The Journal of the American Osteopathic Association
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Telangiectasia macularis eruptiva perstans (TMEP) is a rare form of mastocytosis. It appears most frequently in adults and only occasionally will affect young children or infants. In this disease, multiple brownish-red confluent macules and telangiectasias develop, primarily on the trunk. ⋯ A simple workup can help to differentiate between these two conditions. The authors describe a 48-year old woman who was seen with cutaneous features of TMEP and with multiple symptoms suggesting systemic mastocytosis. They discuss the clinical features, diagnostic workup, and therapeutic options in the management of this relatively rare condition.
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In traumatically injured or medically unstable pediatric patients requiring resuscitation, gaining intravenous access often is frustrating for the physician and agonizing for the patient. Even when cardiopulmonary resuscitation is performed by trained professionals, cardiac arrests in children in the prehospital setting have a mortality of 79% to 100%. Immediate vascular access such as that obtained by intraosseous infusion improves survival. ⋯ Epinephrine, bicarbonate, calcium, lidocaine, and volume expanders can be infused via the intraosseous route. Complications rarely occur. The technique described here is gaining acceptance in both prehospital and emergency department settings.
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J Am Osteopath Assoc · Dec 1993
Case ReportsHantavirus pulmonary syndrome (HPS): report of first case in Louisiana.
Since May 1993, 26 people have died of a "unique, previously unknown" viral illness that presents with flu-like symptoms and progresses rapidly to respiratory failure and death. Originally isolated in the four-corners region of the Southwest, the hantavirus responsible has now been isolated from patients in several other areas. In this article, we describe our experience with "the most puzzling case so far," an infection by a "cousin" of the Southwest hantaviral strain in a Louisiana bridgeworker. This case is unique not only because of the slightly different makeup of the virus, but also because of the absence of deer mice, the suspected carrier of the hantavirus, in the Louisiana region.
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J Am Osteopath Assoc · Oct 1993
Case ReportsComputed tomography in the diagnosis and management of popliteal artery entrapment syndrome.
Popliteal artery entrapment by an anomalous band of the gastrocnemius muscle is an uncommon but apparently under-diagnosed syndrome. Historically, arteriography has been used to diagnose this condition, but the standard method may not demonstrate arterial deviation or differentiate entrapment from other conditions that affect the popliteal artery, such as cystic adventitial disease and thrombosed popliteal artery aneurysms. Computed tomography has become increasingly useful to vascular surgeons in elucidating arterial disorders of the popliteal fossa. This case demonstrates the usefulness of computed tomography evaluation in the diagnosis and management of popliteal artery entrapment.