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April 30 2012
NCBI ROFL: The dangers of intense hand drumming.
Rust urine after intense hand drumming is caused by extracorpuscular hemolysis.
“BACKGROUND AND OBJECTIVES:
During Carnival, groups of > or =60 drummers go drumming with their hands and marching for periods of 2 to 4 h. The objective of this study was to determine the frequency and type of urinary abnormalities after candombe drumming and to evaluate possible pathogenic mechanisms.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:
For analysis of pathogenic mechanisms, a group of individuals were prospectively evaluated before and after candombe drumming. Methods: Candombe drummers were recruited in January 2006, 1 wk before prolonged drumming. After clinical evaluation, urine and blood samples were obtained before and immediately after drumming.
RESULTS:
Forty-five healthy individuals (four women and 41 men), median age 31 yr (14 to 56), were evaluated. Predrumming urine and plasma samples were obtained for 30 individuals. Nineteen (42%) of 45 had a previous history of rust urine emission temporally related with candombe drumming. After drumming, 18 of 26 showed urine abnormalities; six of 26 showed rust urine, eight of 26 had microhematuria, and seven of 26 had proteinuria >1 g/L. The candombe drummers who showed rust urine after heavy drumming ...
April 23 2012
NCBI ROFL: Ever wanted to know what’s really in hotdogs?
Applying morphologic techniques to evaluate hotdogs: what is in the hotdogs we eat?
“Americans consume billions of hotdogs per year resulting in more than a billion dollars in retail sales. Package labels typically list some type of meat as the primary ingredient. The purpose of this study is to assess the meat and water content of several hotdog brands to determine if the package labels are accurate. Eight brands of hotdogs were evaluated for water content by weight. A variety of routine techniques in surgical pathology including routine light microscopy with hematoxylin-eosin-stained sections, special staining, immunohistochemistry, and electron microscopy were used to assess for meat content and for other recognizable components. Package labels indicated that the top-listed ingredient in all 8 brands was meat; the second listed ingredient was water (n = 6) and another type of meat (n = 2). Water comprised 44% to 69% (median, 57%) of the total weight. Meat content determined by microscopic cross-section analysis ranged from 2.9% to 21.2% (median, 5.7%). The cost per hotdog ($0.12-$0.42) roughly correlated with meat content. A variety of tissues were observed besides skeletal muscle including bone (n = 8), collagen (n = 8), blood ...
April 02 2012
NCBI ROFL: Bat attack!: an unusual cause of keratouveitis.
“Eye injury from flying bats are extremely rare, as they have a special ultrasonic echolation system which they use instead of sight to guide their way. This complex system enables them to avoid any obstacles when gliding at high velocities, even in complete darkness. There has been one other report of corneal perforation from collision with a bat. Here we report a case of a bat attack with a corneal foreign body which was a part of the bat’s claw, resulting in localized keratitis and anterior uveitis, a finding which has not been previously described.
A 50-year-old Caucasian male presented with blurred vision and irritation of the right eye after being struck by a flying bat while walking under a tree in the evening. On examination, his visual acuity was 6/18, right eye and 6/6, left eye…. …The tip of a bat’s claw, which was very thin and sharp, was retrieved. Topical antibiotics and steroids were used for 1 week. Two weeks later, the visual acuity returned to 6/6, right eye, though a faint corneal scar remained in the visual axis.
Contrary to the belief that a bat can get caught in people’s ...
March 19 2012
NCBI ROFL: Which brand of ball point pen is best for an emergency airway puncture?
Airflow efficacy of ballpoint pen tubes: a consideration for use in bystander cricothyrotomy.
“OBJECTIVE:To examine the suitability of commonly available ballpoint pens as a substitute emergency tracheostomy tube. METHODS: Commonly available ballpoint pens were examined and compared against two standard cricothyroidotomy sets. The pens were evaluated for dimensions, speed of construction of a temporary tracheostomy tube and airway resistance with differing flow rates. RESULTS: Internal diameters of the pens varied considerably. Time taken to construct a temporary tube ranged from 3 to 170 s, and in the majority of pens the airway resistance increased dramatically as the airflow rate increased. CONCLUSION: Contrary to popular belief, the majority of ballpoint pens appear unsuitable for use as a substitute tracheostomy tube. In this study only two pens fulfilled the criteria for use: the Baron retractable ballpoint and the BIC soft feel Jumbo.”
