Southern medical journal
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Southern medical journal · Mar 2002
Determinants of outcome for patients admitted to a long-term ventilator unit.
This prospective cohort study was done to identify determinants of successful weaning from mechanical ventilation among patients admitted to the 10-bed long-term ventilator unit (LTVU) of a teaching hospital. ⋯ Patients admitted to an LTVU require prolonged hospitalizations and intensive resource utilization. These data suggest that improved methods for identifying patients who are unlikely to benefit from prolonged mechanical ventilation may assist physicians in their discussions with patients and family members as they consider various treatment options.
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Southern medical journal · Mar 2002
Ketorolac for pain management after abdominal surgical procedures in infants.
While the use of intravenous ketorolac in infants less than 6 months old has not been previously reported, ketorolac may reduce opioid use and prevent opioid-associated side effects that are frequent in this age group. We reviewed our experience with ketorolac in infants to develop recommendations for using it after abdominal surgery. ⋯ Ketorolac reduces the amount of morphine required after abdominal surgery in infants less than 6 months old. The use of ketorolac deserves further study as a method of reducing opioid-associated adverse effects in this patient group.
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Southern medical journal · Feb 2002
Case ReportsResolution of dyshidrotic dermatitis of the hand after treatment with continuous positive airway pressure for obstructive sleep apnea.
Eczema of the palm and obstructive sleep apnea (OSA) are common disorders. Proinflammatory cytokines and cell adhesion molecules are elevated in both of these disorders. We describe an unusual patient with OSA who had recurrent free remission of dermatitis after treatment with continuous positive airway pressure. We speculate that the resolution of the patient's skin condition may reflect the effects of increased tissue oxygenation during sleep, reduced sleep fragmentation, and/or a reduction in sympathetic tone associated with successful sleep apnea treatment.
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Southern medical journal · Feb 2002
Liver enzymes as predictors of liver damage due to blunt abdominal trauma in children.
Blunt abdominal trauma in children can result in injury to the liver. In hemodynamically stable patients, initial evaluation of liver transaminase levels may be useful in determining the need for computed tomography (CT). ⋯ When hemodynamically stable pediatric patients with blunt abdominal trauma have AST levels >400 and/or ALT levels >250 IU/L, abdominal CT is indicated. Children in this study with serum transaminase levels below these values were at decreased risk of liver injury.
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Southern medical journal · Feb 2002
ReviewAnesthetic care in developing countries: equipment and techniques.
Various organizations have been formed to provide short-term surgical services in developing countries. In these countries, the ability to provide effective anesthetic care requires the team to transport most of the equipment necessary to provide perioperative care for various surgical procedures. We review the basic supplies necessary to provide such care and discuss some of the issues related to the anesthesia machines, techniques, and monitoring in developing countries. Suggestions and options for preoperative assessment, intraoperative anesthetic care, and postoperative care, including pain management, are provided.