Southern medical journal
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Southern medical journal · Nov 1994
Randomized Controlled Trial Clinical TrialLeft bronchial intubation by a single-lumen tube in adults: effects of bevel and curvature.
This study was designed to determine whether left bronchial intubation could be accomplished by reversal of the direction of the bevel or by changing the direction of curvature of a normal tracheal tube. The 60 study patients were divided into three groups. In group 1, the patients were intubated in the usual manner, with bevel to the left and the tube concave anteriorly. ⋯ In group 3, 18 tubes entered the right primary bronchus and 2 entered the left. The position of the bevel did not influence the positioning of the tracheal tube in the right or left bronchus. In summary, 90 degrees counterclockwise rotation from the usual position and altering the concavity of the tube to face the left significantly increased the likelihood of intubation of the left primary bronchus.
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Southern medical journal · Nov 1994
Factors associated with hypochromia and microcytosis among high school students in the southeastern United States.
We studied hematologic findings in 617 apparently healthy Georgia elementary, middle, and high school students, aged 10 to 19 years, and examined the influence of several parameters (race, sex, iron status, and genetic hemoglobin [Hb] abnormalities) on hypochromia and microcytosis, with or without anemia. Fourteen students (2%) (6 male, 8 female; 4 white, 10 black) were found to be anemic (Hb < 11.8 g/dL in boys or < 11.3 g/dL in girls). ⋯ Iron deficiency was the main associated factor in white students, but in blacks genetic Hb abnormalities, especially alpha-thalassemia trait, were other predisposing factors. The overall prevalence of iron deficiency (serum ferritin < or = 12 ng/mL) was 32.4% in the entire sample population, 30.5%, among blacks, and 33.2% among whites.
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Southern medical journal · Nov 1994
Frequency and outcome of infectious disease admissions to a pediatric intensive care unit.
This prospective clinical study was designed to assess patients with primary infectious disease (ID) necessitating admission to a pediatric intensive care unit (PICU), to identify morbidity and mortality risk factors, and to better define this subpopulation of critically ill children and compare them with patients who had a noninfectious disease (NID). All patients (N = 1,151) admitted to a multidisciplinary, university-affiliated, 20-bed PICU from January through December 1988 were studied. The patients were classified as having either ID or NID as the primary indication for PICU admission. ⋯ We concluded that patients admitted to our PICU with a diagnosis of infectious disease were significantly younger and had higher severity of illness scores than patients admitted with a diagnosis of noninfectious disease. The most frequent cause of death in both groups was multisystem organ failure. Patients with sepsis syndrome showed showed no significant difference in overall mortality, but their PRISM scores and mortality rate were significantly greater than those of the other ID patients.