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March 10 2012
NCBI ROFL: Dangerous liaison: sexually transmitted allergic reaction to Brazil nuts.
“Brazil nuts are the second most frequent cause of nut allergy in the United Kingdom. We report the case of a 20-year-old woman with documented Brazil nut allergy who developed widespread urticaria and mild dyspnea after intercourse with her boyfriend who had earlier consumed Brazil nuts. Skin prick testing with the boyfriend’s semen after Brazil nut consumption confirmed significant reactivity whereas a sample before nut consumption was negative. We believe this to be the first case of a sexually transmitted allergic reaction.”
Photo: flickr/JorgeBRAZIL
Thanks to Per K. for today’s ROFL!
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March 03 2012
NCBI ROFL: Penile fracture seems more likely during sex under stressful situations.
“INTRODUCTION: The unusual event of penile fracture occurs when there is a disruption of the tunica albuginea surrounding engorged erectile tissue during aggressive sexual behavior. There is often an audible crack and rapid detumescence with subcutaneous hemorrhage that follows.
AIMS:
Medical literature has described the etiology and treatment of penile fracture. We report the remarkably unusual social situations of a series of patients who sustained this unique injury.
METHODS:
We conducted a retrospective chart review of 16 patients whose injury was severe enough to require surgical repair at the University of Maryland between 2007 and 2011. Particular attention was paid to the intake interview in the emergency department and the postoperative chart notes by the attending urologist to ascertain out-of-the-ordinary social situations in which the injury was sustained.
MAIN OUTCOME MEASURES:
The occurrence of penile fracture is sufficiently rare that the author was able to interact personally with most of the patients. The patients were remarkably forthcoming with the personal social dynamics of the sexual encounter.
RESULTS:
Half of these penile fracture patients sustained the injury during an extramarital affair. Only three patients sustained the injury in a bedroom; ...
January 04 2012
NCBI ROFL: Sneezing induced by sexual ideation or orgasm: an under-reported phenomenon.
“We describe a hitherto under-recognized curious response in some individuals: of sneezing in response either to sexual ideation or in response to orgasm. Our review suggests that it may be much more common than expected. We surmise that an indiscrete stimulation of the parasympathetic nervous system may be an underlying mechanism to explain this and other reported unusual triggers of sneezing.”
Bonus quote from the full text:
“From the sporadic reports in the medical literature, we surmised that the phenomenon of sneezing in response to sexual ideation or in response to orgasm is more common than recognized. As this is a problem that does not lead to morbidity and may be seen as embarrassing to discuss it may be under-reported. We performed a search of Internet ‘chat rooms’ where this problem may be discussed in an anonymous forum, using the Google search engine and with terms ‘sex, sneeze OR sneezing’. We searched in June 2007, and again six months later in December 2007. We found many discussions of the phenomena, with 17 people of both sexes reporting sneezing immediately upon sexual ideation, and three people after orgasm. Non-expert responses to the queries proposed all ...
December 09 2011
NCBI ROFL: Does bestiality cause penile cancer?
Sex with Animals (SWA): Behavioral Characteristics and Possible Association with Penile Cancer. A Multicenter Study
“Introduction. Zoophilia has been known for a long time but, underreported in the medical literature, is likely a risk factor for human urological diseases. Aim. To investigate the behavioral characteristics of sex with animals (SWA) and its associations with penile cancer (PC) in a case-control study. Methods. A questionnaire about personal and sexual habits was completed in interviews of 118 PC patients and 374 controls (healthy men) recruited between 2009 and 2010 from 16 urology and oncology centers. Main Outcome Measures. SWA rates, geographic distribution, duration, frequency, animals involved, and behavioral habits were investigated and used to estimate the odds of SWA as a PC risk factor. Results. SWA was reported by 171 (34.8%) subjects, 44.9% of PC patients and 31.6% of controls (P < 0.008). The mean ages at first and last SWA episode were 13.5 years (standard deviation [SD] 4.4 years) and 17.1 years (SD 5.3 years), respectively. Subjects who reported SWA also reported more venereal diseases (P < 0.001) and sex with prostitutes (P < 0.001), and were more likely to have had more than 10 lifetime sexual partners (P < 0.001) than those who ...
