Southern medical journal
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Southern medical journal · Feb 1979
Case ReportsAdult respiratory distress syndrome secondary to diffuse pulmonary blastomycosis.
We have described diffuse pulmonary blastomycosis in a previously healthy 19-year-old man, which resulted in the adult respiratory distress syndrome (ARDS). Physicians must have a high index of suspicion for treatable causes of ARDS, and the use of open lung biopsy for early diagnosis is stressed.
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Treatment of the adult respiratory distress syndrome requires an understanding of the current concepts of the pathogenesis of this syndrome. The clinical features and pathophysiology are briefly discussed. Differential diagnosis requires the exclusion of pulmonary infection and left heart failure. ⋯ Currently accepted modalities for improving oxygenation, when oxygen by face mask proves inadequate, include intubation and ventilation with postiive end-expiratory pressure. Other promising technics for improving oxygenation which do not require intubation are continuous positive airway pressure applied by face mask, continuous negative chest wall pressure, and alterations in posture. The long-term prognosis in survivors appears to be good, with only mild residual pulmonary functional abnormalities.
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Southern medical journal · Nov 1978
Case ReportsBulging (sagging) fissure sign in Hemophilus influenzae lobar pneumonia.
A bulging fissure sign was noticed on chest roentgenogram in a patient with H influenzae pneumonia. This sign is usually associated with Klebsiella pneumonia and has also been seen in pneumococcal and plague pneumonia, tuberculosis, mass lesions of the lung, and large lung abscesses. This is thought to be the first report of a bulging fissure sign associated with pneumonia due to H influenzae.
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Southern medical journal · Nov 1978
Subtrochanteric fractures of the femur: treatment with ASIF blade plate fixation.
Management of the severely comminuted subtrochanteric fracture of the femur has been extremely difficult due to problems in stabilization, failure of fixation, and/or failure of the device, as well as associated high morbidity and mortality. Twenty-three such fractures treated with the Association for the Study of Internal Fixation (ASIF) blade plate fixation are reviewed. ⋯ There were two deaths, but only one was due to postoperative complications. This review indicates that ASIF blade plates provide adequate stabilization and fixation with a high rate of union in these fractures.
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From the data presented it appears that acupuncture helped in more than 50% of the patients by either completely or partially controlling pain from certain disorders. Patients helped by acupuncture received 8.55 treatments on the average, while patients not helped by acupuncture only received 4.75 treatments. There is difference between the male and female patients as to the response to acupuncture. ⋯ Patients with backache who had previously had laminectomy showed better response to acupuncture than patients who had had spinal fusion. It appears that good general health plays an important role in favorable response to acupuncture treatment. Acupuncture may be a valuable extension of a conventional pain clinic and an alternative in patients who are desperate to obtain relief from pain which they failed to obtain from other methods.