Military medicine
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Varicella infections affect the U. S. Army, but the extent has not been quantified recently. ⋯ S. Army is to target trainees for screening or vaccination. Refinement of this strategy should be determined from a follow-up cost-effectiveness analysis.
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Comparative Study
The impact of physician training on child maltreatment reporting: a multi-specialty study.
Past studies have suggested that physicians underreport suspected child maltreatment (CM) cases, possibly because of a lack of knowledge of the subject. ⋯ CME seems to positively influence physician reporting practices for CM cases, suggesting a need for universal training protocols.
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Lemierre syndrome consists of septic thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection, usually with Fusobacterium necrophorum. Septic metastatic emboli and distant infection are characteristic. ⋯ In addition, we used magnetic resonance imaging to effectively distinguish between inflammatory venous thrombosis and abscess, thus avoiding surgery in our patient. Early directed antibiotic therapy is mandatory to ensure good outcome.
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Stevens-Johnson syndrome is a cutaneous reaction pattern that represents the progression of symptoms of erythema multiforme. These reactions can range from mild (EM minor) to severe (EM major) and even life-threatening (Stevens-Johnson syndrome or toxic epidermal necrolysis). ⋯ The three most common triggers for Stevens-Johnson syndrome are herpes simplex infection, Mycoplasma infection, and drug reactions. This is a case of Stevens-Johnson syndrome occurring after erythromycin treatment aboard an aircraft carrier while deployed at sea in the Persian Gulf.
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The results reported in this paper are from a larger study examining the relationship between access and stage at diagnosis of breast cancer in African-American and white women. This paper focuses on the results describing the extent to which potential and realized access predict stage at diagnosis within an equal economic access health care system. ⋯ Logistic regression analysis revealed that late-stage breast cancer was more likely to be diagnosed in African-American women from low socioeconomic strata with incidental breast self-examination-discovered cancers. The most significant predictors of late-stage diagnosis were means of discovery and the length of time between discovery and diagnosis.