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European Physicians (european + physician)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Practice Guidelines for Evaluation of Fever in Returning Travelers and Migrants

JOURNAL OF TRAVEL MEDICINE, Issue 2003
Valérie D'Acremont
Background Fever upon return from tropical or subtropical regions can be caused by diseases that are rapidly fatal if left untreated. The differential diagnosis is wide. Physicians often lack the necessary knowledge to appropriately take care of such patients. Objective To develop practice guidelines for the initial evaluation of patients presenting with fever upon return from a tropical or subtropical country in order to reduce delays and potential fatal outcomes and to improve knowledge of physicians. Target audience Medical personnel, usually physicians, who see the returning patients, primarily in an ambulatory setting or in an emergency department of a hospital and specialists in internal medicine, infectious diseases, and travel medicine. Method A systematic review of the literature,mainly extracted from the National Library of Medicine database,was performed between May 2000 and April 2001, using the keywords fever and/or travel and/or migrant and/or guidelines. Eventually, 250 articles were reviewed. The relevant elements of evidence were used in combination with expert knowledge to construct an algorithm with arborescence flagging the level of specialization required to deal with each situation. The proposed diagnoses and treatment plans are restricted to tropical or subtropical diseases (nonautochthonous diseases). The decision chart is accompanied with a detailed document that provides for each level of the tree the degree of evidence and the grade of recommendation as well as the key points of debate. Participants and consensus process Besides the 4 authors (2 specialists in travel/tropical medicine, 1 clinical epidemiologist, and 1 resident physician), a panel of 11 European physicians with different levels of expertise on travel medicine reviewed the guidelines. Thereafter, each point of the proposed recommendations was discussed with 15 experts in travel/tropical medicine from various continents. A final version was produced and submitted for evaluation to all participants. Conclusion Although the quality of evidence was limited by the paucity of clinical studies, these guidelines established with the support of a large and highly experienced panel should help physicians to deal with patients coming back from the Tropics with fever. [source]

Sailors' scurvy before and after James Lind , a reassessment

NUTRITION REVIEWS, Issue 6 2009
Jeremy Hugh Baron
Scurvy is a thousand-year-old stereotypical disease characterized by apathy, weakness, easy bruising with tiny or large skin hemorrhages, friable bleeding gums, and swollen legs. Untreated patients may die. In the last five centuries sailors and some ships' doctors used oranges and lemons to cure and prevent scurvy, yet university-trained European physicians with no experience of either the disease or its cure by citrus fruits persisted in reviews of the extensive but conflicting literature. In the 20th century scurvy was shown to be due to a deficiency of the essential food factor ascorbic acid. This vitamin C was synthesized, and in adequate quantities it completely prevents and completely cures the disease, which is now rare. The protagonist of this medical history was James Lind. His report of a prospective controlled therapeutic trial in 1747 preceded by a half-century the British Navy's prevention and cure of scurvy by citrus fruits. After lime-juice was unwittingly substituted for lemon juice in about 1860, the disease returned, especially among sailors on polar explorations. In recent decades revisionist historians have challenged normative accounts, including that of scurvy, and the historicity of Lind's trial. It is therefore timely to reassess systematically the strengths and weaknesses of the canonical saga. [source]

The discovery of the human melanocyte

PIGMENT CELL & MELANOMA RESEARCH, Issue 3 2006
Wiete Westerhof
Summary Around 2200 bc the first written description of a human pigmentation disorder, most likely vitiligo, was recorded, and from that moment the history of research into human pigmentation can be traced. For the following 4000 yr, the origins of human skin colour remained an enigma that was to generate a multitude of misconceptions. Even after European physicians began to dissect and compare dark and light coloured skin to reveal its underlying anatomy, the origins of skin and hair pigmentation were a matter of frequently erroneous speculation. The true source of human pigmentation was only finally revealed with the discovery of the melanocyte in the 19th century. Once tyrosinase was identified to be the key enzyme in pigment formation, attention focused on elucidating the chemical structure of melanin, an enterprise that remains incomplete. The developmental origins of the melanocyte were described from 1940 to 1960, and the concept of the epidermal melanin unit was introduced together with a description of the ultrastructure of the melanosome and melanosome transfer. With these advances came the realization that different skin types exhibit distinct differences at the histological level that relate to varying amounts of eumelanin and pheomelanin produced by the melanocytes. The foundation established over the past 4000 yr is the basis for all current research into this fascinating cell type. [source]

Schistosomiasis as an unusual cause of appendicitis

CLINICAL MICROBIOLOGY AND INFECTION, Issue 2 2004
B. Doudier
Abstract Millions of people originating from tropical areas now live outside the country of their birth. As a consequence, the number of cases of diseases imported from the tropics and being seen by European physicians in immigrants is growing. As an example of such diseases, schistosomal appendicitis is a specific trait of infection with Schistosoma haematobium and is an uncommon cause of appendicitis in non-endemic areas. Treatment requires anti-schistomal medication in addition to surgery. Physicians, including surgeons, need to be aware of the possibility of seeing atypical presentations of parasitic diseases in immigrant patients. [source]