Southern medical journal
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Southern medical journal · Feb 1981
Mixed Streptococcus pneumoniae and gram-negative bacillary pneumonia in the elderly.
Of 24 elderly patients with Streptococcus pneumoniae pneumonia confirmed by transtracheal aspiration, six had concomitant infection with gram-negative aerobic bacilli. All six patients were elderly men with underlying cardiopulmonary disease. Three had had recent prior episodes of gram-negative pneumonia and four had previously received antibiotics. The clinical, laboratory, and epidemiologic characteristics of these six patients with mixed bacterial pneumonia are reported.
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Southern medical journal · Jan 1981
Ligation of patent ductus arteriosus in premature neonates: anesthetic management.
A retrospective study covering a five-year period was conducted on 40 premature neonates who had had general anesthesia for surgical correction of patent ductus arteriosus. The anesthetic management of these patients was carefully reviewed. The mean weight at surgery was 1,243 gm, and the mean gestational age at birth was 29.5 weeks. ⋯ Two patients had massive blood loss intraoperatively. There were 12 postoperative deaths in the series, and 12 patients had serious long-term disability, many were combinations of hearing, visual, and psychomotor disturbances. Advances in neonatology, surgery, and anesthesiology have improved the outlook of these seriously ill patients.
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We have described a case, with renal biopsy findings and serologic studies, of a patient who had the nephrotic syndrome after sustaining multiple bee stings and who demonstrated a favorable response to steroid therapy. Bee stings have previously been implicated in the development of this syndrome, though the reported cases in the literature are poorly documented.
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Southern medical journal · Jan 1981
Case ReportsHepatic abscess resulting from asymptomatic diverticulitis of the sigmoid colon.
I have described a case of pyogenic liver abscess secondary to completely asymptomatic diverticulitis. Because extensive diverticulitis may be present with minimal or no clinical symptoms, it should be strongly considered as the cause when dealing with a so-called "cryptogenic" liver abscess, and treatment should be planned accordingly.
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This essay is a personal comparison of obstetrics in the 1930s and the 1970s. Maternal and perinatal mortality are contrasted for the two eras. Hospital delivery then and now, and hospital versus home delivery are compared. ⋯ Continuing medical education and electronic fetal monitoring are discussed. The use of drugs during pregnancy, labor, and delivery is considered. Governmental and public intervention in obstetrics is lamented.