Human attacks by large felid carnivores in captivity and in the wild.

Whereas those who live in the native ranges of the large feline carnivores are well aware of the risks of cat and human encounters, North Americans and Europeans are increasingly exposed to exotic animals through travel, ecotourism, leisure pursuits in rural areas, occupational exposure, zoo and animal park visits, wild habitat encroachment at the urban-wildlands interface, and contact with exotic pets. In encounters during which persons have been severely injured, lapses in animal management protocols, lack of appropriate adult supervision, and intoxication have been reported. Unlike common domestic pets that have lived in close association with humans for thousands of years, no matter where individual large felines may have been raised, they remain wild carnivores with strong prey-drive and territorial instincts.

Vaccination for the expatriate and long-term traveler.

Duration of travel is an important factor in addressing travel health safety due to cumulative risk of exposure to illness and injury. The diverse group of expatriate and long-term business and leisure travelers present a different spectrum of issues for the travel medicine practitioner to address during consultation than does the short-term traveler, due to changes in travel patterns and activities, lifestyle alterations, and increased interaction with local populations. Immunization provides one safe and reliable method of preventing infectious illness in this group.

An urban Northeastern United States alligator bite.

Individuals who live and work in the Southeastern coastal range of the 3 US crocodilian carnivores, American alligators, American crocodiles, and caiman, understand the risks of reptile-human encounters. Individuals who live in other parts of the country maybe exposed through contact with exotic pets at private homes, small menageries, or petting zoos or from escaped or abandoned animals. During these encounters, individuals may be severely injured.

Cartilage assessment of the metacarpophalangeal joints: cadaveric study with magnetic resonance arthrography and finger traction.

We investigated the efficacy of axial traction of the fingers combined with magnetic resonance (MR) arthrography in assessing the metacarpophalangeal (MCP) joint cartilage in cadavers. Cartilage was imaged and graded before/after MR arthrography, with/without traction, then correlated with cadaveric sectioning. The application of traction with MR arthrography is a promising technique for improved visualization of the articular cartilage of the MCP joints compared with similar imaging without traction and/or without arthrography, but its true benefit requires further study.

Algid malaria treated with early goal-directed therapy.

Severe malaria complicated by circulatory shock is known as algid malaria. Cases of severe imported malaria are seen increasingly frequently in emergency departments in the United States, Europe, and other locales. The optimal volume resuscitation strategy for patients with severe malaria is not well-defined.

Immunization in travel medicine.

The specialty of travel medicine encompasses a broad and dynamic practice. A thorough pretravel consultation provides an individual with a comprehensive, evidence-based, contextual discussion of the risk profile for specific itinerary-based, travel-related illness and injury, allowing the traveler to use this information in conjunction with his or her personal health belief model, risk tolerance, and experience to decide on an informed management plan. This article focuses on the pretravel consultation with emphasis on the contribution of immunization to traveler's health.

Endovascular treatment of postpartum hemorrhage.

Transcatheter arterial embolization is a minimally invasive intervention developed from diagnostic angiography. The evolution of endovascular techniques, including arterial embolization and the use of occlusion balloons, has established a role for the interventional radiologist in the setting of uncontrolled postpartum hemorrhage. Arterial embolization of the uterine arteries as an alternative to hysterectomy has the advantages of being a minimally invasive treatment that preserves uterus without eliminating the possibility of future surgical intervention if necessary.

Immediate and long-term effects of a sophomore radiology elective.

Rationale And Objectives: The purpose of this study was to determine the influence of sophomore electives in radiology on medical students' career choices and later clinical practice as physicians and to assess the need for change in the curriculum.

Materials And Methods: A survey questionnaire created by the Department of Radiology was sent to graduates of the Chicago Medical School, North Chicago, Ill, who had been offered a series of three sophomore electives in radiology between academic years 1978 and 1998. The survey included five questions concerning the utility of the electives.

Clinical Policy for Procedural Sedation and Analgesia in the Emergency Department.

[American College of Emergency Physicians: Clinical policy for procedural sedation and analgesia in the emergency department. Ann Emerg Med May 1998;31:663-677.].