Websites covering hypocalcaemia

Dr Keith Barnard recommends websites relating to this week's Clinical Review.

Hypocalcaemia in a nutshell
This is not an attractive nutshell, but one of the most boring presentations you will see.

But this plain text account of hypocalcaemia goes briskly through definition, toxic and non-toxic causes, main clinical features, differential diagnosis, investigations and treatment.

Why go there: because it has a useful summary.
Downside: just the bare bones.
Information from: Canadian Centre for Occupational Health and Safety.
Address: www.intox.org/databank/documents/treat/treate/trt27_e.htm

Hypoparathyroidism
This is one of e-Medicine's better offerings - although it provides several screens of data, much of this is in the form of well-spaced bullet-point lists that make absorbing the detailed information a less daunting prospect than it first appears.

Don't bother to click on the differential diagnosis links, they take you to full articles that you have to sift through.

I found this out when I was surprised to see candidiasis as a differential diagnosis, but never found out why.

Why go there: all you need to know.
Downside: very detailed.
Information from: e-Medicine.
Address: Please click here

MI and hypocalcaemia
I like an interesting case history, and this one caught my attention because it involved hypocalcaemia causing an MI in a 37-year-old man.

He underwent a subtotal thyroidectomy some 17 years before. Since then he had been perfectly well, until he presented with chest pain and evidence of an MI.

He was found to have a positive Trousseau's sign that someone was clever enough to recognise when they took his BP.

It only takes a couple of minutes to read and will make an entertaining break between patients.

It is situations like this that make medicine a constant challenge and help interrupt the conveyor belt of everyday conditions.

Why go there: brief and fascinating.
Downside: none.
Information from: Journal of Clinical and Basic Cardiology.
Address: Please click here

This made me smile
This product claims that it will 'strengthen your bones at any stage of life, and if it doesn't do this in 180 days you can have double your money back.' One thing that amused me about this is how you know your bones are stronger or if you've grown new bone, as it also claims will happen?

Do you throw yourself off a cliff and see if you can walk away with your skeleton intact?

I certainly can't see your local X-ray department responding very favourably to a 'before and after' bone scan.

The other item that tickled my fancy was that this marine alga extract apparently works better if strontium is taken with it.

I always associate strontium with the radioactive isotope strontium 90, although only those of a certain Cold War age will appreciate why.

I'm sure this product isn't radioactive, but it would make me feel uneasy nevertheless.

Why go there: light relief.
Downside: might mislead osteoporosis sufferers.
Information from: AlgaeCal.
Address: Please click here

Dr Barnard is a former GP in Fareham, Hampshire

Website of the week
I have chosen a website that is, for a change, a low-technology zone, and because I like the fact that there are some situations where clinical signs can still be useful.

Some of us can remember when clinical signs were almost all you had, before the days of virtually instant biochemistry and techniques such as MRI and ultrasound, and making a diagnosis using these skills was somehow more personally rewarding than a report from the lab.

These pages tell you about Trousseau's and Chvostek's signs for hypocalcaemia, with a little historical background about the two European 19th century physicians. It describes what constitutes a positive response. The two signs are helpful in suspected hypocalcaemia, and interpreting the signs makes an interesting challenge.

Why go there: learn an old-fashioned skill.
Downside: none.
Information from: Hospital Physician Journal.
Address: Please click here

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