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Ludwig’s Angina

May 1st, 2006

Ludwig’s Angina – Part 1

This is a fortunately uncommon but potentially fatal bacterial infection of the fascial planes of the oral cavity. Causative bacteria are most commonly Staphylococcus and Streptococcus, but Haemophilus and anaerobic bacteria have been reported.

Ludwig’s angina presents with neck swelling and redness of the skin (erythema), swelling under the chin (submandibular area), fever, board-like rigidity in the floor of the mouth, elevation and posterior displacement of the tongue, and difficulty swallowing. It can also cause drooling, earache, confusion and mental status changes, and fatigue.

Copyright 2006 Insidesurgery.com

May 1, 2006

May 1st, 2006

Jury Appears Deadlocked in Murder Trial of Eye Surgeon

The jury in the murder trial of Dr. Bradley Schwartz is entering the fourth day of deliberations. Schwartz, an Arizona eye surgeon, is accused of hiring a hit man to kill fellow Arizona eye surgeon Dr. Brian Stidham.

April 30, 2006

April 30th, 2006

Patient Discusses Her Knee Replacements With New, Minimally Invasive Technique

Retired pediatrics nurse Suzy Palmer talks about how easy her knee replacements were for her (no general anesthesia, discharged home on the same day) with the new minimally invasive technique available that spares cutting most of the major muscle groups around the knee.

April 29, 2006

April 29th, 2006

Indian Politician Undergoes Another Round of Surgery

In a very misleading statement, a newspaper article from India is reporting that Pramod Mahajan has undergone an additional “minor” surgery. This is misleading because a tracheostomy, exploratory laparotomy, debridement of necrotic pancreas, and placement of surgical feeding tube in the jejunum in an already ill patient is a hugely morbid procedure. The historical overall mortality rate for ICU patients that receive a tracheostomy alone is 30%.

New Eye Surgery for Patients Who Can’t Get Lasix

A new procedure first approved by the United States Food and Drug Administration this winter is being performed in Omaha, Nebraska. Dr. John Liu of the Omaha Eye and Laser Institute.

April 28, 2006

April 28th, 2006

Barry Bonds’ Surgeon Testifying Today

In the ongoing saga of Barry Bonds and possible steroid use, his orthopedic surgeon Dr. Arthur Ting is scheduled to testify before a grand jury today. The editor’s question is – can he be compelled to testify? Whatever happened to doctor-patient privilege? Or is he volunteering?

Operation Walk Underway in Cuba

Dr. Merrill Ritter and his team from the non-profit organization Operation Walk are in Havanna at the Frank Pais International Orthopedic Center this week on a medical mission to replace hips and knees in ailing Cubans.

Surgeon with Child Porn Photos Allowed to Keep Working

In a frankly baffling ruling, the medical authorities in Australia have allowed Dr. William Joseph Fitzgerald to retain his medical license and to continue providing physician services, although with some restrictions (he is not allowed to operate on anyone under the age of 18 years). He was found in 2004 to have hundreds of sexually explicit pictures of children on his home computer.

April 27, 2006

April 27th, 2006

FDA: Marijuana Is Not A Drug

In a blow to advocates of medical marijuana, who feel access should be free and unrestricted if prescribed by a physician, the United States Food and Drug Administration (clearly populated by people who have never had chemotherapy-induced nausea or AIDS-related wasting or suffered through a Herxheimer reaction from Lyme Disease) has decreed that smoked marijuana has no benefit.

April 25, 2006

April 26th, 2006

This weeks Grand Rounds (Vol 2. No 31) has been posted at Health Business. Please check it out.

April 23, 2006

April 23rd, 2006

Indian Politician Worsens After Being Shot By Brother: Undergoing Emergency Surgery

Pramod Mahajan’s condition has worsened acutely and he was taken to surgery to apparently relieve a condition called hydronephrosis, which is a buildup of fluid in the kidneys.

Irish Officials to Review Death of Women With Delay in Reaching Operating Room

Health authorities in Northern Ireland have agreed to a complete review of the records in the treatment and death of Janine Murtagh. The patient was reported to have a “rupture of her bowel” during an abdominal surgery that was not noticed at the time by the operating team. When she became ill afterwards, there was a four-hour delay in securing an operating room.

This is confusing – the bowel does not rupture during surgery. It either ruptures before surgery and is missed during the operation or the surgeons inadvertently caused a breach of bowel integrity – called an enterotomy. Also, a four-hour delay between time of diagnosis and start of operation at night is not horribly unusual.

April 23, 2006

April 23rd, 2006

Neuroleptic Malignant Syndrome – Part 2

The exact cause of NMS is unknown but it is believed to be related to the levels and action of dopamine in the brain – either by blockage of the dopamine receptors or by the anti-dopamine effect of the causative drug.

Signs and symptoms of NMS include an increased body temperature (hyperthermia), muscle rigidity, a fast heart rate (tachycardia), a fast rate of
Continue reading "April 23, 2006"

April 22, 2006

April 22nd, 2006

Neuroleptic Malignant Syndrome – Part 1

This fortunately rare but dangerous syndrome occurs after administration of certain drugs. It is called an idiosyncratic reaction as it can occur after the first or later doses of a drug and it is not dose-related. NMS occurs after administration of one of the neuroleptic anti-psychotic drugs, which are given
Continue reading "April 22, 2006"

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