Southern medical journal
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Southern medical journal · Feb 2009
Case ReportsUse of intrathecal nicardipine for aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm.
Cerebral vasospasm leading to delayed ischemia is a common and serious complication of aneurysmal subarachnoid hemorrhage that often results in increased morbidity and mortality. Treatments for cerebral vasospasm, including triple-H therapy (therapeutic hypervolemia, hypertension, and hemodilution), nimodipine, balloon angioplasty, and intra-arterial vasodilators have limitations in their efficacy and safety profiles. Nicardipine, a calcium channel blocker, is available for intravenous administration for blood pressure reduction. A recent study reported its efficacy in the treatment of cerebral vasospasm when given intrathecally (IT). We present our experiences with IT nicardipine for treatment of cerebral vasospasm. ⋯ Based on these positive results, we believe that larger scale studies evaluating the safety and efficacy of IT nicardipine for the management of cerebral vasospasm are warranted.
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Southern medical journal · Feb 2009
Case ReportsConcurrent smoking-related interstitial lung diseases in a single patient.
The three smoking-related interstitial lung diseases (ILD) include desquamative interstitial pneumonia (DIP), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), and pulmonary Langerhans cell histiocytosis (PLCH). They are considered discrete entities, yet it is not unusual to find a mixture of pathologic features rendering the histopathologic diagnosis difficult. It is uncommon to have overlap in the different radiologic findings between these diseases. We present a unique case, in that the extent of DIP and PLCH-like changes were manifested both histologically and on high resolution computed tomography (HRCT) with ground-glass attenuation and upper lobe cystic changes suggestive of both diseases.
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Southern medical journal · Jan 2009
Multicenter Study Comparative StudyPrevalence of intra-abdominal surgery: what is an individual's lifetime risk?
The lifetime risk of intra-abdominal surgery is unknown. The objectives of this study were to derive this information from our local population, and to consider the role of incidental surgery. ⋯ The lifetime risk of intra-abdominal surgery can be used to assess the utilization of healthcare among ethnic groups and in considering the role of incidental surgery.
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Southern medical journal · Jan 2009
Knowledge, attitudes, and use of emergency contraception among Hispanic women of North Carolina.
This project was designed to determine the knowledge, attitudes and self-reported use of emergency contraception (EC) of Spanish-speaking women of western North Carolina. ⋯ Considerable opportunity exists to expand patient education about all contraceptive options, including EC with Hispanic women of western North Carolina.
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Southern medical journal · Jan 2009
Case ReportsA case of emphysematous cystitis in cystic fibrosis.
It is postulated that gas-forming organisms ferment glucose within the wall of the urinary bladder leading to air collection; emphysematous cystitis occurs due to the fermentation of glucose by these organisms. Emphysematous cystitis is a rare condition usually seen in patients who are either diabetic or have other immunosuppressive diseases, or have had disruption of the bladder wall due to trauma or surgical instrumentation. ⋯ The patient presented with abdominal pain and was diagnosed with abdominal computed tomography examination. She was managed conservatively with a favorable outcome.