Southern medical journal
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Southern medical journal · Mar 1993
ReviewCarbon monoxide poisoning in infants: treatment with hyperbaric oxygen.
Since 1974 the United States Air Force has treated more than 300 cases of carbon monoxide poisoning with hyperbaric oxygen (HBO). Fourteen of the patients treated were younger than 2 years of age. ⋯ There was complete recovery in 13 of the 14 infant patients. The pathophysiology, presentation, and clinical management of carbon monoxide poisoning in infants is discussed.
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Southern medical journal · Feb 1993
Advance directives on hospital admission: a survey of patient attitudes.
A survey of 200 outpatients using an anonymous, self-administered questionnaire revealed that 18% had already completed an advance directive. Only 5% had received information concerning advance directives from their physicians. Eighty-seven percent stated they would not be offended if, on admission to the hospital, they were to be asked whether they had completed a living will. ⋯ Only 2% consistently gave a negative response to a proposed policy of hospitals providing information concerning advance directives on admission, and a similar percentage was totally opposed to their use. Of those who had completed an advance directive, 50% had secured the only copy in a safety deposit box. This information, as well as the Patient Self-Determination Act of 1990, which will as of December 1, 1991 require hospitals to provide patients with information about advance directives, creates a new framework for the more efficient use of these important but underused documents.
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Southern medical journal · Feb 1993
Effect of insurance status on pain medication prescriptions in a hematology/oncology practice.
To determine whether insurance status (payer class) affects the amount and type of pain medication prescribed, and whether patients in those groups without prescription drug coverage received lower-cost medications, a case-control study with retrospective chart review was initiated in a university-based hematology/oncology practice in northwest Louisiana. Charts of 710 active patients among all insurance groups (private insurance, Medicare, Medicaid, State Hospital System) were analyzed to determine insurance status, pain medication (amount and type), and diagnosis. ⋯ In the studied population of hematology and oncology patients, there is a significant difference in the amount and type of pain medications prescribed between patients with prescription drug coverage (Medicaid) and those without (all other groups including those covered by the statewide system). We propose that consideration be given to alternative methods of financing prescription medications for medically indigent patients.
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Although cutaneous melanoma is rare in African-Americans, it continues to have a poor prognosis. We reviewed our experience with 13 African-American patients who had cutaneous melanoma diagnosed between 1969 and 1990. Eight of these 13 lesions were on the foot. ⋯ Nine of these 13 patients had recurrent disease. This series of patients had a 92% 1-year and a 61% actuarial 5-year survival, with a median follow-up of 45 months. This study emphasizes the need for awareness of the occurrence of this disease in the African-American population in an effort to reduce the mortality from cutaneous melanoma.