Connecticut medicine
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Connecticut medicine · Sep 2009
Case ReportsThoracic endometriosis: an unusual cause of hemothorax.
In this report we describe the clinical presentation, diagnosis, treatment and outcome of a 45-year-old woman with thoracic endometriosis. Four clinical presentations have been described. ⋯ Video-assisted thoracoscopic aurgery confirmed the presence of endometrial tissue embedded in the diaphragmatic pleura. Talc pleurodesis alongwith atotal abdominal hysterectomy and bilateral salpingo-oophorectomy led to a clinical and radiological resolution.
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A 48-year-old man with a 75-pack-year history of tobacco use was referred to pulmonary clinic for evaluation of an abnormal chest roentgenograph. He had been followed by his primary physician for bronchitis and nonproductive cough over the past year and was recently treated with a course of antibiotics with no change in symptoms. He had no other medical history, was currently smoking two packs of cigarettes per day, and reported working on the docks in a shipyard for five years. On physical examination, he was afebrile with stable vital signs and 97% oxygen saturation on room air. He was well-developed in no apparent distress. On cardiovascular examination, he was in sinus rhythm without murmurs. Chest examination was clear to auscultation. There was no lymphadenopathy. The abdomen was soft and benign. The extremities were without clubbing, cyanosis, or edema. The rest of the physical examination was unremarkable. ⋯ The patient had a chest computed tomography (CT) available for review (Fig. 2). What diagnostic study should be performed next?
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Connecticut medicine · May 2009
Comparative StudyComparative results of trauma scoring systems in fatal outcomes.
Trauma scoring systems are vital tools in assessing patient injuries and determining risk of mortality. This study was designed to test which score--the Injury Severity Score (ISS), the Trauma and Injury Severity Score (TRISS), TRISS plus comorbidities (TRISSCOM) or the new International Classification of Disease (ICD-9)-Based Injury Severity Score (ICISS)--has the greatest predictive value at a Level 2 trauma center. ⋯ The TRISSCOM and its modification performed significantly better than the other scores assessed. Elderly patients may require special treatment when included in scoring system comparisons.
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Connecticut medicine · Apr 2009
Biography Historical Article Classical ArticleOn the social responsibility of the medical profession. 1959.