Southern medical journal
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Southern medical journal · Feb 1983
Historical ArticleSciatica and the lumbar disk syndrome: a historic perspective.
The dynamics of the human spine mark the lumbar disk syndrome and accompanying sciatic complaints as long-standing afflictions of our species. Although Greco-Roman erudition suitably described the ailment, uneven diagnostic and therapeutic acumen confused inquiry for many centuries. ⋯ Not, however, until the 1934 landmark publication of Mixter and Barr was the herniated lumbar disk indicated as a major cause of sciatica. Despite such advances, numerous unresolved issues still surround this disease.
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The clinical and laboratory findings in eight patients with spur cell anemia are presented and compared with other cases gathered from the literature. Although there is no specific clinical or laboratory abnormality, the condition can be recognized by a constellation of findings. The majority of patients have a long history of ethanol abuse with clinical and laboratory manifestations of hepatocellular dysfunction. ⋯ The sine qua non for the diagnosis of spur cell anemia is an increased percentage (usually greater than 20%) of acanthocytes on a peripheral smear. The prognosis of spur cell anemia is poor, the majority of patients dying within a year. From our study, spur cell anemia appears to be more prevalent than is generally reported.
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Southern medical journal · Oct 1982
Case ReportsAir embolism in central venous catheterization: diagnosis, treatment, and prevention.
Air embolism associated with central venous catheterization carries with it a significant morbidity and mortality. The diagnosis should be suggested by sudden alterations in cardiovascular, respiratory, or central nervous system function in a patient with a central venous catheter. ⋯ Placing the patient in the left lateral decubitus with the head down allows displacement of the air from the pulmonary outflow tract. Prevention of the complication involves thorough patient and physician preparation before subclavian catheterization, use of a Luer lock between catheter and tubing, meticulous catheter care, and employment of a pump with an in-line air detector.
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The topic of delayed cutaneous hypersensitivity testing is reviewed. When skin tests are used to determine whether an individual is anergic, T cell immunity is evaluated. Skin testing can be used to determine the causative organisms of infection or to discover an immunologic deficiency state. ⋯ Despite the problems, skin testing remains an easy, relatively safe method of assessing the immune system. Some investigators are developing more reliable testing methods and alternative antigens. Further research is needed to develop a reliable method for assessing delayed cutaneous hypersensitivity.