Southern medical journal
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Southern medical journal · Mar 2005
ReviewPain management in children: developmental considerations and mind-body therapies.
One of the most challenging roles of medical providers serving children is to appropriately assess and treat their pain. Pain is one of the most misunderstood, underdiagnosed, and undertreated/ untreated medical problems, particularly in children. ⋯ This review focuses on the clinical assessment of pain, based on a developmental model and addresses common beliefs and myths that affect the management of pain in children. We provide a review of the pain literature that focuses on the integration of mind-body therapies into the management of procedure-related pain, headache, and recurrent abdominal pain in children.
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Southern medical journal · Mar 2005
Case ReportsAcupuncture therapy rapidly terminates intractable hiccups complicating acute myocardial infarction.
Acupuncture is a well-known alternative therapy in practice worldwide. Its dramatic effect on hiccups has been rarely reported. We describe a 77-year-old male who had hiccups after an acute myocardial infarction. ⋯ Eventually, the hiccups were rapidly terminated by acupuncture at acupoint GV14 (Da zhui). To the best of our knowledge, this is the first report of acupuncture's reversing intractable hiccups after an acute myocardial infarction. Acupuncture may be considered for patients with hiccups refractory to conventional therapy.
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Southern medical journal · Feb 2005
Association of clinical and laboratory variables with ultrasound findings in right upper quadrant abdominal pain.
The purpose of this study was to determine how laboratory values and physical examination findings correlate with ultrasound findings in the setting of right upper quadrant pain. ⋯ The findings from this study allow clinicians to apply objective significance to laboratory data and physical examination findings in patients with suspected gallstone disease. The data can be applied to create a predictive model.
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Warfarin is one of the most common anticoagulants in current use. It maintains a narrow therapeutic index resulting in a significant amount of bleeding. ⋯ Supratherapeutic international normalized ratios are usually best treated by holding a dose and/or reducing the weekly dose of warfarin. Patients with acute bleeding require more urgent warfarin reversal.
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Southern medical journal · Jan 2005
Review Case ReportsSurgical management of enoxaparin- and/or warfarin-induced massive retroperitoneal bleeding: report of a case and review of the literature.
A 70-year-old man on enoxaparin and warfarin sodium therapy due to pulmonary embolism was admitted for evaluation of a sudden, sharp pain in the left inguinal region. Physical examination revealed a 5 x 10 cm tender mass. Abdominal ultrasound showed a 9 x 9 x 10 cm left retroperitoneal hematoma. ⋯ A retroperitoneal abscess developed during the postoperative period which was drained percutaneously. He was discharged on postoperative day 33 with no further complaints. This case demonstrates the importance of surgical therapy in the treatment of spontaneous retroperitoneal hemorrhage caused by anticoagulant therapy.