August 02 2011
NCBI ROFL: And the August “no sh*t, Sherlock” award goes to…
Fish-hook injuries: a risk for fishermen.
“Fishing is one of the best known and practiced human activities. However, you should remember that, when casting the hook from the riverbank or grasping it to add bait, fishermen run a real risk of injury if the hook punctures the skin. Briefly we describe a case where a young, 32-year-old fisherman who was reeling the hook back to shore when it hit him in the face and embedded itself in his upper eyelid. Upon examination, the eye was found to be unharmed and the hook was removed through a small incision and the aid of a local anesthetic.In the light of this case report, we think it a good idea to advise our friends and patients who we know to be fishermen to wear some form of eye protection as a precaution.”
Photo: flickr/Lazurite
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July 28 2011
NCBI ROFL: Airplane vacuum toilets: an uncommon travel hazard.
“Each year, millions of people travel aboard airplanes and cruise ships. A significant portion of the newer larger airplanes (the Boeing 767 and the Aerobus) and cruise ships now have vacuum toilet systems. There have been no reports in the medical literature on the frequency of injuries associated with the use of these toilets, but serious injury, including soft tissue trauma and organ evisceration, may be associated with the use of such devices.) The investigators report a case of significant perineal injury accompanied by hypotension associated with the use of a vacuum toilet on an airplane.
A 37-year-old white female was using a vacuum toilet on board an airplane. The toilet seat was upright. The woman was sitting directly on the commode. After flushing while still seated, she experienced pain in the perineal area. She was unable to remove herself from the toilet because of the created suction and she required assistance from the flight attendants. The patient experienced vaginal bleeding, and bright red blood was noted in the toilet. Paramedics were called when the plane landed. There was no diversion of the aircraft…
…Two risk factors for vacuum toilet injury can ...
June 24 2011
NCBI ROFL: Bicyclist’s vulva: observational study.
“Many chronic injuries related to athletic bicycling are now recognised: cyclist’s nipples,1 neuropathic syndromes,2 and skin problems caused by the saddle. We have seen a new clinical problem in female high level cycling competitors: bicyclist’s vulva. Six women, aged 21-38 years, had a unilateral chronic swelling of the labium majus after a few years of intensive bicycling (an average of 462.5 km per week). All six had typical unilateral lymphoedema (five on the right side, one on the left) which was more severe after more intense and longer training. The position of the bicycle saddle, the type of shorts worn, and the women’s perineal hygiene were optimum. There was no family history of lymphoedema in any of the women, nor any common factor that might explain the lymphoedema.”
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Photo: flickr/ richardmasoner
Thanks to Therese M. for today’s ROFL!
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June 02 2011
NCBI ROFL: How good is cola for dissolution of gastric phytobezoars?
[Editor's note: definition of bezoars from the full text: "Bezoars are hard masses or concretions of indigestible food, vegetable fiber or hair that are found in the gastrointestinal (GI) tract, usually in the stomach."]
“AIM: To evaluate the efficacy of cola treatment for gastric phytobezoars, including diospyrobezoars.
METHODS: A total of 17 patients (range: 48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed. Three liters of cola lavage (10 cases) or drink (7 cases) were initially used, and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare. The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola.
RESULTS: After 3 L of cola lavage or drinking, a complete dissolution of bezoars was achieved in four patients (23.5%), while 13 cases (76.5%) were only partially dissolved. Phytobezoars (4 of 6 cases) were observed more frequently than diospyrobezoars (0 of 11) in the group that underwent ...
