Southern medical journal
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Southern medical journal · Aug 1998
Case ReportsClenbuterol and anabolic steroids: a previously unreported cause of myocardial infarction with normal coronary arteriograms.
During the last 10 years, several cases of myocardial infarction associated with anabolic steroid use have been reported. Postulated mechanisms to explain this association have included changes in lipid levels, the fibrinolytic system, and platelet aggregation. ⋯ In this case, synergistic effects of the two agents seem likely to have played a role in the infarct. The normal coronary arteriograms before any anticoagulant or thrombolytic therapy strongly suggest coronary spasm as the mechanism of the infarct.
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Southern medical journal · Aug 1998
Preparedness of practicing pediatricians in Louisiana to manage emergencies.
Surveys in recent years show that office emergencies are likely to occur in pediatric offices and that most offices are not equipped to deal with these situations. ⋯ Deficiencies exist among pediatricians and office staff regarding appropriate levels of preparedness to handle pediatric emergencies. Recommendations are made to attain appropriate levels of preparedness.
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Southern medical journal · Aug 1998
Case ReportsIntestinal strongyloidiasis manifesting as eosinophilic pleural effusion.
Strongyloidiasis caused by the helminth Strongyloides stercoralis is usually asymptomatic or causes mild dermatologic or gastrointestinal symptoms. In immunocompromised hosts, hyperinfection and dissemination can occur. ⋯ There was complete resolution of the pleural effusion after thiabendazole therapy, thus suggesting strongyloidiasis as the cause of the effusion. Helminthic infections like strongyloidiasis should be considered in the differential diagnosis of an eosinophilic pleural effusion, especially in individuals from endemic areas.
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Southern medical journal · Jul 1998
Review Case ReportsElectrocardiographic changes with right-sided pneumothorax.
Pneumothorax is a well-known complication of central line placement in the intensive care unit. Other causes include spontaneous pneumothorax, trauma, and infection. ⋯ We present five cases of right-sided pneumothorax in which electrocardiographic findings resolved with reexpansion of the lung. A new finding is reported in two cases.
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Southern medical journal · Jul 1998
Case ReportsGeriatric acute perforated appendicitis: atypical symptoms lead to a difficult diagnosis.
A geriatric man was admitted to the hospital with left-sided chest pain and subsequently had a full cardiac evaluation by a cardiologist. The workup revealed no cardiac abnormalities, and the patient was discharged on the second hospital day. He returned within 48 hours for recurrence of the left-sided chest pain and the interval development of epigastric and left upper quadrant abdominal pain. ⋯ Mild diffuse abdominal tenderness developed overnight, and computed tomography of the abdomen revealed a perforated appendix with suppuration. An appendectomy was done immediately. The diagnosis of appendicitis in the geriatric patient is occasionally difficult because of atypical and sometimes misleading physical findings.