The Medical journal of Australia
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In two cases of accidental hypothermia, heated humidification of the inspired gases and warming of fluids administered intravenously was associated with an increase in the deep body (core) temperatures at rates of 0-5 degrees to 1-0 degrees C per hour. The first case demonstrated that heat was transferred selectively to the body core, as temperatures here rose during the first three hours of treatment, while skin temperatures remained low. ⋯ The introduction of "active" measures was followed by a more rapid gain. It is suggested that heat supplied to the body core by these measures provides effective additions to metabolic production, particularly when the deep body and cardiac temperatures are at their lowest.
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A female, aged 80 years, presenting with a large abdominal mass causing distension and right-sided hydronephrosis, is presented. The mass proved to be a unilocular cyst attached to the fundus of a thick-walled gallbladder. Histological examination demonstrated invasive adenocarcinoma in the gallbladder. ⋯ The aetiology of this cystic lesion is discussed. It seems most likely that it is an acquired lesion caused by occlusion of the communication into a fundal diverticulum. This lesion is unusual, but should be considered in the differential diagnosis of obscure intraabdominal masses.
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Sixty students who graduated from the University of Queensland in 1958 were traced 15 years later. Sixty per cent were in private practice and 40% were in full-time salaried jobs. ⋯ After specialization, there appeared to be a tendency for the less academically able students to take on full-time salaried jobs rather than to enter private practice. Seventy per cent of women were still in substantially full-time practice.
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The Dalkon shield was withdrawn from the market in the United States of America last year because of the reports of 11 maternal deaths and 209 cases of septic midtrimester abortions associated with the device in situ. Four cases of late midtrimester septic abortions resulting in neonatal deaths are presented. In one of these, the mother developed septicaemic shock and almost died. ⋯ If pregnancy is diagnosed with the device in situ, it should be removed if the string is visible. If pregnancy continues with the shield in place, the patient should be observed closely. Should septic abortion occur, active management is indicated and early evacuation of the uterus is recommended.