Connecticut medicine
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Connecticut medicine · Jun 2006
The significance of parapneumonic pleural effusions developing during antibiotic treatment for pneumonia.
There are little data regarding the outcomes of parapneumonic pleural effusions that first appear during antibiotic treatment of the underlying pneumonia. ⋯ Patients with pneumonia who develop a parapneumonic effusion while receiving antibiotic therapy are unlikely to develop empyema or a complicated effusion requiring drainage.
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Connecticut medicine · May 2006
Case ReportsA 32-year-old patient with hemolytic anemia and fulminant hepatic failure.
Wilson's disease presenting as acute hemolytic anemia and fulminant hepatic failure is a rare and poorly recognized disorder. We report a patient who developed hemolytic anemia and fulminant hepatic failure as the initial manifestations of Wilson's disease. ⋯ Despite intensive medical therapy our patient had a fatal outcome before transplantation could be undertaken. The objective of this report is to discuss the clues to diagnosis in this form of Wilson's disease, as delay in diagnosis seems to be responsible for the high mortality.
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Connecticut medicine · Apr 2006
Case ReportsCardiac surgery in a patient with heparin-induced thrombocytopenia--cautions with use of the direct thrombin inhibitor, argatroban.
Heparin-induced thrombocytopenia (HIT) is being recognized in an increasing number of patients referred for cardiac surgery, as a result of previous exposure to heparin. We present a case of a patient with HIT scheduled for aortic valve replacement and coronary bypass graft surgery, who was managed with the direct thrombin inhibitor, argatroban for anticoagulation during cardiopulmonary bypass (CPB). ⋯ Pertinent reports using argatroban for cardiac surgery with CPB are reviewed in the context of the present case report. The pharmacologic basis, cost analysis and resource utilization of heparin substitutes are discussed for the patient with HIT requiring CPB.
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Connecticut medicine · Apr 2006
Biography Historical Article Classical ArticleThe medical school--Janus of the university. 1956.