Southern medical journal
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Southern medical journal · Dec 1986
Case ReportsUnrecognized esophageal placement of endotracheal tubes.
Unrecognized esophageal placement of endotracheal tubes during general anesthesia or in apneic unanesthetized patients is not an uncommon occurrence. Allowing this mishap to proceed to asphyxia and catastrophe is inexcusable. If one is uncertain, proper placement can be quickly verified by mouth-to-tube insufflation of a subject's lungs with one's own expired air immediately after intubation. This method of verification may be useful in areas other than the operating room, where intubations are performed for resuscitation or airway control.
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Spinal anesthesia has lost its popularity among physicians due to rare occurrences of paraplegia that have precipitated lawsuits, with staggering judgments in favor of claimants. Epidural block has now become a popular alternative because some believe it cannot cause paraplegia; however, paraplegia is as prevalent after induction of epidural anesthesia as after spinal anesthesia. ⋯ Arachnoiditis is also a causative factor when paraplegia follows epidural block. Cord compression and anterior spinal artery syndrome have also been associated with paraplegia after epidural block though they have not been a problem with spinal block.
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Southern medical journal · Oct 1986
Case ReportsElevated pleural fluid glucose: a risk for tension hydrothorax.
We have presented a case of tension hydrothorax that developed after hyperosmolar hyperalimentation fluids were infused into the pleural space through a misplaced jugular venous line. The hyperosmolar state of the pleural fluid appears to have played a prominent role in the development of the tension hydrothorax. We believe there is a risk of tension hydrothorax in any clinical situation in which the pleural fluid glucose concentration is significantly higher than the serum concentration.
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Southern medical journal · Sep 1986
Comparative StudyIron status and liver function in healthy adults: a multiracial pilot study.
We tested 157 apparently healthy, urban adults (78 black, 40 nonblack, 39 race not designated), and found that 7.7% of the entire group had high plasma ferritin levels (6.4%) or transferrin saturation levels (1.3%). Overall, men had significantly higher mean plasma ferritin, serum glutamic pyruvic transaminase, and total serum bilirubin values than women. In this study 17.6% of black men had high plasma ferritin levels and another 11.8% had high transferrin saturation levels. ⋯ Black men had significantly higher mean serum iron, transferrin saturation, plasma ferritin, serum glutamic pyruvic transaminase, and total serum bilirubin levels than black women. The same tests were not significantly different when black and nonblack women were compared. Likely causes of the laboratory abnormalities are occult inflammation and occult liver disease, but a primary disorder of iron metabolism is also possible.