The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Dec 2000
Case ReportsRe-expansion pulmonary edema following puncture of a giant bulla.
Ipsilateral pulmonary edema may occur in a lung that has been rapidly reinflated after a period of collapse. The syndrome of re-expansion pulmonary edema is associated with variable degrees of hypotension and hypoxemia. ⋯ The initial cause of uninflated pulmonary parenchyma described with re-expansion pulmonary edema has typically been either a large undrained pleural effusion or a pneumothorax. The authors describe a patient in whom re-expansion pulmonary edema developed when inadvertent puncture of large emphysematous bullae released previously atelectatic lung.
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J Am Osteopath Assoc · Dec 2000
ReviewAcute gastrointestinal bleeding: clinical essentials for the initial evaluation and risk assessment by the primary care physician.
Acute gastrointestinal bleeding is a common medical emergency that frequently results in hospitalization. Rapid initial assessment of clinical parameters such as estimated volume of blood lost, appearance of expelled blood, hypotension, mental status changes, and coagulopathy should all be evaluated as part of the outcomes prediction equation. ⋯ Endoscopic therapy can reduce the rates of recurrent bleeding, surgery, and length of hospital stay in patient with these "stigmata of recent bleeding." Other endoscopic ulcer appearances such as brown or black pigment in the ulcer base or a clean ulcer base do not require endoscopic therapy, as rates of recurrent bleeding are very low for these lesions. Use of these clinical and endoscopic outcome predictors can also be useful in refining triage decisions as to which patients need to be in the intensive care unit, which need to be admitted to the hospital, and which can have early oral feeding and expedited hospital discharge or outpatient care.
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J Am Osteopath Assoc · Dec 2000
Biography Historical Article Classical ArticleThe future in retrospect. 1935.
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J Am Osteopath Assoc · Dec 2000
Biography Historical Article Classical ArticleTendencies in a social, political, and governmental way which may influence doctors. 1937.