January 04 2011
NCBI ROFL: An unusual finding during screening colonoscopy: a cockroach!
It’s insect week on NCBI ROFL! All week long we’ll be featuring the funniest scientific papers about our favorite creepy crawlies. Enjoy!
“A 52-year-old woman with a history of depression was referred by her primary physician for colorectal cancer screening. She had no family history of colorectal cancer and a review of systems was positive for abdominal bloating. Bowel preparation was done using 4 L of polyethylene glycol the evening prior to screening colonoscopy. The procedure was uncomplicated with no gross mucosal pathology, however, an insect was found in the transverse colon (Fig. 1, to the left), was found in the transverse colon on a routine screening colonoscopy.). The insect was aspirated and sent to the lab for further identification. The insect had three body segments (head, thorax, and abdomen) with ventrodorsal flattening of the body and a segmented abdomen, three pairs of legs extending from the thorax (with spikes and claw-like terminal appendages), elongated hind legs, and a pair of elongated antennae extending from the head to beyond the hind legs.These morphologic findings were most consistent with the nymph form of Blattella germanica (German ...
December 30 2010
NCBI ROFL: An unusual perversion: the desire to be injured by an automobile operated by a woman.
“Some perversions, while representing formidable psychopathology, are also tributes to the complexity of the human mind and unconscious ego mechanisms. The patient, a man in his late twenties, reported a periodic desire to be injured by a woman operating an automobile. This wish, present since adolescence, he had by dint of great ingenuity and effort, gratified hundreds of times without serious injury or detection. Satisfaction could be obtained by inhaling exhaust fumes, having a limb run over on a yielding surface to avoid appreciable damage or by being pressed against the wall by a vehicle. Gratification was enhanced if the woman were attractive by conventional standards. Injuries inflicted by men operating automobiles or other types of injury inflicted by women had no meaning. He experienced pleasure from the experience, thus establishing the symptom as a perversion rather than a compulsion. The patient’s sexual, social, and occupational adjustment was good and his intelligence superior. He intellectualized to a considerable extent but could experience and manage strong positive and negative feelings. He was ashamed of his symptom but somewhat proud of its unusual nature. … At least two interlocking themes are necessary for ...
December 18 2010
NCBI ROFL: Penis stuck in a PVC pipe? We have a solution!
Removal of a Long PVC Pipe Strangulated in the Penis by Hot-Melt Method.
“Introduction. Penile incarceration for erotic or autoerotic purposes has been reported in a wide range of age groups, and often presents a significant challenge to urologic surgeons. No ready method has been reported for removing a polyvinylchloride (PVC) pipe entrapped on the penis. Aim. To present our experience in using hot-melt method to remove a constricted PVC pipe on the penis. Methods. A long melting split was made on the PVC pipe entrapped on the penis by using the long narrow branch of forceps heated on a gas stove. Results. The heated forceps was able to make a melt split on the PVC pipe. Consequently, the PVC pipe was removed by pulling the edges of the pipe apart without much difficulty. The total operation time was 20 minutes. Conclusion. Penile incarceration is a urologic emergency, for which resourcefulness is required in some unexpected cases. Hot-melting has proved to be an easy and effective method for removing penile strangulation by a PVC pipe. To our knowledge, it is the first report about the removal of PVC pipe entrapped on a penis.”
Photo: flickr/mel0808johnson
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November 27 2010
NCBI ROFL: When love makes you blind…literally.
Transient monocular blindness precipitated by sexual intercourse.
“The physiological response to sexual activity includes an increase in sympathetic nervous system activity, heart rate and systolic blood pressure. Our patient experienced transient monocular visual loss every time he reached the climax of sexual intercourse, but never while performing strenuous physical exercise. Hypothetical mechanisms of transient monocular visual loss in our patient include vasoconstriction or embolism in the arterial blood supply of the eye. The repeated and completely transient nature of our patient’s symptoms supports the fact that embolism was not involved, whereas the resolution of the symptoms after initiation of the treatment with the vasodilator enalapril supports vasoconstriction as the cause of transient blindness.”
