Southern medical journal
-
Southern medical journal · May 2008
Case ReportsPostchemotherapy hyperammonemic encephalopathy emulating ornithine transcarbamoylase (OTC) deficiency.
A young patient with hepatocellular carcinoma receiving chemotherapy presented with encephalopathy. Evaluation of the patient revealed a metabolic profile consistent with ornithine transcarbamoylase (OTC) deficiency, an inherited disorder of the urea cycle. ⋯ The hyperammonemic encephalopathy was reversed by the infusion of arginine, a common treatment for hereditary OTC deficiency. This case may represent a distinct syndrome of reversible hyperammonemia in patients with hepatocellular carcinoma.
-
Southern medical journal · May 2008
Case ReportsPoor outcomes associated with drainage of pericardial effusions in patients with pulmonary arterial hypertension.
Pulmonary arterial hypertension (PAH) in its advanced stages is complicated by right heart failure and often pericardial effusion. The optimal treatment of large or hemodynamically significant pericardial effusions in this group has not been defined. ⋯ We found a high mortality related to pericardial fluid drainage in patients with PAH. The pathophysiologic explanation for these deaths remains unclear, but clinicians should consider conservative management in this situation if possible.
-
Despite the legislation passed in the 19th century outlawing human slavery, it is more widespread today than at the conclusion of the civil war. Modern human slavery, termed human trafficking, comes in several forms. The most common type of human trafficking is sex trafficking, the sale of women and children into prostitution. ⋯ Other forms of trafficking include child soldiering, war brides, and organ removal. Healthcare professionals play a critical role in both finding victims of human trafficking while they are still in captivity, as well as caring for their mental and physical needs upon release. Those working in the healthcare profession need to be educated regarding how a trafficking victim may present, as well as their unique healthcare needs.
-
Southern medical journal · Apr 2008
Urologic injuries sustained after free falls from hunting tree stands.
Hunting is a popular recreational pastime in the United States. Injuries sustained from falls out of tree stands remain a significant cause of morbidity among hunters, often resulting in significant urological injury. The purpose of this study is to identify the type and pattern of urologic injuries sustained after free falls from hunting tree stands. ⋯ Accidental falls from hunting tree stands can cause significant urologic morbidity. Fall-arrest system/full body harness use and increased hunter public education and awareness can reduce tree stand falls. Trauma teams need to be aware of the potential for urologic injury, and need to evaluate and treat hunters involved in tree stand accidents accordingly.