Southern medical journal
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Southern medical journal · Jul 1992
Pediatric chest disease: evaluation by computerized tomography, magnetic resonance imaging, and ultrasonography.
The initial method for evaluating pediatric chest disease remains the plain chest roentgenogram. When more precise definition of chest disease is required, computerized tomography (CT), magnetic resonance imaging (MRI), or ultrasonography (US) may be useful. In general, CT offers the widest spectrum of applicability. ⋯ US is helpful in evaluating diseases of the pleura and for characterizing and localizing pleural fluid and masses. US can differentiate normal thymus from other anterior mediastinal masses. Doppler techniques are valuable in evaluating suspected pulmonary sequestration and identifying the feeding vessel.
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Southern medical journal · Jul 1992
Efficacy of the supraclavicular route for temporary hemodialysis access.
The percutaneous supraclavicular approach for temporary central venous hemodialysis access was successfully used in 27 of 34 cases (79%) without significant complications and was found to be a durable technique acceptable to every patient. The supraclavicular site was used from 3 to 156 days (mean, 40 days). The average catheter life was 25 days, and 13 guidewire catheter changes among eight patients were required for catheter limb thrombosis or suspected infection. ⋯ No new clinical evidence of central venous stenosis or thrombosis, such as arm swelling, prominent cutaneous collateral veins, or increased venous pressure at dialysis, was observed. We suggest the supraclavicular approach as the primary route for temporary central venous hemodialysis access. Continued follow-up is necessary to substantiate the initial favorable experience with the supraclavicular technique.
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Southern medical journal · Jul 1992
Physicians' attitudes and practices regarding treatment of HIV-infected patients.
We conducted a statewide survey to identify physicians' experiences, attitudes, and practices related to HIV-infected patients. A random sample, stratified by medical specialty (primary care, surgery, emergency medicine), was drawn. Physicians were concerned about contagion and inadequate knowledge to care for HIV-infected patients; 40% reported refusing or referring new HIV-infected patients. Differences across medical specialty and respondents' interest in various medical education topics to remedy knowledge deficits are discussed.