MedGenMed : Medscape general medicine
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A patient who presented to the emergency department with severe, recurrent abdominal pain demonstrated Chilaiditi's sign, a radiographic term for interposition of the hepatic flexure of the colon between the liver and right hemidiaphragm. Workup of this clinical case revealed anomalous colonic anatomy, which led to successful laparoscopic corrective surgery. We call attention to the potential importance of this sign when associated with clinically recurrent abdominal pain (Chilaiditi's syndrome).
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Consumer-directed health information resources hold great potential for improving public health and easing the demand on health systems. Their value, however, depends largely on the ability of their intended users to access and use them effectively. Little is known about whether British Columbia's ethnocultural communities are using the British Columbia (BC) Ministry of Health's BC HealthGuide (BCHG) program, and if so, when and for what purposes they use the services, as well as level of satisfaction with and users' perceptions of the resources. This study investigated attitudes toward and perceptions of the BCHG program, as well as use patterns and satisfaction levels, within the Iranian community of the Greater Vancouver Area (GVA)--among BC's largest and fastest-growing Middle Eastern immigrant communities--and explored a model for introducing the BCHG program to ethnic communities in the GVA and BC. ⋯ The findings of this study strongly suggest that Iranians living in the GVA are open to alternatives to routine healthcare services, including the use of preventive and self-care resources. However, awareness levels and utilization rates of the BCHG program among the GVA's Iranian immigrant population have until now been low. The noticeable and sustained improvement to attitudes, perceptions, and self-reported utilization rates of the BCHG program among Iranian participants in this study after watching culturally appropriate promotional videos indicates the potential to modify cultural beliefs in regard to the delivery of preventive health information if the relevant messages are delivered appropriately. By carefully considering the demographic and cultural characteristics of the various ethnic communities living in BC, and by targeting promotional activities and services directly to these individual communities, the BCHG program could improve awareness and utilization rates within these communities.
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Case Reports
ST segment elevation on electrocardiogram: the electrocardiographic pattern of Brugada syndrome.
A 77-year-old white diabetic woman was brought to our emergency department (ED) after becoming lightheaded and hypotensive at home. Her routine tests including a chest radiograph were normal. Her electrocardiogram (ECG) showed significant ST segment elevation in leads V1 to V4. ⋯ To diagnose the Brugada syndrome, 1 ECG criterion and 1 clinical criterion should exist. Brugada syndrome can be associated with ventricular tachycardia or fibrillation; the only treatment proven to prevent sudden death is placement of an implantable cardioverter defibrillator, which is recommended in symptomatic patients or in those with ventricular tachycardia induced during electrophysiologic studies and a type 1 ECG pattern of Brugada syndrome. It is important to recognize the Brugada ECG pattern and to differentiate it from other etiologies of ST segment elevation on ECG.