{"title":"Anaesthesia and the Practice of Medicine: Historical Perspectives","authors":"D. Johnston","doi":"10.5860/choice.45-0914","DOIUrl":"https://doi.org/10.5860/choice.45-0914","url":null,"abstract":"This is a delightful volume written by two retired anaesthetists, one a Cambridge graduate and the other a graduate from Harvard. Both worked together at the Massachusetts General Hospital in 1954–55. The book is divided into five parts. \u0000 \u0000Part 1 deals with the origins of anaesthetic drugs. The first use of anaesthetics is open to considerable doubt but excluding alcohol, hemlock, hemp and laudanum, the earliest recorded soporific effects of ether were described as far back as 1540. Nitrous oxide, discovered by a clergyman, Joseph Priestley, started off as a recreational drug and as a cure for tuberculosis and other respiratory illnesses. Beddoes and Humphrey Davy identified its pain relieving properties and in 1800 proposed its use in surgery. It was not until 44 years later that nitrous oxide was used to relieve pain during surgical procedures. Volatile anaesthetics ether and chloroform also started off as recreational drugs and cocaine, the first effective local anaesthetic, continues in that role. Cocaine was initially used to anaesthetise the cornea in eye surgery but as far back as 1889 it was used by the German surgeon August Bier to produce spinal anaesthesia. The last chapter in this section deals with the mechanical aspects of anaesthetics and their development – ventilators, heart-lung machine, and various types of anaesthetic apparatus. \u0000 \u0000Part 2 identifies the impact of a number of historical events, notably the Second World War, and the individuals who helped to establish anaesthetics as an important scientific and clinical discipline. The section concludes with three chapters on curare and neuromuscular blockade reflecting the enormous contribution of these drugs to modern day anaesthesia and the strong research interest of the authors. \u0000 \u0000Part 3 deals with the extension of anaesthesia into other areas of medical practice – maintenance of respiration in poliomyelitis and other diseases requiring respiratory intensive care, cardiac bypass for open heart surgery, cardio-pulmonary resuscitation and the development of short-acting anaesthetic agents for day surgery. Halothane hepatitis and the safety of anaesthetic agents are also discussed. \u0000 \u0000Part 4 discusses the role of the anaesthetist in childbirth and in the care of the newborn. Opposition to pain relief during Victorian times was largely silenced by Queen Victoria'a pronouncement, “We are going to have this baby and we are going to have chloroform”. The important contribution of Virginia Apgar to neonatal intensive care is also discussed. She introduced her Apgar score in 1953, which is probably the most famous eponymous acronym in medicine – Appearance, Pulse, Grimace, Activity, Respiration. \u0000 \u0000The final section concludes on a less optimistic note. This chapter concludes that anaesthetics, like a number of other medical academic disciplines, faces two major problems: the impact of the European Working Time Directive on clinical services and training, and the erosion of the aca","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"45 1","pages":"142 - 142"},"PeriodicalIF":0.0,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89817160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CORONARY ARTERY DISEASE","authors":"C. Oakley","doi":"10.1002/9780470994955.ch15","DOIUrl":"https://doi.org/10.1002/9780470994955.ch15","url":null,"abstract":"UNLIKE most psychiatric textbooks for nurses, usually written by psychiatrists, these revision notes are written by a nurse tutor trained in both general and psychiatric nursing. The approach is problem orientated and the emphasis is on topics of practical value to nurses involved in patient care. A useful series of short selections contains sound advice on how to handle difficult types of patient. A team approach to the management of psychiatric patients is advocated and the functions of the various therapeutic team members are clearly defined. Brief notes are provided about many, though not all, modern developments in patient care. The common psychiatric syndromes are described in note form. A reading list is provided at the end of each section as well as a number of revision questions. The text is clear and concise , though necessarily condensed. Inevitably a number of inaccuracies of fact appear. Nevertheless, this book can be recommended to nurses as a useful short revision text. THIS monograph, which is one of a series on different tonics in medicine, is written by one of the most respected and leading experts in the field of coronary disease. In the preface the author states: \"It is the purpose of Coronary Artery Disease to marshal in one place the majority of the available information concerning the current practice of coronary heart disease,\" and he succeeds not only in doing this, but in presenting it in a concise and interesting fashion. The early chapters cover such topics as methods of investigation, pathogenesis of athero-sclerosis and the anatomy and physiology of the coronary circlulation. Later chanters are devoted to current views on the medical iand surgical treatment of obstructive coronary disease and the material is presented in a well-balanced form. At £13.50 the book is expensive, but it can be strongly recommended to all physicians involved in treating patients with ischaemic heart disease. THE claim on the dust cover of this book states that it is \"a full presentation, in