South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Four cases of Aspergillus pneumonia occurred in an intensive care unit within a short period. Clusters of cases of invasive aspergillosis are rare and have usually been attributed to excessive contamination of the environment. ⋯ Three of the cases were diagnosed ante mortem. One patient survived after early initiation of treatment with amphotericin B.
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A 45-year-old woman with intestinal malabsorption due to eosinophilic gastro-enteritis was found to have markedly fluctuating total serum IgE levels with a positive intradermal skin test and a positive radio-allergosorbent test to milk antigen. No organ-specific or non-organ-specific auto-antibodies were detected in the patient's serum, and her complement profile was normal. Low doses of disodium cromoglycate failed to improve intestinal absorption, whereas a 16-day course of a corticosteroid, beclomethasone dipropionate 3 mg daily, improved D-xylose and carotene absorption without suppressing the hypothalamic-pituitary-adrenal axis.
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The physiology and pharmacological management of postoperative pain are briefly discussed. Although narcotic analgesics are still the mainstay in the management of postoperative pain the judicious use of non-narcotic analgesics, anticholinergics, tranquillizers and soporifics as well as the administration of local anaesthetic agents could contribute greatly to the alleviation of postoperative pain and discomfort. Certain regimens for intravenous medication are outlined and strong emphasis is placed on the fact that postoperative pain relief is the duty of the doctor and not that of unskilled nursing staff.
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Patients with unrecognized fractures of the cervical spine associated with head injuries run the risk of developing spinal cord compression and paralysis while undergoing treatment. A case history demonstrating such a sequence of events is presented. ⋯ Routine radiographic examination of the cervical spine in all patients who have sustained significant injuries to the head or face is advocated. The technique for performing simple lateral radiography of the cervical spine without moving the patient is described.