Southern medical journal
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The estimated 32,600,000 fires that occur annually in the United States produce over 300,000 injuries and 7,500 deaths. Ten percent of hospitalized burn victims die as a direct result of the burn. Initial evaluation and management of the burn patient are critical. ⋯ Wound care is initially directed at preservation of vital function by escharotomy, if restrictive eschar impairs ventilatory or circulatory function. Antibacterial agents may be applied to the burn, but invasive sepsis, defined as greater than 10(5) organisms per gram of tissue with invasion of subjacent viable tissue, requires systemic antibiotic therapy. Wound debridement is done by daily hydrotherapy, tangential excision, chemicals, primary excision, and grafting, tailoring the technique to the individual burn.(ABSTRACT TRUNCATED AT 400 WORDS)
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Southern medical journal · Feb 1984
Case ReportsPneumothorax and subcutaneous emphysema complicating endotracheal intubation.
We report subcutaneous emphysema and pneumothorax as immediate complications of endotracheal intubation in a patient with diffuse interstitial lung disease. We postulate increased intra-alveolar pressure during intubation leading to rupture of a subpleural bleb or cyst as a possible mechanism causing these complications.
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Southern medical journal · Feb 1984
Case ReportsKlebsiella pneumoniae arthritis of the hip in a diabetic patient.
Chronic debilitating diseases may predispose to various joint infections, but early diagnosis of septic arthritis of the hip may be difficult. Klebsiella pneumoniae is an organism uncommonly found in joint infections. We have reviewed the literature on Klebsiella pneumoniae septic arthritis and described a case of a diabetic patient who had severe destruction of the hip joint over a six-month interval due to Klebsiella pneumoniae infection.
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Endocrine metabolic emergencies are common clinical entities seen by most health care professionals in acute care medicine. Except for cardiopulmonary arrest, few situations require such rapid institution of immediate drug therapy to reverse life-threatening metabolic imbalances. To safely guide patients through these situations, the physician requires a basic knowledge and familiarity with the approaches, indications, and limitations of drug therapy as a component of care.
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Southern medical journal · Feb 1984
Case ReportsSubacute salicylate intoxication in an infant with echovirus type 11 infection.
An antigenic variant of E 11 was the most frequently encountered echovirus in the United States in 1979. Several reports have indicated that infection with this agent was often associated with an overwhelming clinical course in neonates. Our case was in a 5-week-old infant with an E 11 infection complicated by subacute salicylate intoxication. This unfavorable combination resulted in a fulminant and fatal illness simulating Reye's syndrome.