Southern medical journal
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Clinical diagnosis is a process of logical deduction from the data gathered by history and physical examination. When organic causes of an illness have been ruled out, a diagnosis of "functional disorder" or "conversion reaction" is considered. ⋯ This report describes a case of paraplegia that was investigated for years before a diagnosis of conversion reaction was firmly made, based on a novel observation. We believe that we describe here a new physical sign, which can be used to diagnose "hysterical paraplegia."
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Southern medical journal · Jul 2000
Case ReportsBacteremia and possible endocarditis caused by Moraxella phenylpyruvica.
Moraxella phenylpyruvica, a gram-negative coccobacillus, is usually considered a nonpathogenic bacterium. Only a few cases of invasive disease caused by this organism were reported in the 1970s. We report a well-documented case of bacteremia and possible endocarditis due to M phenylpyruvica in a previously healthy man.
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Southern medical journal · Jun 2000
Comparative StudyBlood pressure in acute vaso-occlusive crises of sickle cell disease.
We compared blood pressure (BP) in patients with sickle cell disease (SCD)-related crises and black patients without SCD. ⋯ No patients seen in SCD crisis were hypertensive. Patients who were female, had SS disease, or had bilateral pain had lower BP. Significantly higher BP and more hypertension occurred in black patients without SCD.
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Southern medical journal · Jun 2000
Recurrent coagulopathy after antivenom treatment of crotalid snakebite.
We studied whether recurrence of coagulopathy, defined as the return of a coagulation abnormality after initial normalization, occurred after the use of antivenin (Crotalidae) polyvalent. ⋯ Recurrence of coagulopathy after envenomation by North American crotalid snakes may occur after use of antivenin (Crotalidae) polyvalent and can result in severe coagulation abnormalities.
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Penetrating neck trauma may be managed operatively or nonoperatively, depending on precise anatomic location. Conservative management of zone II injuries is currently an issue under debate. ⋯ Support for both expectant and operative management of zone II injuries is given. We conclude that for zone II injuries, mandatory exploration by an experienced surgeon is a safe approach and that conservative management must be undertaken with extreme caution.