Southern medical journal
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Anesthesiologists are now active in the diagnosis of unusual neurologic and neuromuscular disorders. Their skill derives both from a firm understanding of basic sciences and a facility with invasive procedures. Five representative cases are presented to illustrate the scope of diagnostic neuroanesthesiology and the endeavors of the neuroanesthesiologist outside the operating theater.
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Acyclovir, the new virucidal drug recently approved by the Food and Drug Administration for the treatment of herpes simplex virus (HSV), is the first available effective drug to treat such infections. Acyclovir boasts activity against four of the five major herpes-group viruses, including herpes simplex (types 1 and 2), varicella-zoster, and Epstein-Barr. ⋯ Problems of renal toxicity and viral resistance now dampen some of the initial expectations. Present-day research continues to reveal insights into the mechanism and action of acyclovir.
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Malignant hyperthermia, a rapidly progressive, frequently lethal syndrome was not described until quite recently. Although treatment with the drug dantrolene has changed its face, a clear understanding and deep respect for the syndrome are necessary to keep fatalities and tragic sequelae to a minimum. The etiology and pathophysiology, preanesthetic diagnosis, incidence, management of the acute crisis, and anesthesia for susceptible patients are discussed, and a successfully treated fulminant case is analyzed.
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Southern medical journal · Jun 1983
Comparative StudyRh immunoglobulin use with placenta previa and abruptio placentae.
Patients with obstetric hemorrhage from placenta previa or abruptio placentae may be at increased risk of Rh sensitization because they fail to receive Rh immunoglobulin (RhIG) or are given an inadequate dose. To evaluate the use of RhIG in this clinical situation, we studied 498 patients with hemorrhage from placenta previa or abruptio placentae treated at a large municipal hospital from 1975 to 1979. ⋯ This rate of RhIG use was equal to that for patients whose infants were delivered without these complications and significantly higher than that for patients with spontaneous abortion and ectopic pregnancy at the same hospital (P less than .05). Prompt administration of an adequate dose of RhIG to candidates with bleeding from placenta previa or abruptio placentae can further reduce Rh hemolytic disease.