Isr Med Assoc J
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Biography Historical Article
Medicine 100 years ago: a glimpse at Osler's textbook of medicine.
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Fractures of the sternum may be associated with major injuries to thoracic organs, with serious consequences. ⋯ Our findings support the view that patients with isolated sternal fracture and no abnormality in ECG and cardiac enzymes during the early hours after injury are expected to have a benign course and can be discharged home from the emergency room within the first 24 hours.
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Sepsis is an inflammatory syndrome caused by infection. Consequently, anti-inflammatory therapy in sepsis has been a subject of extensive research, and corticosteroids have long been used to treat severe infections. However, studies conducted in the 1980s failed to demonstrate any beneficial effects of high dose, short-term steroid therapy in sepsis and this therapy was therefore abandoned in the last decade. ⋯ It is supported by the observation that many sepsis patients have relative adrenal insufficiency. Moreover, the anti-inflammatory effects of steroids and their ability to improve reactivity to catecholamines further contribute to their effects in sepsis. Large randomized clinical trials will be required to determine the exact role of corticosteroids in septic shock.