Southern medical journal
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Mortality rates for hyperthermia and hypothermia are higher in Alabama than nationally, and Alabama has twice as many hypothermia deaths as hyperthermia deaths. These causes of death have not been studied in the southeastern United States. We describe the epidemiology of heat- and cold-related deaths in Alabama. ⋯ In Alabama, the elderly and black males are most likely to die of hyperthermia or hypothermia. Public health interventions must be directed toward these groups.
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Apophyseal fractures about the pelvis and proximal femur are well-described; however, these injuries rarely involve the greater trochanter. We report the case of a 15-year-old boy of large build who appeared to have all signs and symptoms of a left slipped capital femoral epiphysis. ⋯ Radiographs and bone scan of the capital femoral epiphysis appeared normal, and follow-up radiographs confirmed an apophyseal fracture of the greater trochanter. This case represented a rare occurrence, and its interesting manifestation was similar to that of a slipped capital femoral epiphysis.
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Reexpansion pulmonary edema (RPE) is an unusual complication of thoracentesis. Significant morbidity can result, and death is reported in 20% of cases. It is typically manifested as edema within a lung that has recently been reexpanded. ⋯ We believe this is the first reported case of recurrence and only the fifth overall case of contralateral RPE. We also review the pathophysiology, treatment, and case reports of contralateral RPE. Physicians should be aware of the complications of thoracentesis, particularly RPE, given the significant morbidity and mortality associated with it.
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Blunt pelvic injuries are becoming more common in this era of high-speed, high-energy collisions. At least 5% of blunt injuries result in pelvic fracture. With mortality rates approaching 55% for severe crush injuries of the pelvis, early stabilization and control of bleeding, as well as assessment for other injuries, requires a focused, multidisciplinary approach. We discuss early management and stabilization of severe pelvic fractures.
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Teaching residents the design and creation of skin flaps is challenging because the use of skin flaps is not common enough during the course of a typical residency to provide a broad experience base. ⋯ The materials developed provided an effective, inexpensive nonbiologic model for teaching preoperative skills.