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Oxford Textbook of Medicine$
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Edited by David A. Warrell, Timothy M. Cox, John D. Firth

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Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates
include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Vibration

Chapter:
Vibration
Author(s):

Tar-Ching Aw

DOI:
10.1093/med/9780199204854.003.0905011

November 30, 2011: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

Various occupations can lead to exposure to vibration, which can be transmitted to the whole body or localized to the hands. The main clinical effect of whole body vibration exposure is low back pain. Effects from hand-transmitted vibration can be (1) vascular, with manifestations of secondary Raynaud’s phenomenon; (2) neurological, often presenting as paraesthesia and reduced sensory perception; and (3) musculoskeletal, including reduced grip strength and loss of manual dexterity. Management requires exclusion of differential diagnoses, and the identification and reduction of exposure to vibration at source. Diagnosis of an index case should prompt further investigation and (if possible) modification of the workplace to prevent other cases.

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