Connecticut medicine
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Connecticut medicine · Oct 2007
Management of blunt hepatic trauma at a Connecticut Level I trauma center.
This study examined the management of patients with hepatic trauma treated at a Level I trauma center in Connecticut from January 1, 2003 to December 31, 2003. Forty-four patients over the age of 16 years sustained blunt liver injury and were brought to Hartford Hospital during the study period. Eight of these patients died; three of these deaths occurred in the emergency department (ED) shortly after arrival. ⋯ Our findings suggest that the current standard of care for most patients with blunt hepatic injuries is nonoperative management. It is the rare and most severely injured patient that will require operative management. As reported in the literature, mortality for these patients remains unchanged.
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Connecticut medicine · Aug 2007
Prolonged QTc intervals on admission electrocardiograms: prevalence and correspondence with admission electrolyte abnormalities.
Prolonged QTc (corrected QT) interval and torsades de pointes (TDP) are associated with hypocalcemia, hypomagnesemia, hypokalemia, possibly alkalosis and may result in syncope and sudden cardiac death. ⋯ Using conventional criteria, electronically measured prolonged QTc intervals were quite common at the time of admission among general medicine service patients, hospitalized for non-cardiac complaints. Admission electrolyte values were not associated with QTc intervals. We conclude that the association of metabolic derangements and QTc abnormalities may not be as strong as is widely believed.
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Connecticut medicine · Mar 2007
Case ReportsAddiction and chronic pain: diagnostic and treatment dilemmas.
Chronic pain and addictive disorders present significant medical and public health problems; both are underdiagnosed and inadequately treated. The cooccurrence of pain and addiction adds complexity to the assessment and treatment of both disorders. Research on the link between pain and substance use disorders (SUDs) has focused on the bidirectional relationship between chronic pain and opioid dependence. ⋯ Although the relationship between alcohol and pain has been less studied, alcohol use disorders are also prevalent among chronic pain patients and are of high clinical interest. In both subgroups of patients, failure to alleviate chronic pain contributes to poor clinical and functional outcomes. This review discusses common evaluation and diagnostic dilemmas in treating this challenging population.