Scot Med J
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Ethylene glycol is recognised as a potentially lethal poison if ingested. Approximately 100 mls may be fatal in a 70 kg adult. ⋯ In the absence of these symptoms, metabolic acidosis or ethylene glycol concentration more than 8 mmol/l a single loading dose of ethanol and observation were the recommended course of management until recently. We report a case of a patient who remained relatively asymptomatic for almost 24 hours but then developed clinical symptoms with marked metabolic acidosis and renal impairment requiring intensive treatment including haemodialysis.
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Rheumatoid Arthritis (RA) is a common inflammatory arthritis' with pain and loss of function among its most disabling symptoms. These are mostly secondary to inflammation or mechanical damage to the joints. However it is also important to consider disease complications as a cause of symptoms, especially when the response to treatment is suboptimal. We report an RA patient whose symptoms were resistant to standard therapy, and were actually due to peripheral neuropathy.
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Comparative Study
Review of patients in general practice with a diagnosis of epilepsy: development of a practice nurse checklist and an assessment of resource implications.
SIGN has recommended annual review of all patients with epilepsy. Annual review is rewarded in the new GMS contract. There is no information on how or by whom reviews should be carried out, nor on resource implications for secondary care. ⋯ Annual reviews of patients with epilepsy can be carried out by practice nurses, but some training is required. The review process is likely to increase the burden on secondary care and have a significant adverse effect on neurology waiting times.
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Comparative Study
Temporal scanner thermometry: a new method of core temperature estimation in ICU patients.
Temperature measurement is a routine task of patient care, with considerable clinical impact, especially in the ICU. This study was conducted to evaluate the accuracy and variability of the Temporal Artery Thermometer (TAT) in ICU-patients. Therefore, a convenience sample of 57 adult patients, with indwelling pulmonary artery catheters (PAC) in a 40-bed intensive care unit in a university teaching hospital was used. ⋯ We can conclude that the temporal scanner has a relatively good reliability with an acceptable accuracy and variability in patients with normothermia. The results are comparable to those of the AT, but they do not seem to be sufficient to prove any substantial benefit compared to rectal, oral or bladder thermometry.
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We wanted to determine whether the practice of routinely sending an anaesthetist to cardiac arrests is common within Scotland. We also wished to evaluate the interventions performed by our intensive care anaesthetist when responding to cardiac arrest calls. ⋯ Patients who remain in cardiac arrest upon the arrival of the anaesthetist have a very high mortality. The practice of routinely sending an anaesthetist to cardiac arrest calls is not justified.