Southern medical journal
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Southern medical journal · Jul 1998
Review Case ReportsElectrocardiographic changes with right-sided pneumothorax.
Pneumothorax is a well-known complication of central line placement in the intensive care unit. Other causes include spontaneous pneumothorax, trauma, and infection. ⋯ We present five cases of right-sided pneumothorax in which electrocardiographic findings resolved with reexpansion of the lung. A new finding is reported in two cases.
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Southern medical journal · Jul 1998
Case ReportsGeriatric acute perforated appendicitis: atypical symptoms lead to a difficult diagnosis.
A geriatric man was admitted to the hospital with left-sided chest pain and subsequently had a full cardiac evaluation by a cardiologist. The workup revealed no cardiac abnormalities, and the patient was discharged on the second hospital day. He returned within 48 hours for recurrence of the left-sided chest pain and the interval development of epigastric and left upper quadrant abdominal pain. ⋯ Mild diffuse abdominal tenderness developed overnight, and computed tomography of the abdomen revealed a perforated appendix with suppuration. An appendectomy was done immediately. The diagnosis of appendicitis in the geriatric patient is occasionally difficult because of atypical and sometimes misleading physical findings.
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Southern medical journal · Jul 1998
Decrease in costs for management of lower airway disease in the pediatric intensive care unit.
We investigated whether a recently restructured pediatric intensive care unit (PICU) had a decrease in the cost of patient care over the years. ⋯ The costs of management for these previously healthy patients treated for lower airway disease decreased over the study period. We speculate that the time related decrease in costs is a reflection of the learning curve of the pediatric critical care team. The decrease in POC did not shift costs to other areas of the hospital.