 1996, Britain had been in the throes of the BSE epidemic for ten years and it was believed that cows had contracted the disease by consumption of scrapie contaminated food-stuff, scrapie being a similar but much older disease in sheep. Because this represented a species jump from sheep to cows, it was predicted in many quarters that BSE posed a new threat to human health. Therefore the Government took steps to remove BSE contaminated products from the human food chain and the Department of Health set up a surveillance programme to monitor the incidence of CJD in UK
For the Relief of Pain
Get PDF“We humans are the most exquisite devices ever made for the experiencing of pain: the richer our inner lives, the greater the varieties of pain there are for us to feel - and the more resources we will have for mitigating pain”\u27 so say the authors of your trusty Oxford Handbook of Clinical Medicine. Hmm. Few people like to experience pain (there is the odd masochist out there) but we endure it knowing it is for our own good. Looking back though my second year neuroscience notes I find Dr. Malcom Wright exhorting us to remember that: “Pain is an unpleasant sensory experience quite distinct from any other form of sensation. It occurs following noxious (nociciptive) stimuli in normal persons and is the presenting symptom in many disease states. It is a warning that damage has occurred in the body”2
RIE
Get PDFThe building of the New Royal Infirmary is now under way. How can this smaller hospital meet the demands of its surrounding population? The Royal Infirmary of Edinburgh at Lauriston Place is soon to be replaced by a new 869 bed teaching hospital to be built in Little France, 3 \u27/2 miles from the city centre. Currently the 1067 bed hospital provides acute care, rehabilitation and long term care as in-patient services as well as a wide range of out-patient facilities. The new RIE will be adopting a new method of care provision and will be organised in a different way to maintain the existing clinical services at the same time as meeting the demands of teaching and research
Health for All by the Year 2000 - Where has the WHO gone?
Get PDFEnjoyment of the highest attainable standard of health is a fundamental human right of all people 2. This is seen as an important outcome as well as a goal of sustainable human development. Yet at the dawn of the 21st century massive worldwide disparities in the provision of health care continue to exist; 800 million people still lack access to health services 3. The rate of development of the first world has been greater than that of the third world so the gap between “haves” and “have nots” is greater than ever; the richest 1.2 billion people in the world account for 82.7% of the total global wealth4