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November 2008

Online Updates

The Merck Manual is continually updating the online version. Updates of selected topics are posted about every two months. The following updated topics have recently been posted:

bullet Mineral Deficiency and Toxicity
Tumors of the Head and Neck
Cataract
Optic Nerve Disorders
Orbital Diseases
Acne and Related Disorders
Fungal Skin Infections
Parasitic Skin Infections
Hair Disorders
Leukemias
Lymphomas
Overview of Cancer
Porphyrias
Immunodeficiency Disorders
Allergic and Other Hypersensitivity Disorders
Function and Dysfunction of the Cerebral Lobes
Cystic Fibrosis
Cold Injury
Principles of Radiologic Imaging

View entire Table of Contents
featured_topic
Frostbite

Selected excerpt from topic
Cold Injury


“Ice crystals form within or between tissue cells, essentially freezing the tissue and causing cell death. Adjacent unfrozen areas are at risk because local vasoconstriction and thrombosis can cause endothelial and ischemic damage. With reperfusion during rewarming, inflammatory cytokines (eg, thromboxanes, prostaglandins) are released, exacerbating tissue injury.”

Selected Current Literature on Featured Topic

1. Sammut SJ, Brackley PT, Duncan C, et al: Frostbite following use of a commercially available cryotherapy device for the removal of viral warts. Dermatology Online Journal Jun 15; 14(6):9, 2008.

2. Bruen KJ, Ballard JR, Morris SE, et al: Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy. Archives of Surgery Jun; 142(6):546–551; discussion 551–553, 2007.

3. Folio LR, Arkin K, and Butler WP: Frostbite in a mountain climber treated with hyperbaric oxygen: case report. Military Medicine May; 172(5):560–563, 2007.

4. Jurkovich GJ: Environmental cold-induced injury. Surgical Clinics of North America Feb; 87(1):247–267, viii, 2007.

5. Yazawa H, Saga K, Omori F, et al: The chilblain-like eruption as a diagnostic clue to the blast crisis of chronic myelocytic leukemia. Journal of the American Academy of Dermatology Feb; 50(2 Suppl):S42–S44, 2004.

MinlQuiz

Weekly podcasts provide reviews of patient symptoms based on topics of the same title from The Merck Manual of Patient Symptoms. Click here to listen.

Recently released podcasts

  • Chest Pain
  • Hemoptysis
  • Hiccups

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MinlQuiz

Each issue features a MinIQuiz relating to the recently updated topics. The MinIQuiz for this issue covers Cold Injuries, Acne and Related Disorders, Hair Disorders, and Optic Nerve Disorders. Correctly answer the MinIQuiz questions (you can use The Merck Manual Online) to be entered in a drawing to win a print or a PDA download version of The Merck Manual.
(Click here for MinIQuiz entry rules.)

Symptoms of frostbite can include all of the following except:

Blisters

Autoamputation

Soft, red, warm, and numb extremities
Gangrene
Take the quiz!
Last month's MinIQuiz Answers & Winner

Last issue’s MinIQuiz focused on Neck and Back Pain, Anemias Caused by Deficient Erythropoiesis, Somatoform and Factitious Disorders, and Thyroid Disorders. Our winner is Dr. Elyse Michelson, an internist in a multi-specialty practice in Reistertown, Maryland.

View last issue's MinIQuiz answers.
 
   
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