accessible and largely non-technical language, of the biological and medical details of rabies, together with a discussion of present policies, in the U.K. and elsewhere, for its prevention and elimination\". Eight authors have written seven chapters on different aspects of the rabies problem in man and in animals which do much to substantiate the above claim. However, because of the multiple authorship, some unevenness in style is evident and there is …","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"113 1","pages":"133 - 133"},"PeriodicalIF":0.0,"publicationDate":"2007-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84864840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ethics Manual","authors":"Bob Taylor","doi":"10.7326/0003-4819-114-9-826_11","DOIUrl":"https://doi.org/10.7326/0003-4819-114-9-826_11","url":null,"abstract":"The differing activities and proclivities of males and females over the ages mean that Y-chromosomal DNA and mitochondrial DNA allow us to open a window on population histories, and put some flesh on the bare bones of legend and myth. Perhaps surprisingly, this approach is bearing significant fruit, some of which borders on the shocking. In 2003, Zerjal et al. reported an astonishingly high carriage rate of a recent Y-chromosome signature across the old Mongol empire up to 8% of the Y-chromosomes appeared to show an origin from around the time of Genghis Khan the tempting inference (which may well be correct) is that this is the genetic legacy of Genghis himself. He and his descendants were well known for their sexual voracity, and association with the ruling family would have boosted their reproductive luck somewhat.","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"60 1","pages":"64 - 64"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91054368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oxford Desk Reference: Clinical Genetics","authors":"T. Dabir","doi":"10.1093/med/9780192628961.001.0001","DOIUrl":"https://doi.org/10.1093/med/9780192628961.001.0001","url":null,"abstract":"Clinical genetics is a relatively young speciality dealing with genetic disorders of all organ systems affecting all age groups. To say writing a comprehensive and useful book for clinical geneticists is a Herculean task is like stating the obvious. The authors of Oxford Desk Reference: Clinical Genetics deserve to be congratulated for achieving the impossible. This is one hands on guide sorely missed by trainee geneticists in the past. Dr Helen Firth and Dr Jane Hurst not only realised the need for such handbook but managed to address it effectively. \u0000 \u0000Oxford Desk Reference is divided into seven sections and contains over 600 pages. The book begins with glossary of terms used in the world of dysmorphology and genetics followed by a brief introduction of basic and essential concepts such as modes of inheritance, genetic testing and confidentiality. This symbolises the approach of the authors through out the book of ‘not taking anything for granted’ as far as the basic knowledge for the speciality is concerned. The second section deals with the clinical approach to various clinical scenarios (almost a hundred) faced by geneticists in their day-to-day practice. Differential diagnosis of one single clinical finding and the practical approach to it highlights this section. This section emphasises on a structured approach to a clinical problem and is quite stimulating. The third section deals with common genetics consultations giving a brief overview of common and uncommon genetic conditions. Around 400 pages are dedicated to these two sections making it an indispensable tool for geneticists and other physicians with interest in genetics. The fourth and fifth section deals with cancer genetics and various chromosomal disorders. The sixth section is about pregnancy and fertility. This contains a useful overview of the differential diagnosis of various antenatal scan findings and other issues commonly encountered in prenatal clinics. All the chapters in these sections end with information about relevant support group and the expert advisors. The last section is equally valuable with more than 50 pages encompassing growth and development charts, skeletal dysplasia charts, ISCN nomenclature and other useful information for clinicians. \u0000 \u0000Overall this book is a winner and is a must for every clinical genetics department. This is arguably the most important book ever published for trainees in genetics. However this should not be interpreted as less valuable for trained geneticists or other physicians with interest in clinical genetics. This is one book, which can be considered as an extremely useful reference source to any genetics physician. Be it a prenatal clinic, a cancer clinic or a dysmorphology clinic it is a desirable companion. As aptly described in the preface this book is a ‘peripheral brain’ and ‘life saver’ for the geneticists in many situations!","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"1 1","pages":"235 - 235"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83096114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Successful Stenting in Endobronchial Wegener's Granulomatosis","authors":"J. Tiernan, C. Shah, J. McGuigan, J. Elborn","doi":"10.6084/M9.FIGSHARE.16037","DOIUrl":"https://doi.org/10.6084/M9.FIGSHARE.16037","url":null,"abstract":"Wegener's Granulomatosis (WG) is a multisystem disorder characterized by granulomatous necrotizing vasculitis. Classic Wegener's granulomatosis is a triad of necrotizing angiitis of the upper and lower respiratory tract and focal glomerulonephritis of the