Southern medical journal
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Citalopram is the newest selective serotonin reuptake inhibitor (SSRI) available in the United States. It is currently approved by the Food and Drug Administration for the treatment of major depression. However, a number of studies have found it to be effective in the treatment of panic disorder as well. ⋯ We present the case of a 61-year-old woman who had frank panic attacks after her citalopram dose was increased. She had had no history of anxiety symptoms. Anxiety abated completely upon discontinuance of citalopram therapy.
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Southern medical journal · Sep 2002
Case ReportsNecrotizing fasciitis of the upper extremity resulting from a water moccasin bite.
Aeromonas hydrophila infection has been described as the cause of necrotizing fasciitis in patients with suppressed immune systems, burns, or trauma in an aquatic setting. We report a case in which severe necrotizing fasciitis involving hand, arm, chest, and lateral side of trunk, along with toxic shock, developed after the patient was bitten by a venomous snake. Mixed aerobic and anaerobic bacteria, including A hydrophila, were isolated from the wound culture. ⋯ After the application of skin grafts, the wound completely healed. This case illustrates that a venomous snakebite may result in infection with A hydrophila and can cause severe necrotizing fasciitis. Early and aggressive surgical intervention should be implemented as soon as the necrotizing fasciitis is diagnosed.
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Southern medical journal · Aug 2002
Case ReportsHemothorax and retroperitoneal hematoma after anticoagulation with enoxaparin.
A 58-year-old woman with chronic obstructive pulmonary disease had spontaneous bilateral hemothorax and a retroperitoneal hematoma after 4 days of anticoagulation therapy with enoxaparin (1 mg/kg subcutaneously every 12 hours) for suspected pulmonary thromboembolism. The patient was successfully managed with red blood cell and plasma transfusions, multiple thoracenteses for evacuation of blood from the pleural space, short-term mechanical ventilation, and administration of bronchodilators, corticosteroids, and antibiotics. This is the first report of spontaneous hemothorax and the third report of spontaneous retroperitoneal hematoma associated with enoxaparin therapy.
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Southern medical journal · Aug 2002
Comparative StudyNoninvasive carbon dioxide monitoring during neurosurgical procedures in adults: end-tidal versus transcutaneous techniques.
We prospectively compared transcutaneous (TC) versus end-tidal (ET) carbon dioxide monitoring during neurosurgical procedures in adults. ⋯ Transcutaneous CO2 monitoring provides a more accurate estimate of PaCO2 than ET-CO2 monitoring during neurosurgical procedures.
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Southern medical journal · Aug 2002
Comparative StudyEmergency department overcrowding in Florida, New York, and Texas.
This study was done to determine the incidence, causes, and effects of overcrowding in emergency departments (EDs) in Florida, New York, and Texas. ⋯ In this survey of EDs, overcrowding was pervasive. Many factors contribute to ED overcrowding. Poor medical outcomes may occur because of overcrowding.