Southern medical journal
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The clinical presentation and results of management of septic thrombophlebitis in 35 patients over a seven-year period are reviewed. There were 25 men and ten women; 20 patients were over age 50. At diagnosis, fever was present in 33 patients (94%), and 33 (94%) had local signs of inflammation. ⋯ Other infections were responsible for persistent fever after total excision. Septic thrombophlebitis is best prevented by strict asepsis in catheter placement and rotation of infusion sites every 48 hours. Total excision of the infected vein remains the treatment of choice.
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Southern medical journal · Aug 1982
Medical illness in psychiatric patients: barriers to diagnosis and treatment.
We report a study of 102 consecutive admissions to the acute medical care unit of a large psychiatric hospital. The study was designed to investigate the epidemiology and the barriers to diagnosis and treatment of medical illness among female psychiatric inpatients. ⋯ Ninety-two percent of the sample were found to have at least one with an average of three previously undiagnosed physical diseases not predicted by their symptoms on referral. We advocate a high index of suspicion of physical disease in the psychiatric population, and recommend an aggressive multidisciplinary diagnostic and therapeutic approach.
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Southern medical journal · Jul 1982
Randomized Controlled Trial Clinical TrialPreoperative hair removal: a random prospective study of shaving versus clipping.
We report the results of a random, prospective study of electrical clipping versus routine razor shaving in the removal of hair immediately before operation. Two hundred patients having elective inguinal herniorrhaphy according to strict protocol were included in this study. ⋯ Two subcutaneous wound infections occurred in the shaved group (2%) and one in the clipped group (1%). This study indicates that preoperative clipping of hair with electric barber's clippers immediately before operation is a safe, well tolerated procedure that does not increase the risk of postoperative wound infection.
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Septic shock continues to be a serious problem with a mortality ranging from 11% to 82%, depending upon the cause, the time of diagnosis, and the type of treatment. The condition is seen in pregnant patients with postabortal or postpartal endometritis, chorioamnionitis, and pyelonephritis. ⋯ Over the period July 1, 1959, to June 30, 1981, 91 patients were treated for septic shock with a mortality of 18%. Although medical treatment is important, the most important aspect of treatment for most patients is removal of the septic focus.
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Hydrocarbons remain a significant cause of childhood poisoning. Aspiration of hydrocarbons into the lung causing a chemical pneumonitis is the most prominent feature of this poisoning. The symptoms of respiratory compromise occur shortly after the poisoning and may become more severe during the first 48 hours. Therapy is supportive, and prevention of further aspiration is very important.