Scot Med J
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Case Reports
Persuasion, coercion, medical paternalism or the Mental Health Act: the dilemma of detention in the general hospital.
This paper describes the cases of three patients where the question of the need for formal detention arose due to mental disorder, apparently primarily due to physical illness, which in each case required further investigation and treatment in a general hospital. It states some of the issues facing those caring for patients under these circumstances and offers advice on overcoming some of the problems.
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The outcome of patients transported by coastguard helicopter to the Lewis Hospital, Stornoway was studied for the first 30 months of the service. Although undoubtedly life-saving in some cases, some patients were transferred for trivial reasons. Feedback between the hospital and ships' captains and owners may reduce possible abuse of this service. Most patients were uplifted entirely appropriately.
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Biography Historical Article
Scottish women medical pioneers: Manchuria 1894-1912.
In Edwardian Britain, less than 2% of all registered medical practitioners were women. Yet during that era, women played a significant role in providing medical care and education in what were lonely, harrowing and difficult conditions in the Third World. This is the story of how a group of Scottish women doctors brought Western medicine to a remote region of Manchuria between 1894 and 1912.
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Bullet emboli are an interesting but rare occurrence and their management when situated in the venous system remains controversial. Two cases of venous bullet embolism to the right heart are reported due to airgun pellet injuries. Both cases required bullet embolectomy using cardio-pulmonary bypass.
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A review was undertaken of 220 case reports of eosinophilic gastroenteritis involving the gastrointestinal tract, with particular regard to its clinical presentation and management. The stomach was the single commonest site of involvement (43%), while 36% were found to have two or more sites of disease at the time of presentation. The most common presenting symptoms were episodic abdominal pain (77%) and diarrhoea (42%). ⋯ Two thirds of patients had reported symptoms of more than six months duration prior to diagnosis, while in 26%, five years or more had elapsed. Although surgical intervention was undertaken in 44% of patients at some stage in their management, the most successful mode of management was the institution of steroid therapy, where 90% reported rapid clinical improvement. There is no evidence that patients with eosinophilic gastroenteritis have a higher incidence of subsequent gastrointestinal malignancies.