Southern medical journal
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Tracheal agenesis is a rare congenital anomaly. We report a case and review the cases previously reported. ⋯ For immediate management of the affected infant, we recommend intubation of the esophagus with an endotracheal tube to provide an air passage, and determination of the level of the defect by careful use of contrast material and roentgenography. Infants having type I tracheal agenesis may benefit from immediate tracheostomy.
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Intrauterine exposure to cocaine is reaching epidemic proportions and is affecting the lives of an increasing number of infants and children. The toxic effects are manifested as microcephaly, growth retardation, brain infarcts, congenital malformations, and withdrawal symptoms lasting for several weeks. Preliminary long-term follow-up studies reveal worrisome psychologic alterations that may profoundly affect the personality of exposed individuals.
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Southern medical journal · Jul 1990
Review Case ReportsHangman's fracture resulting from improper seat belt use.
Diagonal seat belt application without accompanying lap belt closure may produce severe cervical spine injuries, including hangman's fracture and decapitation. Seat belts are effective in reducing injury, but they must be worn properly to do so. ⋯ We have presented a case in which the driver in a motor vehicle accident sustained a hangman's fracture (bilateral fracture of the pedicles of C-2) caused by use of a diagonal seat belt without accompanying lap belt closure. The mechanism of injury, as classically described in judicial hanging, is hyperextension and distraction, which occurred when the victim "submarined" under the diagonal seat belt and was caught at the neck.
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Southern medical journal · Jul 1990
Acute dissecting aortic aneurysm: community hospital experience in 20 cases.
Of 20 patients with dissecting aortic aneurysm managed at our community hospital, 16 had type A (ascending) dissection and four had type B (descending) dissection. Twelve of the patients with type A dissection were operated on; six of them survived and six died postoperatively. ⋯ Although acute aortic dissection is not commonly seen at community hospitals, expedient management of such patients can have a major impact on their survival. Patients at extreme risk are those with type A dissection, particularly those with cardiopulmonary arrest.
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Southern medical journal · Jul 1990
Pelvic fractures: an analysis of factors affecting prehospital triage and patient outcome.
Using an established prehospital regional triage protocol, 175 patients sustaining fractures of the pelvis were managed in a level one trauma center during a 38-month interval. The majority of injuries (51.7%) were caused by motor vehicle accidents and involved an average trauma score (TS) of 13 and an average injury severity score (ISS) of 24. ⋯ It appears that TS alone is not reliable in prehospital triage of patients with pelvic fractures. Age and mechanism of injury may better identify the patient at risk for morbidity and mortality.