The Western journal of medicine
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In the past 8 years, lung transplantation has become a standard therapy for benign end-stage pulmonary disease. Rapid advances have occurred involving indications and operative management that have allowed pulmonary transplantation to be a viable option for an increasingly diverse patient population. In part I, we review the current indications and operative techniques, and in part II we will cover the postoperative management and results.
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About 350,000 persons in the United States have multiple sclerosis, and primary care physicians are often called on to provide symptomatic therapy for these patients. We review our current pharmacologic approach to the management of multiple sclerosis exacerbations and the symptoms of spasticity, fatigue, bladder and bowel involvement, neurobehavioral complaints, pain syndromes, dystonic spasms, and tremor and ataxia.
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Survival rates for burn patients in general have improved markedly over the past several decades. The development of topical antibiotic therapy for burn wounds, the institution of the practice of early excision and grafting, and major advances in intensive care management have all contributed to this success. In this review we address these 3 important advances in the modern treatment of burn injuries and provide a brief historical overview of these accomplishments and others, emphasizing specific achievements of note and promises for the future. We also discuss 3 topics of interest to burn physicians, including the special problems and high mortality of elderly burn patients, the disturbingly high mortality in burn patients with inhalation injury, and the possible use of artificial skin to facilitate rapid wound closure.