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surgery

  Laparoscopic cholecystectomy in a patient with an implantabl  2008-04-11, 00:00:00

  Pressure-controlled ventilation improves oxygenation during  2008-04-11, 00:00:00

  Analgesic effectiveness of caudal levobupivacaine and ketami  2008-04-11, 00:00:00

  Xenon or propofol anaesthesia for patients at cardiovascular  2008-04-11, 00:00:00

  Perioperative anaemia management: consensus statement on the  2008-04-11, 00:00:00

  East Perth Dentist has Become a Participating Dentist  2008-04-16, 22:14:43

  Murdoch Dentist has Become a Participating Dentist  2008-04-16, 22:44:38

  South Perth Dentist has Become a Participating Dentist  2008-04-16, 23:00:44

  How Long Should it be from Diagnosis to Surgery?  2008-04-12, 08:49:05

  Ewan McGregor skin cancer?  2008-04-23, 19:44:45

  
Questions:
1) What has been learned about this entity since 1982?
2) Should he be rechallenged with penicillin and kept on long-term antibiotic prophylaxis.
3) What role does "hypersensitivity" to bacterial exotoxins play in the dermatitis.
4) Does anyone have magic for cases such as this?
5) Allergic contact dermatitis will be ruled out by patch testing.

Comment: My plan at the moment is to "clean up" any residual infection, consider prophylactic antibiotics and work on the dermatitis. I will refer him to a lymphedema center, if possible, for evaluation. Aggressive management of his leg swelling will help. He was told not to bathe the leg and I think this sets him up for infection. Your thoughts will be greatly appreciated. This man's life revolves around his leg. He is a keen student, a political scientist and in his later years he must focus exclusively on a leg. Let's give him "a leg to stand on!"

Reference:
Recurrent cellulitis after saphenous venectomy for coronary bypass surgery.
Baddour LM, Bisno AL.
Ann Intern Med. 1982 Oct;97(4):493-6.

We describe a previously unreported complication of coronary artery bypass
grafting, recurrent cellulitis. Five patients had 20 episodes of acute
cellulitis, each occurring in the lower extremity in which saphenous venectomy
had been done. The cases were striking because the patients presented with high
fever and considerable systemic toxicity. The appearance of the lesions, presence
in one case of obvious associated lymphangitis, and prompt response in three
instances to therapy with penicillin alone all suggest group A streptococcal
infection. In one case, a beta-hemolytic, bacitracin-susceptible Streptococcus
strain was isolated from the lesion. The pathogenesis of this syndrome remains
obscure but, based on our understanding of postsurgical erysipelas, this
cellulitis likely results from the interplay of several factors, including local
compromise of lymphatic drainage, direct bacterial invasion, and acquired
hypersensitivity to streptococcal exotoxins.">A Leg to Stand On
 2008-04-04, 00:46:00

  Covariates of tramadol disposition in the first months of li  2008-03-16, 00:00:00

  Pharmacodynamic modelling of the bispectral index response t  2008-03-16, 00:00:00

  Ketamine gargle for attenuating postoperative sore throat  2008-03-16, 00:00:00

  One-lung ventilation induces hyperperfusion and alveolar dam  2008-03-16, 00:00:00

  Comparison of high- and low-dose intrathecal morphine for sp  2008-03-16, 00:00:00

  Infusion of hypertonic saline before elective hysterectomy:  2008-03-16, 00:00:00

  Drug-eluting stent thrombosis in patients undergoing non-car  2008-03-16, 00:00:00

  Comparison of the effects of gelatin and a modern hydroxyeth  2008-03-16, 00:00:00

  Perioperative hyperinsulinaemic normoglycaemic clamp causes  2008-03-16, 00:00:00

  Ultrasound-guided lumbar plexus block through the acoustic w  2008-03-16, 00:00:00

  Indooroopilly Dentist is Becoming a Participating Dentist  2008-03-10, 12:17:20

  

In a statement issued to Bernama in Kuala Lumpur today, the Malaysian Embassy in Paris said Dr Tan's father, Datuk Tan Gin Soon, believed that her daughter would have wanted him to donate her organs, given her "deep and abiding interest" to serve fellow human beings.

