Southern medical journal
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Spontaneous pneumothorax is a common disorder that is easily recognized and treated. Occasionally reexpansion of the collapsed lung is complicated by unilateral pulmonary edema, heralded by tachypnea, unilateral rales, and profuse expectoration of frothy secretions within several hours of reexpansion. ⋯ Increased pulmonary capillary permeability rather than hydrostatic transudation is believed to underlie its development. For patients with pneumothorax of prolonged duration close observation in an intensive care unit for 24 hours after evacuation of air and the routine use of supplemental oxygen during and after lung reexpansion seem indicated.
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Southern medical journal · Mar 1984
Abuse of antibiotics by abusers of parenteral heroin or cocaine.
We studied antibiotic intake in 197 abusers of alcohol, sedatives, or parenteral heroin or cocaine. Thirteen patients, all abusers of parenteral heroin or cocaine, had taken antibiotics without prescription, obtained from friends, from old prescriptions, or by purchase on the street. ⋯ Physicians treating abusers of parenteral heroin or cocaine should be aware that such patients may be taking antibiotics without medical supervision. This practice may be an important factor in the development and spread of methicillin-resistant S aureus.
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The estimated 32,600,000 fires that occur annually in the United States produce over 300,000 injuries and 7,500 deaths. Ten percent of hospitalized burn victims die as a direct result of the burn. Initial evaluation and management of the burn patient are critical. ⋯ Wound care is initially directed at preservation of vital function by escharotomy, if restrictive eschar impairs ventilatory or circulatory function. Antibacterial agents may be applied to the burn, but invasive sepsis, defined as greater than 10(5) organisms per gram of tissue with invasion of subjacent viable tissue, requires systemic antibiotic therapy. Wound debridement is done by daily hydrotherapy, tangential excision, chemicals, primary excision, and grafting, tailoring the technique to the individual burn.(ABSTRACT TRUNCATED AT 400 WORDS)
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Southern medical journal · Feb 1984
Case ReportsPneumothorax and subcutaneous emphysema complicating endotracheal intubation.
We report subcutaneous emphysema and pneumothorax as immediate complications of endotracheal intubation in a patient with diffuse interstitial lung disease. We postulate increased intra-alveolar pressure during intubation leading to rupture of a subpleural bleb or cyst as a possible mechanism causing these complications.
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Southern medical journal · Feb 1984
Case ReportsKlebsiella pneumoniae arthritis of the hip in a diabetic patient.
Chronic debilitating diseases may predispose to various joint infections, but early diagnosis of septic arthritis of the hip may be difficult. Klebsiella pneumoniae is an organism uncommonly found in joint infections. We have reviewed the literature on Klebsiella pneumoniae septic arthritis and described a case of a diabetic patient who had severe destruction of the hip joint over a six-month interval due to Klebsiella pneumoniae infection.