JAMA : the journal of the American Medical Association
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Septicemia developed in 34 patients per 10,000 admissions to a community hospital during 1970 through 1973. Two thirds of the 207 patients had community-acquired septicemia, and one third had nosocomial septicemia. Septicemia-related mortality was 20.3%. ⋯ Septicemia was associated with shock in 9.7% of the patients. Foley catheterization and prophylactic antibiotic therapy could not be implicated as major risk factors for the development of septicemia. This study shows an incidence of Gram-negative bacteremia, septic shock, and mortality substantially less than that described in published data from noncommunity hospitals.
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Situations requiring immediate lowering of systemic blood pressure are infrequent. Certain clinical syndromes resulting from or complicated by severe hypertension demand vigorous, usually parenteral, antihypertensive therapy. ⋯ Use of furosemide reinforces the hypotensive effect of these agents. Theoretical advantages and disadvantages of these agents are not always encountered in clinical use.
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An 81-year-old man suffered a spontaneous rupture of the thoracic aorta through an atheromatous plaque, leading to total dysphagia and eventual esophageal infarction.