Southern medical journal
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The indications for emergency and elective cesarean hysterectomy have remained controversial throughout modern obstetric history. In an attempt to clarify the role of cesarean hysterectomy in today's practice, we retrospectively studied 216 peripartum hysterectomies done at our institution from 1956 to 1988. We analyzed indications, surgical procedures, and intraoperative and postoperative complications in an attempt to illustrate evolving obstetric trends.
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Southern medical journal · Oct 1989
Biography Historical ArticleFrancois Magendie, Claude Bernard, and the interrelation of science, history, and philosophy.
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Southern medical journal · Oct 1989
Randomized Controlled Trial Comparative Study Clinical TrialMetoclopramide versus droperidol for prevention of nausea and vomiting during epidural anesthesia for cesarean section.
In a randomized, double-blind study, we compared the efficacy of metoclopramide hydrochloride with that of low-dose droperidol for prevention of nausea and vomiting during and after elective cesarean section with epidural anesthesia. Immediately after the umbilical cord was clamped, each patient received fentanyl (50 micrograms) and the study drug intravenously over 30 to 60 seconds. In one study group, 40 women received metoclopramide (15 mg); in the other group, 41 women received droperidol (0.5 mg). ⋯ During the first four postoperative hours, five women (12%) in each group complained of nausea. Three women (7%) in each group had postoperative vomiting. We conclude that metoclopramide (15 mg) and droperidol (0.5 mg) were similarly effective.
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Southern medical journal · Oct 1989
Review Case ReportsLeptospirosis: a forgotten cause of aseptic meningitis and multisystem febrile illness.
Leptospirosis is a worldwide spirochetal zoonosis that spans a clinical spectrum from a mild febrile illness to a severe icteric disease with renal failure (Weil's syndrome). The illness is characteristically biphasic with conjunctival suffusion and an "immune" meningitis during the later phase of illness. ⋯ The diagnosis is confirmed by serology, by culture of blood or spinal fluid during the first phase of illness, or by culture of urine during the second phase. Doxycycline is the recommended therapy and is effective if given within the first several days of illness; it may also have a role in prophylaxis.
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Southern medical journal · Oct 1989
Case ReportsAdenoid cystic carcinoma metastasizing before detection of the primary lesion.
Although adenoid cystic carcinomas are occasionally manifested in atypical ways, metastatic disease preceding detection of the primary tumor has not been previously reported. We have described a patient in whom multiple pulmonary metastatic nodules were found one year before identification of primary adenoid cystic carcinoma of the maxilla. This case illustrates the need to include adenoid cystic carcinoma in the differential diagnosis of patients with metastatic disease and an unknown primary lesion. The use of special stains and electron microscopy can be helpful in confirming a diagnosis of adenoid cystic carcinoma.