Southern medical journal
-
Multiple systems organ failure (MSOF) is a relatively new clinical syndrome that should be considered as a unified and identifiable clinical condition. In many ways it is a product of the technologic advances developed in the last few years to treat seriously ill patients. Failing respiratory, renal, and cardiovascular systems are the most frequently encountered combinations, with sepsis, faulty nutrition, and metabolic derangements often present. ⋯ The patients at risk are usually in an intensive care unit and are easy to identify. Because there is no specific treatment, prevention is of utmost importance. When MSOF occurs, correction of the obvious deficits, active support of the failing systems, and prevention of failure of other still functioning systems are the key to survival.
-
We have described a 22-year-old black man with pernicious anemia, classically considered a disease of middle-aged and elderly Northern Europeans. It is considered rare in non-caucasians and children. ⋯ Furthermore, all five patients under 25 years of age and eight of nine under 35 were black. We found no racial difference in the incidence of pernicious anemia, but we believe it may occur at a younger age in black patients.
-
During early 1982, an outbreak of yersiniosis occurred in northern Mississippi. Abdominal pain suggestive of appendicitis was a common manifestation, but laparotomy revealed mesenteric adenitis. Yersinia enteritis should enter the differential diagnosis of acute appendicitis.
-
Southern medical journal · Oct 1984
Case Reports Comparative StudySplenic trauma: a trial at selective management.
The experience with splenic trauma at the Metropolitan Nashville General Hospital and at Vanderbilt University Hospital between 1972 and 1983 is the subject of this report. Of 154 emergency cases involving splenic injury, 134 were due to blunt trauma, with 20 cases resulting from penetrating injury. In 124 patients, exploratory laparotomy was done immediately after resuscitation and evaluation. ⋯ There were 19 deaths (12.3%), 11 of them from head injuries. Splenectomy should be done promptly in cases of concomitant splenic and cerebral injury and in patients with injury of multiple organ systems. Nonoperative management of suspected splenic injury should be reserved for patients in stable condition and with few if any associated injuries.
-
Southern medical journal · Oct 1984
Case ReportsMyofascial trigger points in persistent posttraumatic shoulder pain.
Persistent pain and disability after injuries to the shoulder sometimes create a difficult diagnostic and therapeutic problem. In many such cases, myofascial trigger points seem to cause symptoms. Three cases in which pain had persisted for eight to 33 months after injury illustrate the manifestations of posttraumatic myofascial trigger point disorders. ⋯ Failure to recognize the myofascial source of pain can lead to erroneous diagnoses of articular, neurologic, or emotional disorder. Current pathophysiologic theories about trigger points may explain the persistence and topographic spreading of pain after muscular injuries. Appropriate treatment of myofascial trigger points can relieve chronic pain and disability.