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IF YOU ARE AN EXPAT, AND ENGLISH IS NOT YOUR FIRST LANGUAGE , HAVE YOU HAD TROUBLE WITH IDIOMS?

TROUBLE WITH IDIOMS. After finishing medical school in Louvain Belgium, I came to Schenectady, NY in the US to do my internship. My knowledge of English was what I knew from my high school language classes. this translates into “very little practical knowledge”. At first I struggled but caught on fast (I had to). What did not come so fast was my understanding of the use of idioms. In earlier blogs I related my embarrassment with “pain in the neck” and “prick”. Here is an other one which at the time gave me a red face but now after so many years makes me chuckle. Anne and I lived in a small apartment close to the hospital and got by on a small, very small, salary (this was the late fifties). So did all the other interns. Therefore our entertainment consisted of pot-luck weekend evenings at each other’s apartments on a rotating basis. When it was our turn to host the get together we had told our friends to come around 8:00 pm. In Belgium this means arrival at the earliest around 8:15 or even later. Of course this is quite different in the punctual American culture. That evening the bell rang at 8:01 with the arrival of the first guests. I opened the door, sat them down, started the background music and offered them a drink, as other guests arrived. While they all were sipping their wine, whiskey, or soft drink, someone asked where Anne was. She was still getting ready, not expecting any one until sometime after 8 pm. I told them “Anne is taking a douche.” Now, a douche is actually the French word for shower and is also commonly used in the Dutch language, but of course in the English language that word has quite a different meaning. When I told everyone quite innocently, that Anne was taking a douche, people’s mouths fell open and I could see on their faces the disbelief and hidden thoughts …”what kind of party is this going to be?” A similar confusion occurred toward the end of our stay in Schenectady, when the student nurses, many of whom had befriended Anne, who was now in her first pregnancy, told me that they were planning to give her a baby shower. They asked me not to say anything and keep it as a surprise. However, I felt compelled to warn Anne that she was going to receive a gift of a shower for the baby, rather than a bath. I felt that I needed to prepare her for this unusual gift, as I knew that babies in Belgium are washed in a small bath and not in a shower. Of course we had a good laugh when we realized our misunderstanding. And so it goes!! If you want to read more and similar experiences you can read my book “Crosscultural Doctoring. On and Off the Beaten Path. You can download it for free from Smashwords at: https://www.smashwords.com/books/view/161522. Our just google: Crosscultural Doctoring. I would love to hear about similar experiences from people, medical or non medical, around the world who have had difficulty with english idioms.  
DR William LeMaire
over 4 years ago
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Tinnitus severely affects person’s quality of life | PerfScience

A research paper published in the journal JAMA Otolaryngology-Head & Neck Surgery has unveiled that the rate of tinnitus is higher among Americans who are regularly exposed to noisy environments. Around one in 10 American adults face the problem of chronic tinnitus, a condition in which a person constantly have ringing or roaring in the ears or head.  
perfscience.com
over 4 years ago
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Physical Examination of Head and Neck

this video shows how to examine head and neck properly  
youtube.com
over 4 years ago
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10

Imaging Case of the Week 207 Answer

The chest x-ray shows major neck vessels that are outlined by air, producing the tubular artery sign. This is suggestive of pneumomediastinum.  
emergucate.com
over 4 years ago
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7

Why we do what we do: Antibiotics for dog bites

For a long time when encountering a patient who had suffered a dog bite I reflexively placed the patient on antibiotics. Generally, either amoxicillin/clavulanate or clindamycin. Along the way I began to question whether or not there is evidence to support this practice, since I also haven’t seen many infected dog bites. As you may already be aware, most dog bites are from an animal known to the victim. One study from Australia noted that >4/5 were known. In children under 5 the bites are more likely to be in the head/neck (60-70%). See Patronek at al. for more. In older children and adults the extremities – more commonly the dominant hand – are involved.  
pemcincinnati.com
over 4 years ago
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8

Chest and neck pain in a 22 year old woman

A 22 year old woman was referred to the emergency department by her general practitioner owing to severe chest pain that was now radiating to her neck. The pain has been worsening over the past 24 hours. It first started when she was eating fish at a seafood restaurant. What does the lateral soft …  
feeds.bmj.com
over 4 years ago
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10

Chest and neck pain in a 22 year old woman

A 22 year old woman was referred to the emergency department by her general practitioner owing to severe chest pain that was now radiating to her neck. The pain has been worsening over the past 24 hours. It first started when she was eating fish at a seafood restaurant. What does the lateral soft …  
feeds.bmj.com
over 4 years ago
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7

Genes Tell How the Giraffe Got Its Long Neck

Scientists have sequenced the genome of the giraffe for the first time, uncovering DNA quirks that help explain how the tallest animals on earth developed their remarkably long necks.  
medscape.com
over 4 years ago
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Imaging Case of the Week 203 Answer

