Southern medical journal
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Southern medical journal · Jul 1995
Case ReportsRecurrent bilateral spontaneous pneumothoraces associated with pulmonary angiocentric immunoproliferative lesion.
A 28-year-old man had a left pneumothorax and diffuse reticulonodular infiltrates. He subsequently had a right pneumothorax and manifested bilateral recurrences after treatment of the initial pneumothoraces. ⋯ Treatment with combination chemotherapy improved the infiltrates, but failed to prevent another pneumothorax. Etiologic considerations for the recurrent pneumothoraces are proposed.
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Southern medical journal · Jun 1995
Review Case ReportsTraining room evaluation of chest pain in the adolescent athlete.
A physician or athletic trainer will often be faced with an athlete complaining of chest pain during or after an event. Chest pain in children and adolescents is usually of a noncardiac origin; only 5% of cases are due to cardiac problems. ⋯ The various diagnostic possibilities include cardiac, musculoskeletal, pulmonary, gastrointestinal, and psychiatric causes of pain. We discuss several specific conditions, as well as the signs, symptoms, and basic management.
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Southern medical journal · May 1995
Case ReportsAcute epidural hematoma of the cervical spine: an unusual cause of neck pain.
Cervical spinal epidural hematoma is an unusual neurosurgical disorder that usually requires emergent surgical decompressive therapy. We report the case of an 85-year-old woman with acute, severe neck and shoulder pain with progressive neurologic deficits. ⋯ It is incumbent on the emergency physician to recognize this disorder and arrange emergent neurosurgical consultation to ensure an optimal outcome. Further, the differential diagnosis of neck pain and progressive neurologic findings should include this entity.
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Southern medical journal · May 1995
Case ReportsEpinephrine-induced lactic acidosis in the setting of status asthmaticus.
A relationship between intravenous epinephrine infusion and the development of lactic acidosis has been well described. We report a temporal association between the administration of subcutaneous epinephrine and the development of lactic acidosis in the setting of status asthmaticus. A 20-year-old woman with a history of asthma came to the emergency service in acute respiratory distress and was treated with subcutaneous epinephrine. ⋯ The lactic acidosis resolved within 15 hours. The patient never exhibited signs of hypotension, hypoxemia, or sepsis, and other potential etiologies for lactic acidosis were excluded. We believe the events of this case constitute a new observation and theorize a mechanism of peripheral vasoconstriction and transient tissue hypoperfusion mediated by the subcutaneous epinephrine.