ABSTRACT
Recently there has been increased interest in the use and development of virtual clinics, particularly in the wake of the COVID-19 pandemic. The need to provide clinical care, while minimising patient interaction, has led to wider adoption of both telephone and online consultations, with the potential complications and pitfalls that accompany such a change in practice. A literature search was performed using the Pubmed, MEDLINE and Embase databases, from database inception up to 25 January 2021. A total of 21 papers were identified as discussing virtual clinical assessment and the medicolegal implications. The main areas of concern included consent, misdiagnosis, lack of physical examination, privacy and patient satisfaction. This article assesses these areas and suggests techniques to address them.
Subject(s)
COVID-19 , Pandemics , Databases, Factual , Humans , Patient Satisfaction , SARS-CoV-2ABSTRACT
Agave americana is a low growing, thick, long-leaved, subtropical plant used for medicinal, commercial, and ornamental purposes. The plant's sap contains calcium oxalate crystals, acrid oils, saponins, and other compounds. Despite these known irritants, Agave-induced irritant dermatitis has rarely been reported. Previous case reports have noted a papulovesicular eruption consistent with an irritant contact dermatitis. We report a case of Agave-induced purpura in an otherwise healthy patient. Histopathology was consistent with an evolving leukocytoclastic vasculitis.
Subject(s)
Dermatitis, Irritant/etiology , Plants, Toxic , Plants , Pruritus/etiology , Adult , Biopsy , Capillaries/pathology , Dermatitis, Irritant/diagnosis , Dermatitis, Irritant/pathology , Humans , Male , Neutrophils/pathology , Pruritus/pathology , Skin/blood supply , Skin/pathology , Vasculitis, Leukocytoclastic, Cutaneous/diagnosis , Vasculitis, Leukocytoclastic, Cutaneous/etiology , Vasculitis, Leukocytoclastic, Cutaneous/pathologyABSTRACT
A study was conducted to determine the prevalence of substandard visual acuity in a sample of the diverse communities of the United States Air Force. In addition, mobility readiness (visual), ocular disease, time since last visual examination, and adherence to ocular requirements per AFR 160-43 were assessed. Comprehensive eye examinations were performed in the Optometry Clinic on 207 randomly chosen members scheduled by Squadron Schedulers using random computer lists of personnel generated by Military Personnel Flight. Of the 207 individuals, 112 (54%) had not had a professional eye examination in the last 2 years, 51 (24%) were not mobility ready, 6 (3%) had inadequate visual acuity per AFR 160-43, and 4 (1.9%) had ocular disease. The study reinforces the concept that comprehensive, periodic ocular examinations should be performed by an optometrist or ophthalmologist on all active duty members to ensure that they see properly to perform assigned duties, that members on mobility have required optical materials to be deployment ready, and that members who develop ocular disease are identified in a timely manner.
