Southern medical journal
-
Southern medical journal · Mar 1998
Randomized Controlled Trial Clinical TrialUtility of dipstick urinalysis as a guide to management of adults with suspected infection or hematuria.
This study was done to determine whether emergency department (ED) patient management decisions made on the basis of dipstick urinalysis are altered when results of urine microscopy become available. ⋯ Dipstick urinalysis for blood or UTI is a reliable diagnostic test in ED patients. In 94% of patients, subsequent findings on urine microscopy did not prompt a change in management. Microscopy added nothing to dipstick results when clinicians suspected conditions causing hematuria alone. Primary use of dipstick urinalysis, with microscopy in selected cases, would likely result in considerable cost and time saving without compromising patient care.
-
Southern medical journal · Feb 1998
Comparative StudyTraumatic vulvar hematomas: conservative versus surgical management.
Vulvar hematomas are relatively uncommon and usually result from blunt trauma. They are more commonly diagnosed in postpartum patients, but hematomas after straddle-type injuries, coitus, or physical assault have been reported. Conservative and surgical management have both been advocated as the appropriate initial treatment. ⋯ In the absence of acute hematoma expansion, conservative management was often successful.
-
Southern medical journal · Feb 1998
Case ReportsPrompt differentiation of Addison's disease from anorexia nervosa during weight loss and vomiting.
An 18-year-old white woman had nausea, vomiting, weight loss, and a diagnosis of anorexia nervosa. Copper-colored skin was noted on physical examination, and serum chemistry values were normal. Subsequent fever, disorientation, and confusion led to the discovery of Addison's disease, which responded well to corticosteroid replacement therapy. ⋯ Other commonalities include prolongation of electrocardiographic PR and QT intervals and generalized slowing on electroencephalogram. Important differences include a brown color to the skin in Addison's disease instead of a yellowish color in anorexia. Addisonian patients also display hypocortisolism, hypoglycemia, and hyperkalemia, in contrast to the hypercortisolism, hyperglycemia, and hypokalemia seen in anorexia.
-
Southern medical journal · Dec 1997
Prospective assessment of triage in an urban emergency department.
This study examined the effectiveness of a triage system based on patient complaints, medical history, vital signs, and triage nurse impression. Measurements included recognizing patients needing admission, in correlating with disposition, and its effectiveness in all age groups. ⋯ This triage system accurately correlated with disposition and determined waiting time to examination.
-
Southern medical journal · Dec 1997
Focal reexpansion pulmonary edema after drainage of large pleural effusions: clinical evidence suggesting hypoxic injury to the lung as the cause of edema.
The purposes of this study were to review possible causes of reexpansion pulmonary edema (RPE) and to attempt to explain atypical distributions of RPE after drainage of large pleural effusions. ⋯ This suggests that hypoxic injury to the atelectatic lung, rather than mechanical stress, is the most plausible explanation for RPE.