Died from complications

Her family has donated her organs, including her corneas, heart, kidneys and liver, to patients in France and other countries of Europe.

The statement said Dr Tan had undergone treatment at the Fondation Rothschild, under the care of Professor Jacques Moret, a world-renowned interventional neuro-radiologist.

It said the complicated procedure of the embolization of the AVM on March 11 went well but Dr Tan's condition took a turn for the worse and she died on Wednesday due to complications from the follow-up surgeries.

Dr Tan's remains will be flown from Paris to Penang today.


I am so sad to hear this piece of news.

I have also read all the accounts posted in Chev's Facebook leading to the unfortunate event.

My condolences.

Update links:
Star
MAF
Flickr
">Malaysian doc donates organs to European patients
 2008-03-29, 09:05:00

  Perth Dentist is Becoming a Participating Dentist  2008-03-05, 11:02:08

  Felixstown Dentist is Becoming a Participating Dentist  1970-01-01, 02:00:00

  Anyone Else Have Chronic Constipation After Colon Surgery?  2008-02-18, 08:24:04

  Awareness and memory function during paediatric anaesthesia  2008-02-14, 00:00:00

  Inflammation-induced up-regulation of ionotropic glutamate r  2008-02-14, 00:00:00

  Effects of magnesium sulphate on intraoperative anaesthetic  2008-02-14, 00:00:00

  Perioperative tobacco use interventions in Japan: a survey o  2008-02-14, 00:00:00

  Evaluation of a decision support system to predict preoperat  2008-02-14, 00:00:00

  Effects of colloid and crystalloid solutions on endogenous a  2008-02-14, 00:00:00

  Delta down compared with delta pulse pressure as an indicato  2008-01-22, 00:00:00

  Preventive effects of perioperative parecoxib on post-discec  2008-01-22, 00:00:00

  Controlled comparison between betamethasone gel and lidocain  2008-01-22, 00:00:00

  Tracheal intubation of morbidly obese patients: a randomized  2008-01-22, 00:00:00

  Coronary artery bypass grafting in the awake patient combini  2008-01-22, 00:00:00

  Epidural analgesia compared with peripheral nerve blockade a  2008-01-22, 00:00:00

  Labor Digs its Teeth into HIV Dental Help  1970-01-01, 02:00:00

  Pets Need Dental Care Just Like People  1970-01-01, 02:00:00

  Unusual Keratoderma  2008-01-08, 12:09:00

  Overview of Colon Cancer Surgery  2007-12-01, 08:10:52

  the Y chromosome  2006-03-08, 14:21:00

  sevoflurane  2006-03-15, 13:53:00

  Benoxinate  2006-03-17, 13:26:00

  Effect of communication on pain during intravenous cannulati  2007-11-15, 00:00:00

  Anaesthesia for spinal surgery in children  2007-11-15, 00:00:00

  Determinants of outcome in critically ill octogenarians afte  2007-11-15, 00:00:00

  Preoperative shuttle walking testing and outcome after oesop  2007-11-15, 00:00:00

  Prevalence of anaemia before major joint arthroplasty and th  2007-11-15, 00:00:00

  Reduction of pain during induction with target-controlled pr  2007-11-15, 00:00:00

  Serious Bad Breath  1970-01-01, 03:00:00

  Top 4 Lasers for Removing Acne Scars  2007-05-18, 15:58:44

  

I know almost every time it's going to rain. It's not superstition; it's knee surgery. Believe me when I tell you, my knee is as accurate in predicting rain as the Doppler 5000.

Later that morning we got into the car to go the the gym, and it happened. Rain.

I excitedly flipped on the windshield wipers -- I had purchased new ones the day before Easter and hadn't used them yet. Like two little kids, we were entranced by the blades slapping away the rain in efficient strokes. It was a satisfying a moment, really. Not five minutes later we were rudely interrupted by the vibrating, whooping sound of new wipers dragging across a dry windshield.

Itā??s hard to fathom how a place as lush with flora and vegetation as Southern California could be so dry. Incredibly, the average rainfall in San Diego is just 7 inches -- we used to get 7 inches on any given weekend in North Carolina.

