Expert Witness Features – page 6

To be a toxicologist takes more than knowing the smell of bitter almonds

by Dr BOJAN FLAKS PhD DSc CBiol FIBiol FRCPath, of InfoResearch International TOXICOLOGY IS the science of poisons.

It is the study of the adverse effects of chemicals on living organisms, including the study of symptoms, mechanisms, treatments and detection of the poisoning of people or animals.

It is defined by the Oxford English Dictionary as: “...that department of pathology or medicine which deals with the nature and effects of poisons. So Toxicologist, a person versed in t[oxicology]”.

Does ‘acceleration’ really exist?

by Dr ANTHONY CLARKE, consultant rheumatologist

IN THE LAST issue of Your Expert Witness, Mark Phillips challenged the concept of the likelihood of clinicians being able to predict by how much an injury could bring forward degenerative change. I would like to take that argument further and challenge the related topic of acceleration of socalled constitutional musculoskeletal problems by trauma.

As a rheumatologist with a special interest in chronic pain I am frequently asked to provide an opinion where an orthopaedic surgeon asserts that there are degenerative changes visible on x-ray and that inevitably the claimant would have similar disabling symptoms within two or three years. On what evidence is that opinion based?

What the legal profession can learn from the consultant cardiologist

by NICHOLAS GALL MSc MD FRCP, consultant cardiologist and cardiac electrophysiologist at King’s College Hospital and honorary senior lecturer at King’s College London. Nickgall@doctors.org.uk.

CARDIOLOGY is the medical specialty dealing with heart problems, but also with other related areas such as blackouts of uncertain cause and high blood pressure. In the past cardiology was an extension of general internal medicine, staffed by doctors with an interest in the area.

A developing specialism

by RALPH B GRAHAM FCPodS FCPodMed BSc(Hons), consultant podiatric surgeon

SPECIALIST treatment of the foot has been established since the 18th century, as the emerging barber surgeons and medical practitioners refused to treat the foot. From those early beginnings the profession became established in the UK until registration with the pre-war voluntary system and then the Council for Professions Supplementary to Medicine in 1960.

At the turn of this century regulation was re-drawn; the Health Professions Council was established and podiatry and podiatric surgery are now regulated by the HPC.

Maxillofacial surgery and the Holy Grail

by PROFESSOR KHURSHEED MOOS

EVERY surgical specialty inevitably overlaps with another. For maxillofacial surgery that tends to be with ENT, plastic surgery, dental surgery and sometimes ophthalmic surgery.

For maxillofacial trauma, cleft lip and palate surgery and head and neck surgery (cancer), there is now little argument that it is primarily maxillofacial surgery. When the surgery requested is for facial deformity or aesthetic (cosmetic) surgery the issues are often more difficult for the patient and the surgeon.