Southern medical journal
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Amiodarone, a widely used antiarrhythmic drug, is associated with pulmonary toxicity, with an estimated mortality of 1% to 33%. Standard treatment for amiodarone pulmonary toxicity (APT) has been discontinuance of the drug and steroid therapy. We report a case of APT that recurred after withdrawal of steroids and failed to respond to reinstatement of steroid therapy. Recurrent APT is a rare clinical entity that has been reported only twice in recent literature.
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We evaluated 20 patients with pulmonary strongyloidiasis for risk factors, clinical and imaging manifestations, complications, treatment, and outcome. Eighteen (90%) had risk factors for strongyloidiasis including steroid use, age greater than 65, chronic lung disease, use of histamine blockers, or chronic debilitating illness. Pulmonary signs and symptoms, including cough, shortness of breath, wheezing, and hemoptysis, were present in 19 (95%); adult respiratory distress syndrome (ARDS) developed in 9 (45%). ⋯ All were treated with thiabendazole, 25 mg/kg twice daily; on average, patients without ARDS were treated for 3 days, versus 7 days for those with ARDS. Seventy percent responded to therapy; 30% died. Preexisting chronic lung disease and ARDS were statistically significant predictors of a poor prognosis.
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Southern medical journal · Jan 1996
Bayesian analysis of noninvasive versus oral temperature measurements to determine hypothermia in postoperative patients.
Measurement of body temperature in the postanesthesia care unit (PACU) is an important parameter in patient management. Failure to reach minimal acceptable body temperature standards has been associated with physiologic derangements, the application of additional therapy, and prolonged PACU stays. Newer methods to monitor temperature introduced into the PACU have been touted to be adequate for detecting clinically significant changes in temperature. ⋯ Mean temperatures obtained by LCT (35.5 +/- 1.0 degrees C), AT (35.1 +/- 0.9 degrees C), and ITT (36.3 +/- 0.8 degrees C) differed significantly from OT (36.0 +/- 0.7 degrees C) mean temperatures. We applied Bayesian analysis to assess the sensitivity and specificity of each method, using a hypothermia reference of < 36 degrees C. Results suggest that the definition of hypothermia may depend on the modality used to assess body temperature in the PACU.