Postgraduate medicine
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Hyperbaric oxygen therapy is an important adjunct in the management of respiratory injuries secondary to smoke inhalation, especially when injury is complicated by inhalation of a toxic chemical such as carbon monoxide or cyanide. For carbon monoxide poisoning, such therapy has become a standard of practice. As more information becomes available concerning the ability of hyperbaric oxygen to reduce reperfusion injuries, we anticipate that this therapy will become a standard of practice for managing smoke inhalation injuries and cyanide poisoning as well.
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Trauma is the leading cause of death in young Americans and is responsible for the loss of more productive years of life than heart disease and cancer combined. Initial management of trauma consists of the establishment or maintenance of a patent airway, ensurance of adequate breathing, and resuscitation of the circulation. All of these are accomplished simultaneously with a cursory survey to identify immediately life-threatening injuries and to prevent permanent disability.
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Chest pain in teenagers often has no obvious organic cause. Onset of symptoms with an emotionally stressful situation may indicate psychogenic chest pain. ⋯ Most teenagers with chest pain have no such illness, and symptoms usually resolve without therapy. An important role for primary care physicians is to provide support during evaluation and follow-up.
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Postgraduate medicine · Aug 1990
ReviewThe new antimicrobial agents. When they're the best choice and when they're not.
The number of antibiotics available to the clinician for treatment of infectious diseases continues to increase. However, choosing an agent just because it is new is not always cost-effective and may encourage the development of bacterial resistance. The site of infection, pharmacokinetic data, minimum inhibitory concentration, and cost must all be considered in selecting the optimal antimicrobial agent for a particular clinical situation.
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Vaccination has greatly reduced the incidence of measles in the United States. Yet, because of the highly infectious nature and potentially fatal complications of the disease, primary care physicians need to remain alert to possible cases and to react aggressively during an outbreak. Dr Holtan discusses why measles persists, who is at risk, and how immunity is achieved.