kidney.1 The classic respiratory feature is multiple pulmonary nodules on chest radiograph.2. In many cases extensive medical evaluation and laboratory test have proven non-diagnostic. In 1966, Carrington and Liebow introduced the concept of “limited Wegener's” granulomatosis to identify otherwise classic vasculitis lacking renal involvement.3 Limited Wegener's granulomatosis has a better prognosis than classic disease but it may be extremely challenging to recognize and diagnose.3,4 \u0000 \u0000We report an unusual case of limited Wegener's granulomatosis presenting with focal endobronchial WG with lobar collapse requiring stenting. \u0000 \u0000CASE REPORT \u0000A 19 year old female student presented to Otorhinolaryngology in June 1997 with a 3-week history of nasal obstruction, anosmia, headache, post-nasal drip and cough, unresponsive to recurrent antibiotic courses. X-Ray of paranasal sinuses revealed both maxillary sinus opacity. She was admitted in January 1998 for bilateral antral washouts and nasal endoscopy. Postoperatively, she developed fever, malaise, anorexia and unexplained weight loss. CT scan of paranasal sinuses revealed pansinusitis. She had bilateral functional endoscopic sinus surgery without much benefit. A CT Scan of brain excluded intracranial abscess. Revision endoscopic sinus surgery, performed 9 days later, revealed pus with necrotic material in the maxillary sinuses. Despite repeated sinus drainage procedures and intravenous broad-spectrum antibiotics during her hospitalisation, she continued to be febrile with weight loss. She had persistently elevated C – reactive protein [130 – 393 mg/l]. Her Westergren erythrocyte sedimentation rate was 110mm/hour. All cultures were negative. No granuloma or fungus was observed on biopsies. Initial autoimmune and vasculitic tests demonstrated no elevation in autoantibodies. She developed a normocytic anaemia, transient polyarthralgia and destructive inflammation of her nasal bridge. \u0000 \u0000Despite the initial absence of granuloma on histology or Anti Neutrophil Cytoplasmic Antibody (ANCA) in serum, a provisional clinical diagnosis of Wegener's granulomatosis was made. The patient was commenced on high dose oral steroids and co-trimoxazole. Steroid therapy resulted in prompt response and rapid clinical improvement, evident within 24 hours. \u0000 \u0000Indirect serum immunofluoresence in early February 1998 showed an atypical positive pattern for cANCA and Antiproteinase 3 level 6.2U/L [Normal <2]. Cyclophosphamide was added to her management regime. Rapid symptomatic improvement followed and she was discharged home. \u0000 \u0000In June 1998 she presented acutely unwell with shortness of breath and fever. A chest radiograph revealed complete collapse of the left lower lobe (fig","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"55 1","pages":"155 - 157"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76246124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical And Medical Treatment In Art","authors":"N. Mcclure","doi":"10.1177/014107680609900428","DOIUrl":"https://doi.org/10.1177/014107680609900428","url":null,"abstract":"This is a fascinating compilation of sixty-six paintings chosen by the authors to demonstrate the relationship between medicine and art from 1275 BC to 2002. Paintings are taken from all over the world and deal with all branches of medicine (including some which are no longer mainline practice!). Each painting is accompanied with a potted biography of the artist and a commentary which places the painting in its context: sociological, medical and artistic. Whilst I was aware of some of the paintings, many are new to me. I particularly liked the portrait of Sir Alexander Morrison by Richard Dadd – the father of Psychiatry in the United Kingdom. This is a stunning portrait by an inmate and is absolutely timeless in its style. The mediaeval representations of consultations between doctor and patient show just how much medicine has changed. Although on the previous page, the mediaeval surgery on haemorrhoids is a little distressing! In a wider sense, it is fascinating to see how our work has progressed over the years particularly since the Renaissance. It is also fascinating to see just how atmospheric so many of the paintings are – for example, that of Theodore Billroth operating by Sligenn. Here, we have a Master at work with seven scrubbed attendants and at least forty observers. Given the increasing numbers of medical students expected in our own medical school in Belfast, could this be the way of the future? I would commend this beautiful book to all with an interest in medical and surgical art: it is a fascinating read. Those of us who has been in clinical practice for many years will have undoubtedly encountered the patient who despite our best intentions is never cured or relieved of their symptoms by conventional medicines. Then one day they come into your consulting room and announce that they have been to an alternative practitioner, who has prescribed homeopathic medicine and this has miraculously cured them. Book Reviews Due to several experiences like this, I looked into the possibility of prescribing homeopathic medicine and I consulted the available textbooks. None really attempted to look at the various homeopathic medicines on a scientific basis. One was expected to believe that they all worked because the author stated that they did. However, at that time I wish I had had a book like this, which does attempt to try and bring a scientific basis to …","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"519 1","pages":"165 - 