The lateral neck x-ray shows fish bone lodged in the pyriform fossa of the hypopharynx as shown below. There is air in the prevertebral space secondary to perforation of the hypopharynx.  
emergucate.com
over 4 years ago
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Remote-Access Thyroidectomy an Option for Some, ATA Says

Thyroid-surgery procedures that spare the neck incision are "niche" and really should be recommended only for selected patients and when performed by high-volume surgeons, experts conclude.  
medscape.com
over 4 years ago
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Imaging Case of the Week 203

This lateral neck x-ray is from a 60 year old who has presented with a chicken bone stuck in his throat. What can be seen?Answer will be posted on 4/5/16.  
emergucate.com
over 4 years ago
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Spurling's Test or Cervical Axial Compression Test | eHealthStar

The Spurling test--a downward pressure on the head--is intended to determine if the pain in an arm is due to a pinched nerve in the neck.  
ehealthstar.com
over 4 years ago
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Forget About Saving a Life by Plunging a Pen Through the Neck

Few movie scenes create more drama than a character saving a dying person's life by plunging a pen into his neck to open up his airway, but a new study from Germany suggests viewers shouldn't try that trick at home.  
medscape.com
over 4 years ago
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Head and neck cancer drug 'game changer' - BBC News

A new type of cancer drug that wakes up the patient's own immune system to fight tumours could be a game changer for tackling head and neck cancers, say experts.  
bbc.co.uk
over 4 years ago
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7

Fever with seizure and confusion

A 41 year old previously healthy man presented with a six day history of fever, headache, and vomiting, followed by two episodes of staring spells and unresponsiveness and secondarily generalised tonic-clonic seizures. In the emergency department he was restless, inattentive, and not oriented to time, place, and person (Glasgow coma score 10/15; best eye opening response (E): 3; best motor response (M): 5 and best verbal response (V):2). He had neck stiffness; Kernig’s sign was positive and his ocular fundi were normal. He had no limb weakness or ataxia and deep tendon reflexes and plantar reflexes were normal. He tested negative for HIV1/2 antigen and antibody. His blood coagulation profile and platelet count were normal. An initial unenhanced computed tomogram of the brain found no contraindications for lumbar puncture. Analysis of cerebral spinal fluid (CSF) showed glucose 3.4 mmol/L (reference range 2.2-3.9 mmol/L; corresponding blood glucose was 5.8 mmol/L), protein 2.59 g/L (0.15-0.45 g/L), 450×106 white blood cells/L (100% lymphocytes; 0-5×106), and 40×106 red blood cells/L. Gram staining of the CSF was negative and bacterial culture was sterile. A confirmatory microbiological test was performed on his CSF and computed tomography of the brain repeated the second week after the onset of symptoms (fig 1⇓).  
feeds.bmj.com
over 4 years ago
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Fever with seizure and confusion

A 41 year old previously healthy man presented with a six day history of fever, headache, and vomiting, followed by two episodes of staring spells and unresponsiveness and secondarily generalised tonic-clonic seizures. In the emergency department he was restless, inattentive, and not oriented to time, place, and person (Glasgow coma score 10/15; best eye opening response (E): 3; best motor response (M): 5 and best verbal response (V):2). He had neck stiffness; Kernig’s sign was positive and his ocular fundi were normal. He had no limb weakness or ataxia and deep tendon reflexes and plantar reflexes were normal. He tested negative for HIV1/2 antigen and antibody. His blood coagulation profile and platelet count were normal. An initial unenhanced computed tomogram of the brain found no contraindications for lumbar puncture. Analysis of cerebral spinal fluid (CSF) showed glucose 3.4 mmol/L (reference range 2.2-3.9 mmol/L; corresponding blood glucose was 5.8 mmol/L), protein 2.59 g/L (0.15-0.45 g/L), 450×106 white blood cells/L (100% lymphocytes; 0-5×106), and 40×106 red blood cells/L. Gram staining of the CSF was negative and bacterial culture was sterile. A confirmatory microbiological test was performed on his CSF and computed tomography of the brain repeated the second week after the onset of symptoms (fig 1⇓).  
feeds.bmj.com
over 4 years ago
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6

UMEM Educational Pearls - University of Maryland School of Medicine, Department of Emergency Medicine

-Name of specific bone and specific site on bone (Shaft, head, neck, distal, proximal, styloid)  
umem.org
over 4 years ago
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Radiological Case: Venous Malformation

What was the etiology of this young woman's calcified neck mass?  
medscape.com
over 4 years ago
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Case – Blunt Trauma to the Neck - emdocs

emDocs post containing very useful emergency medicine information  
emdocs.net
over 4 years ago