A 45-year-old tourist developed AMS three hours after starting to ski in a glacier skiing-region in Austria. His history was noteworthy for chronic stress, coffee-overuse, chronic sleep-deprivation, and previous AMS, 14 years ago at ∼3000 m and six years ago at ∼5100 m. He occasionally trekked to altitudes of 1500–2500 m without problems. The night before suffering AMS he had slept for four hou...

We have studied 17 patients diagnosed in life as having absent left atrioventricular connection (14 patients) or an imperforate left atrioventricular valve (three patients). Ten patients presented below the age of 3 months with tachypnoea, mild cyanosis, and heart failure. Seven patients, including two with moderate and one with severe pulmonary outflow tract obstruction, presented at a mean ag...

In developing countries primary health care workers are being trained to manage and treat acute respiratory infections with a protocol developed by the WHO. We tested the ability of nurses and nursing assistants in Swaziland to recognise the signs and symptoms of pneumonia; with the results of a paediatrician's examination as "gold standard", sensitivities and specificities were calculated. Dan...

Abstract Introduction Rheumatoid arthritis (RA) affects the larynx in 13-75% of cases and is usually subclinical. Airway obstruction due to vocal cord fixation occurs late RA presents as an inspiratory stridor. Case presentation An 85-year-old woman presented A&E Resus with tachypnoea, stridor drowsiness. ABG showed hypercapnic respiratory failure. A flexible nasendoscopy was performed whic...

A 25-yr-old man, subsequently shown to be malignant hyperthermia (MH) susceptible by in vitro contracture testing, developed MH during anaesthesia for tonsillectomy. Prompt treatment, including dantrolene, led to rapid resolution of the metabolic crisis. Eighteen hours later the patient's trachea was extubated in the ICU, when he had been stable and apyrexial overnight. Twenty minutes after ext...

A 69 yr old man was admitted with a 10 day history of fever, arthromyalgia, dyspnoea, dry cough and pleuritic pain. Temperature was 38 degrees C; tachypnoea 36 rpm. Extensive crackles were audible over both upper lung fields. Chest X-ray showed bilateral alveolar infiltrates. Forced vital capacity was 49% of predicted, and carbon monoxide transfer coefficient was 32% of predicted value. The pat...

CASE HISTORY A previously healthy 3-yr-old male was evaluated for fever and abdominal pain, and a chest radiograph was performed (fig. 1). A detailed history was collected and the parents reported the child having a ‘‘distended abdomen’’ from a few months old. They had the impression he was a calm child, less inclined to run and play than his peers. In the previous year, two episodes of bronchi...

a time, and capable of ninety-four press-ups in one minute. While representing his firm in a Superstars competition, he was required to perform a maximum number of chin-ups while hanging from an overhead bar. After completing the twentieth, and final repetition he experienced left anterior chest pain. Initially present only while jogging, the pain then began to manifest itself during rest, and ...