Photo: flickr/Lianne Viau
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November 18 2010
NCBI ROFL: Voodoo allergy cure fail.
Voodoo dermatitis after an attempted voodoo cure for marking nut dermatitis
“A 42-year-old Indian man from Bhilai, Chhattisgarh State, presented with a 4-day history of severe itching over the back, starting 2 days after application of diluted marking nut juice over two human figures etched by a knife on his back by a local traditional healer. The healer was attempting to cure the patient of his repeated skin problems induced by exposure to the marking nuts. Cutaneous examination revealed marked erythema around the two human figures etched on the patient’s back (Fig. 1). There were no systemic complaints. He had not used any local or oral medication. Systemic examination was not contributory, and routine hematology and urine examination were normal. The patient had suffered from several episodes of severely itchy facial skin lesions and periorbital edema, developing after exposure to the fumes of marking nuts being boiled in pots by his neighbors (Fig. 2a). On two occasions, he required hospitalization and treatment with hydrocortisone acetate injections and hydroxyzine hydrochloride tablets. Fed up with this, he consulted a traditional healer, who assured him of a cure by etching the figures of his supposed enemies and exposing them to the same allergen. He improved after 3 weeks of treatment with hydrocortisone acetate injections and hydroxyzine hydrochloride tablets, 25 mg twice daily.”
Bonus figure:
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November 16 2010
NCBI ROFL: Free-range maggots better for cleaning putrid wounds.
Maggot debridement therapy: free-range or contained? An in-vivo study.
“OBJECTIVE: To determine which method of maggot debridement therapy–free-range or contained–is more effective for wound healing. METHODS: In vivo study of 64 patients with 69 chronic wounds that showed signs of gangrenous or necrotic tissue. Patients were treated with either free-range or contained maggot debridement therapy according to maggot availability, dressing difficulty, and physician preference. RESULTS: Significantly better outcomes were achieved with the free-range technique versus the contained technique (P = .028). With the free-range technique, the mean number of maggot applications and the total number of maggots per treatment were significantly lower than with the contained application technique (P = .028 and P < .001, respectively). CONCLUSION: This clinical in vivo study supports in vitro studies in which containment of maggots was found to reduce the effectiveness of maggot debridement therapy.”
Photo: flickr/gruntzooki
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October 22 2010
NCBI ROFL: Accidental condom inhalation.
It’s case study flashback week on NCBI ROFL! All this week we’ll be featuring some of our favorite medical case studies from the archives. Enjoy!
“A 27-year-old lady presented with persistent cough, sputum and fever for the preceding six months. In spite of trials with antibiotics and anti-tuberculosis treatment for the preceeding four months, her symptoms did not improve. A subsequent chest radiograph showed non-homogeneous collapse-consolidation of right upper lobe. Videobronchoscopy revealed an inverted bag like structure in right upper lobe bronchus and rigid bronchoscopic removal with biopsy forceps confirmed the presence of a condom. Detailed retrospective history also confirmed accidental inhalation of the condom during fellatio.”
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Photo: flickr/letmehearyousaydeskomdeskom
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October 21 2010
NCBI ROFL: Morphing into Michael Jackson.
It’s case study flashback week on NCBI ROFL! All this week we’ll be featuring some of our favorite medical case studies from the archives. Enjoy!
Mandibular angle augmentation with the use of distraction and homologous lyophilized cartilage in a case of morphing to Michael Jackson surgery.
“Correction of an ill-defined mandibular angle is not an easy task, whether it is requested by the “congenital, orthognathic or cosmetic” patient. Deliberate over-correction has not been reported to our knowledge. This article presents a combination of distraction osteogenesis and lyophilized cartilage used to three-dimensionally over-augment the mandibular angle of a long-face prognathic patient who had the wish to be morphed to Michael Jackson or at least as far as current technique and his endogenic features allowed.”
Photo: flickr/dalbera
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