Southern medical journal
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Southern medical journal · May 1979
Case ReportsLightning: a rare cause of intrauterine death with maternal survival.
Being struck by lightning is frequently a fatal event. Prompt attention to cardiopulmonary resuscitation, even in the patient who appears dead, will often bring dramatic results. In the pregnant patient, one can only hope that rapid restoration of cardiac and pulmonary activity will decrease perinatal mortality.
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Acute infectious arthritis is an uncommon disease that is most commonly caused by Neisseria gonorrhoeae or gram-positive cocci. Gram-negative bacteria are an infrequent and highly virulent cause of septic arthritis and most commonly enter the circulation through the urinary tract, as in this case after ureteroneocystostomy. ⋯ Early recognition and treatment with appropriate antibiotics and mechanical drainage is imperative. Needle drainage of the affected joint has been shown superior to open surgical drainage.
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Southern medical journal · Apr 1979
Case ReportsDeath caused by brain herniation during hemodialysis.
Brain edema with brain herniation during or after dialysis has been reported previously. However, coexisting lesions of the central nervous system (CNS) which might play a facilitating role were present in these case reports. ⋯ Autopsy results documented brain edema with uncal and cerebellar tonsillar herniation without other coexisting pathologic lesions. The etiology of brain edema during the initial phase of dialysis is discussed.
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Southern medical journal · Mar 1979
Case ReportsVentilation-perfusion lung imaging in diaphragmatic paralysis.
We have described a patient with paralysis of the diaphragm, in whom dyspnea, hypoxemia, and hypercapnia increased when he changed from the upright to the supine position. Ventilation (V) and perfusion (P) images of the right lung appeared to be normal and remained nearly the same in the upright and supine positions. In contrast, V and P images of the left lung were smaller than those of the right lung in the upright position and decreased further in the supine position. In addition, the ventilation image of the left lung was much smaller than the perfusion image in both positions.
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Southern medical journal · Mar 1979
Case ReportsRheumatic fever and gonococcal pharyngitis in an adult.
The arthritis of rheumatic fever in adults may mimic acute gonococcal arthritis. To further characterize this clinical picture the features of six patients presenting with the migratory polyarthritis of acute rheumatic fever have been analyzed. There were two men and four women, ranging in age from 18 to 43; in five the initial clinical impression was gonococcal arthritis. ⋯ In three patients synovial fluid WBC exceeded 28,000/cu mm, with greater than 90% neutrophils. In five of the six, gonococcal arthritis was ruled out by appropriate studies and by failure to respond to antibiotics in all patients. The one patient with serum antigonococcal antibodies had gonococcal pharyngitis and acute rheumatic fever.