Southern medical journal
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Entrapment and knotting of epidural catheters has been described, as well as techniques for removal. Several cases of successful removal have been reported; however, significant resistance was encountered during removal. Following the techniques described previously, we successfully removed a knotted epidural catheter.
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Amniotic fluid embolism is a rare occurrence, with no single pathognomonic clinical or laboratory finding. Diagnosis is based on clinical presentation and supportive laboratory values. We describe the case of a 17-year-old nulliparous woman at 27 weeks' gestation who had uterine bleeding, hematuria, hemoptysis, hypotension, dyspnea, and hypoxemia within 30 minutes of vaginal delivery. ⋯ Supportive measures, including oxygenation, fluid resuscitation, and plasma, were administered. Central hemodynamic monitoring and inotropic support were necessary. Our patient recovered uneventfully and 6 weeks later was living an unrestricted life-style.
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Southern medical journal · Jul 2000
Case ReportsTranscatheter arterial embolization in blunt hepatic trauma.
Patients with blunt hepatic injury can safely be managed nonoperatively if they show hemodynamic stability. Transcatheter arterial embolization (TAE) is a useful adjunct in the treatment of patients who show evidence of continued hemorrhage or who have pooling of contrast material on computed tomography (CT). In these patients, TAE may reduce transfusion requirements and allow healing of the injury without operation. Complications are uncommon and are usually managed nonoperatively.
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Clinical diagnosis is a process of logical deduction from the data gathered by history and physical examination. When organic causes of an illness have been ruled out, a diagnosis of "functional disorder" or "conversion reaction" is considered. ⋯ This report describes a case of paraplegia that was investigated for years before a diagnosis of conversion reaction was firmly made, based on a novel observation. We believe that we describe here a new physical sign, which can be used to diagnose "hysterical paraplegia."
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Southern medical journal · Jul 2000
Case ReportsBacteremia and possible endocarditis caused by Moraxella phenylpyruvica.
Moraxella phenylpyruvica, a gram-negative coccobacillus, is usually considered a nonpathogenic bacterium. Only a few cases of invasive disease caused by this organism were reported in the 1970s. We report a well-documented case of bacteremia and possible endocarditis due to M phenylpyruvica in a previously healthy man.