Atoms
July 1837 She had seen so many similar cases before. A previously (in the vernacular) bonny lass, frolicking in the meadows 1 day only to be sickly, confined to the sheets, the next. The common pattern—the sniffle and sore throat heralding the aching limbs, the blotchy marks, the delirium, the laboured breathing. Some physicians purported to have heard ‘murmurs over the precordium’, but maybe that was simply a cry from the (literal) heart of an ill child. They had nothing to offer in terms of assuaging, nothing but hope that the ague would pass. Hope, though, should never be underestimated—not then, not in 2025—it’s powerful stuff. Active (ated) intervention Trends in practice in the treatment of ingestion and overdose in terms of preventing or at least reducing absorption after the event has a history of its own in microcosm. Tradition during that narrow (1–2 hour) window (between swallowing...
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Ending nuclear weapons, before they end us
This May, the World Health Assembly (WHA) will vote on re-establishing a mandate for the WHO to address the health consequences of nuclear weapons and war.1 Health professionals and their associations should urge their governments to support such a mandate and support the new United Nations (UN) comprehensive study on the effects of nuclear war. The first atomic bomb exploded in the New Mexico desert 80 years ago, in July 1945. Three weeks later, two relatively small (by today’s standards), tactical-size nuclear weapons unleashed a cataclysm of radioactive incineration on Hiroshima and Nagasaki. By the end of 1945, about 213 000 people were dead.2 Tens of thousands more have died from late effects of the bombings. Last December, Nihon Hidankyo, a movement that brings together atomic bomb survivors, was awarded the Nobel Peace Prize for its ‘efforts to achieve a world free of nuclear weapons...
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CT coronary angiography in Kawasaki disease: current perspectives
Introduction Kawasaki disease (KD) is a common vasculitic disorder in children that preferentially involves the coronary arteries.1 Coronary artery abnormalities (CAAs) may develop in 15–25% of patients with KD who do not get timely treatment. However, even with appropriate treatment, CAAs can still develop in ~5% of patients.1 Precise diagnosis of CAAs is important for treatment planning.1–3 CAAs are the most important complication of KD and necessitate prompt and accurate diagnosis. While CAAs are more common in proximal segments, these can also occur distally.1–3 Presence of CAAs in both distal and proximal segments of coronary arteries impacts treatment planning. With time, CAAs may resolve, remodel or persist and may be complicated by thrombosis, steno-occlusive lesions and mural calcifications.1–3 There are several imaging techniques for assessment of...
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The relevance of miracles in court decisions affecting children
It is unsettling when parents refuse treatment for their child’s serious illness based on their expectation of a miraculous cure. We have in 15 years encountered 26 cases where parents opposed serious treatment. But only on one occasion was surgical treatment for an infant postponed by his parents, who awaited a miracle.1 Can the common law provide insight into the nature of pleas based on the hope of a miracle, or evidence of the success of such an approach? Family Court judgements on matters relating to immigration, domestic upheaval or child abuse record parents’ occasional resort to ‘miracles’ in support of their case. It is unlikely that these pleas were seriously intended as a reference to anticipated divine intervention. In families who contest a clinical decision to withdraw care in childhood, a frequent area of contention relates to their religious beliefs. This may be articulated as the...
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