165"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88024320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medical Genetics","authors":"A. Magee","doi":"10.32388/n9d3ol","DOIUrl":"https://doi.org/10.32388/n9d3ol","url":null,"abstract":"Medical Genetics has long been a part of the undergraduate curriculum and is a rapidly increasing component of postgraduate training at all levels, in all specialities. Ian Young has provided a textbook which will delight both undergraduate and postgraduate readers. There are many textbooks which claim to cover essential medical genetic teaching, but many of these are too big, too detailed and too expensive. This text is presented in a clear, logical manner with well illustrated chapters and excellent use of colour for key points and boxes. The text is interspersed with case histories, landmark publications and the novel use of a \" case célèbre \" to illustrate many chapters – and what an excellent memory tool that is. Do you know why Dolly the sheep was called Dolly? Or that Frédéric Chopin may have had cystic fibrosis? There are fourteen chapters from the first \" Gene structure and function \" travelling through the realm of clinical genetics to end with chapters on \" Clinical skills \" (so you think you know how to interpret a laboratory report?) and \" Applied clinical genetics \". The useful appendices cover medical school core curriculum and teaching medical genetics to undergraduate medical students. Each chapter ends with a few MCQs, the answers having succinct explanations. Ian Young is respected worldwide as a clinician, author and teacher of medical genetics. From Northern Ireland originally, he has not lost the art of communication. This is a text clinicians at any level will enjoy either for serious study or occasional casual reading (it is just about the right size and has enough flexibility for reading in bed). My one criticism is that it was not available when I needed it as a student (far too many years ago). An Irish-American medic called Gus McWilliams returns home to Northern Ireland, his urgent mission to find a donor kidney for his ill son – whose renal function is deteriorating – at all costs. His own kidney problems suggest hereditary renal disease and other modern (and old) ethical and genetic dilemmas feature in this novel where in the quiet village of Rostrevor, his genealogy research uncovers a mysterious crime committed in the last century against his ancestors. He uncovers evidence of a 19th century rogue scientist called Diogenes who has discovered the secrets of human cloning. Sinister elements from both sides of the local terrorist divide mix with some …","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"2 1","pages":"108 - 108"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89963178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cicadas","authors":"P. Morrison","doi":"10.1515/9781400884018-003","DOIUrl":"https://doi.org/10.1515/9781400884018-003","url":null,"abstract":"Medical Genetics has long been a part of the undergraduate curriculum and is a rapidly increasing component of postgraduate training at all levels, in all specialities. Ian Young has provided a textbook which will delight both undergraduate and postgraduate readers. There are many textbooks which claim to cover essential medical genetic teaching, but many of these are too big, too detailed and too expensive. This text is presented in a clear, logical manner with well illustrated chapters and excellent use of colour for key points and boxes. The text is interspersed with case histories, landmark publications and the novel use of a \" case célèbre \" to illustrate many chapters – and what an excellent memory tool that is. Do you know why Dolly the sheep was called Dolly? Or that Frédéric Chopin may have had cystic fibrosis? There are fourteen chapters from the first \" Gene structure and function \" travelling through the realm of clinical genetics to end with chapters on \" Clinical skills \" (so you think you know how to interpret a laboratory report?) and \" Applied clinical genetics \". The useful appendices cover medical school core curriculum and teaching medical genetics to undergraduate medical students. Each chapter ends with a few MCQs, the answers having succinct explanations. Ian Young is respected worldwide as a clinician, author and teacher of medical genetics. From Northern Ireland originally, he has not lost the art of communication. This is a text clinicians at any level will enjoy either for serious study or occasional casual reading (it is just about the right size and has enough flexibility for reading in bed). My one criticism is that it was not available when I needed it as a student (far too many years ago). An Irish-American medic called Gus McWilliams returns home to Northern Ireland, his urgent mission to find a donor kidney for his ill son – whose renal function is deteriorating – at all costs. His own kidney problems suggest hereditary renal disease and other modern (and old) ethical and genetic dilemmas feature in this novel where in the quiet village of Rostrevor, his genealogy research uncovers a mysterious crime committed in the last century against his ancestors. He uncovers evidence of a 19th century rogue scientist called Diogenes who has discovered the secrets of human cloning. Sinister elements from both sides of the local terrorist divide mix with some …","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"14 1","pages":"108 - 108"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88457964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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