Southern medical journal
-
Southern medical journal · May 1997
Case ReportsAngioedema associated with angiotensin II receptor antagonist losartan.
Angioedema has not been associated with losartan therapy in hemodialysis patients, as it has been with angiotensin converting enzyme (ACE) inhibitors. We report the case of a hemodialysis patient who previously had angioedema after therapy with ACE inhibitors and again had angioedema while taking losartan. We suggest caution in using losartan in patients with known sensitivity to ACE inhibitors manifested by angioedema.
-
Southern medical journal · Apr 1997
Outcome in medical intensive care unit patients requiring abdominal surgery: prospective validation of a risk classification system.
To prospectively validate a previously developed two-factor logistic regression model as a predictor of mortality, we studied its effectiveness in predicting outcome for patients in medical intensive care units (ICUs) who had surgical laparotomy. A high-risk classification was assigned to patients with an Organ System Failure Index (OSFI) > or = 3 or an APACHE (Acute Physiology and Chronic Health Evaluation) II score > 18 within 24 hours of surgery. ⋯ Mortality after surgery correlated with presence or absence of the two variables from the logistic regression model: neither present, 9.5%; APACHE II > 18 present, 68.0%; OSFI > or = 3 present, 75.0%; both present, 88.2%. We showed that a two-factor risk classification at the time of surgical evaluation can be used to stratify medical ICU patients according to risk of in-hospital mortality.
-
Ipsilateral, concomitant femoral neck and shaft fracture is a rare fracture pattern encountered by orthopaedic surgeons. We review 11 cases of this fracture pattern. Treatment was by reduction and stabilization of the femoral neck fracture with one or more cannulated screws, followed by fixation of the femoral shaft using a Russell-Taylor reconstruction nail or a Russell-Taylor Delta reconstruction nail. ⋯ No avascular necrosis of the femoral head or nonunion of either fracture site occurred. In our series, one patient with delayed union had varus angulation of 120 degrees of the femoral neck. Good functional outcome based on patients' ability to perform activities of daily living was achieved.
-
Southern medical journal · Feb 1997
Ineffectiveness of latex condoms in preventing contamination of the transvaginal ultrasound transducer head.
The efficacy of condoms in preventing contamination of the transvaginal ultrasound transducer head and possible transmission of blood-borne pathogens is unknown. Our objective was to determine the rate of contamination of the transvaginal ultrasound probe after use in the emergency department. After indicated transvaginal ultrasound scans, the latex condom was removed and the transducer head was inspected for contamination. ⋯ Latex condoms are ineffective in preventing contamination of the transvaginal ultrasound transducer head. Visual inspection of the transducer head often fails to identify the presence of blood or body fluids. This suggests that additional measures should be taken to prevent transmission of blood-borne pathogens.