Southern medical journal
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Southern medical journal · Jul 2004
Case ReportsPrimary cutaneous cryptococcosis in a lung transplant recipient.
Cryptococcal skin lesions are found in 10 to 15% of patients with disseminated cryptococcosis. Primary skin inoculation by Cryptococcus neoformans is rare but has been reported. We report the first known case of primary cutaneous cryptococcosis in a lung transplant recipient. ⋯ Primary cutaneous cryptococcosis has been reported in kidney and liver recipients but not in lung transplantation recipients. Nonhealing ulcers in immunocompromised patients mandate aggressive diagnostic procedures. Differential diagnosis of these cutaneous lesions should consider fungi, including C. neoformans.
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A 34-year-old woman was brought to our emergency department because of sudden loss of consciousness. Ventricular tachycardia and fibrillation were noted on electrocardiographic monitoring and reverted to sinus rhythm after repeated defibrillation. ⋯ This is an unusual case because the patient's initial presentation was cardiac arrest without previous history of cardiac disease. To our knowledge, this is the first reported case where ventricular tachyarrhythmia was the initial presenting sign of thyroid storm.
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Southern medical journal · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialSedation during mechanical ventilation in infants and children: dexmedetomidine versus midazolam.
We sought to compare the efficacy of midazolam versus dexmedetomidine for sedation during mechanical ventilation in infants and children. ⋯ At a dose of 0.25 microg/kg/h, dexmedetomidine was approximately equivalent to midazolam at 0.22 mg/kg/h. At 0.5 microg/kg/h, dexmedetomidine provided more effective sedation as demonstrated by the need for fewer bolus doses of morphine, a decrease in the 24-hour requirements for supplemental morphine, as well as a decrease in the total number of assessment points with a Ramsay score of 1 (inadequate sedation) and the number of patients who had a Ramsay score of 1.
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Southern medical journal · May 2004
Income, income inequality, and cardiovascular disease mortality: relations among county populations of the United States, 1985 to 1994.
Despite the major contribution of cardiovascular disease (CVD) to total mortality, and reports demonstrating strong relations between income and CVD, the joint relations of population-level income and income inequality with CVD mortality are not well described. This study was undertaken to describe relations among population-level income, income equality, and mortality due to cardiovascular disease, coronary heart disease, and stroke. ⋯ The CVD mortality experiences of county populations are related to both income and income distribution in a complex, disease-dependent manner. The authors' findings are especially relevant to the Southeast, a region of high income inequality, low income, and high stroke mortality.
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Southern medical journal · May 2004
Is eclampsia preventable? A case control review of consecutive cases from an urban underserved region.
The purpose of this study was to determine whether eclampsia is potentially preventable. ⋯ In this underserved population, a significant percentage of eclampsia cases are potentially preventable by patient education or health care response. In a smaller percentage, eclampsia may develop without any symptomatology or preeclampsia.