While life without rain has its distinct advantages, sometimes I just long for a rainy day. We had some Ballykissangel to watch, some magazines to catch up on, and, of course, some soup to make. Because whatā??s a chilly, rainy day without a good bowl of steaming hot soup? The all too brief interlude of rain didn't deter us. We savored a few episodes of Ballykissangel, made it through at least a third of our magazine pile, and enjoyed some wholesome red lentil mulligatawny with apple-celery salsa.

The recipe is adapted from an original in Cooking Light. The zesty, crunchy apple-celery salsa contrasts pleasingly with the smooth, creamy lentils. I adjusted the soup by sauteing the onions for added depth and mixing in some extra seasonings--the cinnamon in particular lends a lovely sweet, aromatic touch. Made with creamy coconut milk, this is a warming, savory soup perfect for a rainy day. Or a chilly day. Or a windy day. Or a sunny day.


Red Lentil Mulligatawny with Apple-Celery Salsa
Print this recipe here.
Makes 2 bowls or 4 cups

Salsa:
½ cup finely chopped Granny Smith apple
¼ cup finely chopped celery
½ Tbsp chopped fresh cilantro
½ Tbsp fresh lime juice

Soup:
2 tsp olive oil
¾ c chopped onion
1 ½ c water
¾ c red lentils
¾ cup light coconut milk
1 tsp fresh grated ginger
½ tsp ground cumin
¼ tsp turmeric
¼ tsp coriander
¼ tsp cayenne pepper
1/8 tsp ground cinnamon
½ tsp fresh lime juice
Salt, to taste

For salsa: Combine all ingredients; set aside.

For soup: Heat oil in a medium saucepan over medium heat. Add onion; sautƩ until golden, about 3-5 minutes. Add lentils and water; bring to a boil. Cover, reduce heat to low, and simmer 12-15 minutes or until lentils are tender. Pour half of the lentil mixture in a blender; let stand for 5 minutes (so the soup will cool and not cause the cover to pop off!) Pour pureed lentil mixture into a bowl, and repeat process with the remaining half of lentil mixture. Once the soup is blended, return to the pan; add coconut milk, ginger, cumin, turmeric, coriander, cayenne, and cinnamon; stir well. Cover and simmer for about 5-10 minutes or until thoroughly heated through. Remove from heat; stir in the lime juice and season with salt. Ladle soup into bowls and garnish with some salsa.

I am submitting this post to Haalo of the beautiful Cook (almost) Anything ...at Least Once who is hosting this week's edition of the ever popular Weekend Herb Blogging created by Kalyn. In addition to being quick cooking and delicious, red lentils are high in protein, soluble fiber, and magnesium. So they'll keep you satisfied and help promote cardiovascular health.

Here are some other rainy day foods you might like:

Italian Pignoli Cookies and Spiced Coffee
Nanā??s Italian Lentil Soup
Butternut Squash Risotto with Toasted Walnuts and Blue Cheese

And here are a few more tasty dishes featuring red lentils:
Daily Unadventures in Cooking's Red Lentil and Yam Curry
Group Recipes' Everyday Red Lentil Dal
Habeas Brulee's Pasta with Red Lentils, Ginger, and Spinach

Save This Page on Del.icio.us ">Red Lentil Soup and Rainy Days (Rainy Minutes Anyway)
 2007-10-05, 15:50:00

  High rate of wound complications in skin biopsies performed  2007-11-04, 01:44:16

  
The patient is a pleasant outgoing woman who appears about her stated age. She has velvety hyperpigmentation of her skin folds.



In addition, she has developed around 10 verrucous tumors measuring 8 - 10 mm in diameter on arms and legs. One of these was biopsied.

A C.T. scan performed on the day of the dermatology visit revealed what appeared to be metastatic tumors in the peritoneum. The workup is in progress.

Most cases of acanthosis nigricans (AN) are benign and related to ethnicity, obesity or endocrinopathy. AN developing in an elderly individual should be a red light to pursue a work-up for malignancy. AN is an easy diagnosis to make and a four month delay in diagnosis is unfortunate. In all likelihood, this tumor had metastasized before the AN became manifest, but it seems unfortunate that the delay in diagnosis occurred.

A good review of AN can be found on eMedicine."