American family physician
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American family physician · Feb 2004
Letter Case ReportsParaphimosis in a middle-aged adult after intercourse.
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In the course of their clinical work or during leisure activity, family physicians occasionally may encounter patients with injuries from marine creatures. Poisoning, envenomation, and direct trauma are all possible in the marine environment. Ciguatera poisoning can result from ingestion of predatory fish that have accumulated biotoxins. ⋯ Hemorrhage and tissue damage occasionally are severe. Infections with organisms unique to the marine environment are possible; antibiotic choices are based on location and type of injury. Shark attacks, although rare, require immediate attention.
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American family physician · Feb 2004
ReviewRegional anesthesia for office procedures: part I. Head and neck surgeries.
Although local anesthesia usually is used in surgical procedures, field or nerve blocks can provide more effective anesthesia in some situations. In a field block, local anesthetic is infiltrated around the border of the surgical field, leaving the operative area undisturbed. In field blocks, epinephrine may be added to the anesthetic to enhance vasoconstriction and prolong the duration of anesthesia. ⋯ Systemic toxicity is rare with regional anesthesia and can be prevented by using the smallest dose possible and aspirating before the injection. Supraorbital, supratrochlear, infraorbital, and mental nerve blocks can provide adequate anesthesia in procedures on parts of the face. Field block also may be considered when operating on the ear or lips.