CURRENT Medical Diagnosis and Treatment 2010

The #1 annually updated text in internal medicine!
The annual classic that puts research where it belongs…into your practice


Written by clincians renowned in their respective fields, CMDT offers the most current insights into symptoms, signs, epidemiology, and treatment for more than 1,000 diseases and disorders. For each topic you’ll find concise, evidence-based answers to questions regarding both hospital and ambulatory medicine. This streamlined reference is the fastest and easiest way to keep abreast of the latest medical advances, prevention strategies, cost-effective treatments, and more. As an added bonus, this is the first edition to offer additional material online at no additional cost. Chapters on anti-infective chemotherapeutic and antibiotic agents, diagnostic testing and medical decision making, basic genetics, and information technology in patient care care.

.More information on patient care in less text:
*A strong focus on the clinical diagnosis and patient management tools essential to daily practice
*Broad range of internal medicine and primary care topics, including gynecology and obstetrics, dermatology, neurology, and ophthalmology
*The only text with an annual HIV infection update
*Hundreds of drug treatment tables, with indexed trade names and updated prices — plus helpful diagnostic and treatment algorithms
*Recent references with PMID numbers for fast access to abstracts or full-text articles
*ICD-9 codes are listed on the inside covers

.NEW TO THIS EDITION:
*New topics include H1N1 influenza A, acute knee pain, vaccine safety, neuromyelitis optica, and Chikungunya fever
*Expanded 24-page color insert
*Rewritten Cancer chapter by new authors
*New ACC/AHA Task Force Guidelines for management of congenital heart disease in pregnant women
*Major revision of antithrombotic therapy

PART 1   -   PART 2 

Lumbrical action

Lumbrical action is to hold a pea, that is to flex the metacarpophalangeal joint and extend the interphalangeal joints. When look at hand in this position, can see this makes an “L” shape, since L is for Lumbrical...............

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Farquharson's Textbook of Operative General Surgery

First published in 1954, Farquharson’s Textbook of Operative Surgery is a textbook that has helped to train generations of surgeons around the world in general operative procedures. This new edition continues this tradition, presenting all the operations that the trainee surgeon may be expected to undertake, and discussing the basic techniques available and the reasons for their application. Techniques and options are described in sufficient detail to allow any surgeon who has limited experience of a particular procedure to proceed with confidence and safety. The text is thus also valuable for qualified surgeons practicing in smaller hospitals worldwide where specialized advice may not otherwise be available. This ninth edition has been fully updated, with many chapters entirely rewritten. New contributing authors bring their particular experience in sub-specialties such as vascular medicine, orthopaedics and trauma, all of which overlap with the work of the general surgeon. Farquharson’s Textbook of Operative General Surgery remains an unrivalled aid to training in operative surgical procedures, and an invaluable ready reference for the more experienced surgeon working in a variety of settings and locations.

Onion skin periosteal reaction

A multilayered periosteal reaction, also known as a lamellated or onion skin periosteal reaction, demonstrates multiple concentric parallel layers of new bone adjacent to the cortex, reminiscent of the layers on an onion. The layers are thought to be the result of periods of variable growth .

It can be seen with:

1.  osteosarcoma
2.  acute osteomyelitis
3.  Ewing sarcoma
4.  Langerhans cell histiocytosis (LCH)                                                               

Ewing sarcoma - distal femur - “Ewing sarcoma of the distal femur in a 9 year old boy with onion skin periosteal reaction.

Button battery in ear; How dangerous is it ?

Young children commonly place foreign bodies in the ear canal and nose. If a vegetable foreign body is present, do not use ear drops because they will cause the foreign body to swell.

One of the most dangerous foreign bodies is a button battery. This type of foreign body should be removed immediately. Prior to removal, the use of ear drops of any kind is absolutely contraindicated.

The electrical charge of the battery will produce electrolysis of any electrolyte-rich fluid. This produces hydroxides which will cause a severe alkaline burn. The picture above shows a severe burn of the external auditory canal which resulted in the exposure of bone over 180 degrees of the ear canal's circumference. The battery was in the child's ear for approximately three days and the picture was taken one month after the battery was removed. Healing is slow and damage to the eardrum, facial nerve, and inner ear can occur. Luckily in this patient the injury was confined to the ear canal.