Funtabulously Frivolous Friday Five 340

Paediatricians were only equivalent to a coin toss (correct 50% of the time), Nurses nailed it 59% of the time.

Thirty babies, born at term, were consecutively enrolled on the postnatal ward at Guy’s Hospital in Great Britain.  With the permission of families, photographs were taken of babies who were wrapped, with only the face left fully exposed.  These photographs were randomly shown to 53 adults, who were asked to provide an opinion as to the baby’s sex.  Of the observers, 21 were men, 12 were pediatricians, 14 were pediatric or neonatal nurses, and 27 were not health care workers.  Forty of the 53 were also parents.  

Nurses came out top with 59%, Paediatricians at 50% and non-medical staff could identify the correct sex 54% of the time.

Needless to say, observers had some fixed ideas about what babies should look like, based on their sex.  “Less attractive” and hairy babies tended to be more often assigned the male gender, providing a strong underscoring of the sugar and spice and everything nice bias of the feminine gender.

Reference:

• Round JEC, Dheragoda M.  Sex: can you get it right?  BMJ 2002;325:1446–7

Meralgia paresthetica 

Meralgia paresthetica is a painful mononeuropathy of the lateral femoral cutaneous nerve (LFCN) that manifests clinically as numbness, burning, itching, or pain over the anterior and lateral aspects of the thigh. Also known as the Bernhardt–Roth syndrome

It periodically enters the medical literature depending on the latest fashion trends, hip-huggers were to blame in the 2000s and recently a trend with “taille basse” – low cut jeans or selecting a size too small inflicts pressure on the LFCN.

Diagnosis can be obtained from nerve conduction studies but they are not 100% sensitive.

Using our trusted emergency ultrasound we can anaesthetise the LFCN with your agent of choice +/- methylprednisolone. The accuracy of the injection was confirmed by obtaining anterolateral thigh paresthesia.

The initial treatment of meralgia paresthetica is conservative by correcting mechanical or postural problems (weight loss, looser clothing), the use of local anesthetics and steroids, bed rest, anti-inflammatory drugs, and single or multiple therapeutic nerve blocks.

References:

• Parmar MS.  Hiphuggers’ tingly thighs. Can Med Assoc J 2003; 168(1): 16
• Moucharafieh R et al. Meralgia paresthetica: A result of tight new trendy low cut trousers (‘taille basse’). International Journal of Surgery. 2008;6(2):164-168
• Tomaszewski KA, Popieluszko P, Henry BM, Roy J, Sanna B, Kijek MR, Walocha JA. The surgical anatomy of the lateral femoral cutaneous nerve in the inguinal region: a meta-analysis. Hernia. 2016 Oct;20(5):649-57.

The “colonic index” relates to the fact that journals actually keep records of the titles of their medical papers with respect to whether or not a colon appears in the title.  

It seems that there is a distaste for the use of the colon in a journal article title on the part of journal editors, but over time, the use of the colon has changed.  A study reported in the British Medical Journal (Cameron H, 1997) has shown that the use of the colon has dramatically increased in the Lancet and the British Medical Journal (by a factor of six-fold in the years 1970 through 1995).  

During the same period, the editors of the New England Journal of Medicine had been fairly meticulous in weeding out this punctuation mark, save for the one colon that appeared in the New England Journal of Medicine in 1985, a colon let in by Dr. Arnold Relman, Editor at the time.  

The use of the colon in British journals perhaps represents further evidence of an obsession with matters intestinal, a variant of inflammatory vowel disease.

Reference:

• Cameron H, Robertson A. The colon in medicine: nothing to do with the intestinal tract. BMJ. 1997 Dec 20-27;315(7123):1657-8.

Not very…

All of us have seen pictures of fire-eaters and have marvelled at the ability to perform such stunts.  One is also impressed that there seem to be no acute respiratory injuries associated with this occupation, a common observation that is absolutely correct, medically.  

A study, however, reported in Archives of Medical Research shows that not all is well with those who like to eat fire.  Of 30 fire-eaters, all men 19 to 42 years of age, two-thirds had respiratory studies showing serious chronic obstructive pulmonary abnormalities. 

These abnormalities were associated with airflow decrement consistent with emphysema, the degree of which appeared to relate to the number of years spent in the activity of fire-eating.

Those who play with fire are going to get burned, one way or another.

Reference:

• Cabrera A, Vargas MH, Ochoa LG, Escobedo G, Ashley-Sosa G, Rico-Méndez FG. Spirometric changes in fire-eating subjects in Mexico City. Arch Med Res. 2003 Jul-Aug;34(4):276-80