Clues from hands Part 1: personal details about patients revealed by hand examination.

This is the first part of a two-part article on personal details revealed by the hand examination. Daily activities revealed by hand examination are the focus of Part 1, while personal details including nutrition and psychological assessment are presented in Part 2. These clues enable the examiner to discern hobbies, vocation, sporting activities, dietary information, and psychosocial information of the patient. We describe signs that may aid the clinician in determining these activities, enabling us to provide better patient care by establishing good patient rapport. Part 1, presented here, focuses on detection of visible traces on the hands of sporting activities, hobbies, and vocation. The patient through long familiarity may be oblivious to these features or may find them too insignificant to mention, yet they can provide meaningful social details for the

Obtundation and Myocardial Infarction in a Case of Systemic Loxoscelism.

We report an atypical course of a likely brown recluse spider bite in a 79-year-old male. The Rader scale and Loxosceles reclusa venom detection by ELISA provide supporting evidence for a loxoscelism diagnosis. Obtundation and myocardial infarction occurred following a drop in hemoglobin to 6.5g/dL. The rapid loss of blood volume was considered a significant etiologic factor for both the obtundation and myocardial infarction. The neurological symptoms reversed rapidly after packed red blood cell transfusion.