Southern medical journal
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Because of recent advances in the treatment and improved outcome of acute respiratory distress syndrome (ARDS), we present an overview of ARDS to update general practitioners on the management of this condition. ⋯ Acute respiratory distress syndrome is a severe form of acute lung injury associated with significant mortality and morbidity. In recent years, significant progress has been made in the understanding of this condition, but the management of ARDS remains complex and requires multidisciplinary and specialized care.
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Southern medical journal · May 1999
Use of advance directives by health care workers and their families.
Advance directives (ADs) are advocated for many but executed by few. To ascertain the importance of education in the decision to execute an AD, I did this study to determine the rate at which health care workers (a medically educated group) and their families execute ADs. ⋯ Health care workers do not appear to complete ADs at a rate any higher than the general population. Thus, education may be necessary, but alone it appears insufficient to increase use of ADs. Frequent family discussions occur among health care providers and their families. Such discussions may be an important outcome in their own right.
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Southern medical journal · May 1999
Case ReportsAcute respiratory distress syndrome in a welder exposed to metal fumes.
A 43-year-old man began having malaise, chills, and fever 12 hours after cutting a galvanized steel grating with an acetylene torch at work. Over the next 72 hours, his symptoms persisted and became worse with progressive shortness of breath. He was admitted to the hospital and begun on antibiotics and steroids. ⋯ The patient remained on mechanical ventilation for 10 days and was discharged from the hospital 2 days after extubation. He continued to improve, with minimal symptoms and a return to normal activity levels several months after the incident with no continued treatment. Re-creation of his exposure was done under controlled circumstances, with air sampling revealing elevated air levels for cadmium and zinc and borderline levels of arsenic, manganese, lead, and iron.
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Southern medical journal · Apr 1999
Randomized Controlled Trial Clinical TrialTeaching telephone management skills to pediatric residents in a pilot program using a standardized patient.
Pediatricians spend a significant amount of time on the telephone but receive little formal training in telephone management skills. We found only two previous reports in the literature using a randomized controlled trial (RCT) that documented the effectiveness of a telephone management program for residents. ⋯ Further studies involving larger number of residents and revised study design are needed in planning effective approaches to teaching these important skills to pediatric residents in our training program.
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Southern medical journal · Mar 1999
Case ReportsNear fatal acute respiratory distress syndrome in a patient with human ehrlichiosis.
Human ehrlichiosis is not a common cause of acute respiratory distress syndrome (ARDS). Physicians should be aware of this life-threatening but treatable entity. ⋯ We describe a case of ARDS resulting from human ehrlichiosis. A unique feature in our case was that despite the early use of doxycycline, the patient had near fatal ARDS that responded dramatically to high doses of steroids.