Minnesota medicine
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Until recently, domestic violence was considered a criminal justice or social service problem. However, physicians see victims in emergency settings and clinics with complaints and symptoms that go beyond physical injuries. ⋯ This article discusses the prevalence of domestic violence and the variety of presentations. Guidelines for screening, what to do with a positive response, when to call the police, and how to document and code are reviewed, as are issues unique to older victims of domestic violence.
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Tetanus is a rare disease in the United States, with only 40 to 60 cases reported annually. This potentially lethal disease affects unimmunized or partially immunized persons, with the elderly at greatest risk. Tetanus usually follows an injury such as a puncture wound, abrasion, or laceration. ⋯ Patients with tetanus usually require intensive care with dose monitoring and extensive supportive care. Most patients experience full recovery with no signs of neurological sequelae. This case report and discussion illustrate the severity of the disease and the complexity of managing a patient with tetanus.