Postgraduate medicine
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Postgraduate medicine · Jan 1994
Opportunistic infections in AIDS patients. Current management and prevention.
The number of drugs available for treatment and prevention of opportunistic infections in patients who are seropositive for HIV infection is limited, although some agents currently being studied show promise. Pneumocystis carinii pneumonia, the most common opportunistic infection, can be effectively managed, although prophylaxis must be continued indefinitely. ⋯ Intensive therapy with five or six drugs may be necessary. Isoniazid (Nydrazid) is recommended for prophylaxis.
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Postgraduate medicine · Jan 1994
Oncologic emergencies. Treating acute problems resulting from cancer and chemotherapy.
Oncologic emergencies can occur in cancer patients who have a good prognosis. In all of them, the challenge to the clinician is to diagnose and treat before irreversible complications occur. In febrile patients with neutropenia, cultures of body fluids should be obtained and therapy should be started immediately with broad-spectrum antibiotics. ⋯ For brain metastases, immediate treatment with dexamethasone (Decadron, Dexone, Hexadrol) is indicated. For hypercalcemia, a number of drugs that inhibit bone resorption, resulting in lower serum calcium levels, are now available. Malignant cardiac tamponade is relatively rare but potentially lethal; emergency pericardiocentesis often results in marked improvement.