Southern medical journal
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Southern medical journal · Aug 1980
Case ReportsYellow nail syndrome: complete triad with pleural protein turnover studies.
Lymphedema, pleural effusions, and yellow nails constitute the yellow nail syndrome, which commonly is associated with chronic lower respiratory infections and sinusitis. Of 50 cases reported, only 13 have had the complete triad; we report another. ⋯ She has other conditions which are reported in high frequency with the syndrome, including sinusitis, thyroiditis, and malignancy. An albumin turnover rate was determined on the pleural effusion by a radioactive tracer method.
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Basic and advanced cardiopulmonary resuscitation training is worthwhile yet time consuming. Anesthesiologists should be among the most qualified leaders in CPR teaching programs. Using a modular self-teaching presentation for basic and advanced cardiac life support courses, minimal instructor time is required to accomplish proficiency in both didactic and mannequin performance for participants. This method can be adapted to various educational levels and time constraints without compromising quality of teaching.
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Southern medical journal · Jun 1980
Bacteremia related to IV cannulation: variability of underlying venous infection.
During 1977, 22 of 66 cases of nosocomial bacteremia in our hospital were directly or indirectly attributable to infection from the intravenous (IV) site. IV-site-related bacteremia (IVSRB) occurred most frequently in patients with serious underlying disease. The characteristic clinical picture was one of fever, tachycardia, and hypotension. ⋯ Short percutaneous plastic catheters were incriminated in most cases, and gram-negative rods, especially Klebsiella and Serratia, were the most frequent infecting bacteria. Initial treatment consisted of removal of the IV cannula and administration of parenteral antibiotics. Although no deaths could be attributed to recognized and treated IVSRB, it resulted in significant morbidity including the need for excision of veins contiguous with the IV site in six patients.
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Southern medical journal · Mar 1980
Case ReportsBrompton's mixture in alleviating pain of terminal neoplastic disease: preliminary results.
We conducted a one-year preliminary study on 107 patients in a hospice for incurable cancer to assess the efficacy of a modified Brompton's Mixture (an oral analgesic solution) in alleviating intractable pain. The results presented indicate that in patients who can tolerate oral medication, the present formulation can be used in lieu of parenteral narcotics, often with superior results and always with cost effectiveness. ⋯ As documented by four representative case reports, the patient is pain-free, ambulatory, communicating with his environment, and experiencing an improved nutritional status, thereby improving the quality of life. Brompton's Mixture appears to be a valuable adjunct to conventional therapy, giving the patient an effective alternative to parenteral medication for control of pain.
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Southern medical journal · Jan 1980
Chronic neck and back pain: a reassessment of usual surgical treatment.
One hundred seventeen patients with chronic (noncancerous) back or neck pain had multidisciplinary evaluation in the Medical College of Virginia Pain Center and were followed up for one year. They ranged in age from 26 to 57 years. The 57 patients who had surgery had an average of 2.5 procedures (either laminectomies or back fusion) and only five of them returned to work. By contrast, 16 of 60 patients who had not had operation were able to secure employment after evaluation and treatment in the Pain Center.