Biomedical subjects

Wilhelmine Wiese

Publications and source records attributed to Wilhelmine Wiese.

3 recordsLinked to original sources

PubMed2004

Medical errors and the trainee: ethical concerns.

How medical errors are handled by individual physicians and hospital systems is a topic of considerable interest. In teaching hospitals, medical students and house officers often observe and commit mistakes. Commission of a mistake is associated with serious emotional turmoil and uncertainty among trainees as well as experienced physicians. Although disclosure is the ethical standard, the consequences of disclosure are feared by many. This article focuses on the issues that surround medical errors as they pertain to medical students and residents. It is important that this group of future physicians has appropriate training, mentoring, and support when dealing with errors.

Aged↗

PubMed2004

Paraneoplastic polyarthritis in an ovarian teratoma.

A 34-year-old woman presented to the rheumatology clinic with severe low back pain and arthralgia; later she developed bilateral knee pain and swelling, with limitation in ambulation and minimal improvement with nonsteroidal antiinflammatory drugs. Two weeks later she developed pain on the volar aspect of the right wrist and on the hypothenar region of the right hand. Examination showed swelling and tenderness of the right hypothenar region, tenderness and decreased flexion and extension of the right wrist, and bilateral knee effusions. The combination of arthritis and tenosynovitis raised the possibility of an ovarian tumor. A pelvic ultrasound revealed a complex, hyperechoic ovarian mass consistent with a cystic teratoma. Four weeks after removal of the teratoma, the polyarthritis and related symptoms resolved without therapy.

Adult↗

PubMed2003

Association of pancreatitis with administration of contrast medium and intravenous lipid emulsion in a patient with the acquired immunodeficiency syndrome.

Computed tomography is widely used to diagnose acute pancreatitis. Iodinated contrast medium lengthens the duration of pancreatitis and may increase the incidence of local or systemic complications. Total parenteral nutrition including IV lipid emulsion plays an important role in the management of patients with pancreatitis. Induction of pancreatitis by IV lipid emulsion is exceedingly rare. We report a 30-year-old patient with the acquired immunodeficiency syndrome in whom pancreatitis was exacerbated by oral and IV contrast medium and also by IV lipid emulsion in the absence of hypertriglyceridemia. Exclusion of the lipid emulsion resulted in prompt reduction of lipase levels on three separate occasions. This case is the first to implicate IV lipid emulsion in the exacerbation of pancreatitis in a patient with acquired immunodeficiency syndrome and normal baseline triglyceride levels. Thus, this case report suggests that we must exercise caution in the use of contrast medium and IV lipids in the diagnosis and management of acute pancreatitis.

Acquired Immunodeficiency Syndrome↗