Texas medicine
-
Obstructive sleep apnea is diagnosed with the use of polysomnography by documenting repetitive periods of upper airway closure during sleep. Apneic episodes can compromise gas exchange and disrupt the sleep pattern. ⋯ The history of loud snoring plus daytime hypersomnolence or multiple awakenings during sleep justifies ordering a polysomnogram. The importance of diagnosing obstructive sleep apnea is underscored by the resolution of its sequelae with effective medical or surgical treatment.
-
The spectrum of blunt cardiac trauma ranges from injuries with no actual cellular damage (myocardial concussion) to cardiac chamber rupture. Although blunt injuries to the heart are common and potentially lethal, rupture of a cardiac chamber is rare. This injury should be suspected in any patient who presents with cardiac tamponade after blunt trauma. A child who sustained blunt rupture of the right atrium is presented, and the pathophysiology, diagnosis, and treatment of these injuries are discussed.
-
Comparative Study
Firearm mortality in Texas, 1976-1985: how far is Fort Smith?
Firearm injuries significantly affect mortality rates in many states throughout the United States. We reviewed all deaths due to injuries in all state for 1985 to determine deaths from firearm injury in proportion to deaths from all injuries in each state. We then compared Texas data with those of other states. ⋯ Firearms accounted for 11% of the total years of productive life lost. The economic cost of firearm deaths in Texas was estimated to be $40.7 billion per year. Strategies for preventing these deaths are discussed.
-
Comparative Study
Medical ethics reflected in codes of ethics: the Hippocratic Oath and the 1980 AMA code compared.
The Hippocratic Oath and 1980 Code of Ethics of the American Medical Association (AMA) are compared to evaluate the nature of the relationship between students and teachers of medicine and the ethical injunctions that guide practice and make up the essence of the Hippocratic Oath. Such injunctions include the need to take care that harm is not done, to maintain confidentiality, and to avoid acts leading to death. The AMA code is analyzed from the perspective of its injunctions to give competent and compassionate care, to follow the law, to be responsible for guarding patients against incompetent physicians, and to assure that patient care is based on principles of compassion and skill. The centrality of trust in the relationship between patient and doctor as a crucial value in defining a profession is emphasized.