Southern medical journal
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Treatment of the adult respiratory distress syndrome requires an understanding of the current concepts of the pathogenesis of this syndrome. The clinical features and pathophysiology are briefly discussed. Differential diagnosis requires the exclusion of pulmonary infection and left heart failure. ⋯ Currently accepted modalities for improving oxygenation, when oxygen by face mask proves inadequate, include intubation and ventilation with postiive end-expiratory pressure. Other promising technics for improving oxygenation which do not require intubation are continuous positive airway pressure applied by face mask, continuous negative chest wall pressure, and alterations in posture. The long-term prognosis in survivors appears to be good, with only mild residual pulmonary functional abnormalities.
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Southern medical journal · Nov 1978
Case ReportsBulging (sagging) fissure sign in Hemophilus influenzae lobar pneumonia.
A bulging fissure sign was noticed on chest roentgenogram in a patient with H influenzae pneumonia. This sign is usually associated with Klebsiella pneumonia and has also been seen in pneumococcal and plague pneumonia, tuberculosis, mass lesions of the lung, and large lung abscesses. This is thought to be the first report of a bulging fissure sign associated with pneumonia due to H influenzae.
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Southern medical journal · Nov 1978
Subtrochanteric fractures of the femur: treatment with ASIF blade plate fixation.
Management of the severely comminuted subtrochanteric fracture of the femur has been extremely difficult due to problems in stabilization, failure of fixation, and/or failure of the device, as well as associated high morbidity and mortality. Twenty-three such fractures treated with the Association for the Study of Internal Fixation (ASIF) blade plate fixation are reviewed. ⋯ There were two deaths, but only one was due to postoperative complications. This review indicates that ASIF blade plates provide adequate stabilization and fixation with a high rate of union in these fractures.