Southern medical journal
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The clinical and laboratory findings in eight patients with spur cell anemia are presented and compared with other cases gathered from the literature. Although there is no specific clinical or laboratory abnormality, the condition can be recognized by a constellation of findings. The majority of patients have a long history of ethanol abuse with clinical and laboratory manifestations of hepatocellular dysfunction. ⋯ The sine qua non for the diagnosis of spur cell anemia is an increased percentage (usually greater than 20%) of acanthocytes on a peripheral smear. The prognosis of spur cell anemia is poor, the majority of patients dying within a year. From our study, spur cell anemia appears to be more prevalent than is generally reported.
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Southern medical journal · Oct 1982
Case ReportsAir embolism in central venous catheterization: diagnosis, treatment, and prevention.
Air embolism associated with central venous catheterization carries with it a significant morbidity and mortality. The diagnosis should be suggested by sudden alterations in cardiovascular, respiratory, or central nervous system function in a patient with a central venous catheter. ⋯ Placing the patient in the left lateral decubitus with the head down allows displacement of the air from the pulmonary outflow tract. Prevention of the complication involves thorough patient and physician preparation before subclavian catheterization, use of a Luer lock between catheter and tubing, meticulous catheter care, and employment of a pump with an in-line air detector.