Southern medical journal
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Southern medical journal · Dec 2008
Predictive factors for septic shock in patients with ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is one of the most frequent infections in intensive care units (ICUs), and nearly 50% of patients with VAP develop septic shock. Septic shock is an independent predictor for mortality in these patients. ⋯ Some clinical parameters such as lymphocytopenia, blood glucose >120 mg/dL, increasing age, and CPIS can predict septic shock during VAP, but large randomized controlled studies are needed to confirm these results.
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Caring for loved ones with dementia is challenging and stressful for family members who have to provide the home care. The responsibility takes a huge physical, emotional, and financial toll on the caregivers, which is known as caregiver burden. ⋯ The physician should periodically assess caregivers for the level of perceived burden, presence of depression and anxiety, social support, behavioral problems in the care recipient, and coping strategies and help the patient and caregiver with advance care planning. Strategies that meld support, education, and practical counseling about common caregiving stresses and community resources seem to mitigate caregiver burden and depression.
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Southern medical journal · Nov 2008
The role of ankle-brachial index as a screening test for coronary artery disease in the Hispanic population.
This study evaluated the role of ankle-brachial index (ABI) as an effective screening test of coronary artery disease (CAD) in the Hispanic population. ⋯ ABI is an effective and cost-efficient screening test for CAD.
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Southern medical journal · Oct 2008
Case ReportsPneumococcal purpura fulminans successfully treated with activated protein C.
Evidence suggests that sepsis is a systemic inflammatory condition complicated by dysequilibrium in coagulation and fibrinolytic homeostasis, with a shift in the balance towards increased coagulation over fibrinolysis. Protein C is a natural anticoagulant consumed and inactivated during sepsis. We present the case of a 33-year-old female, postsplenectomy, with pneumococcal sepsis and purpura fulminans, successfully treated with activated protein C.