The Western journal of medicine
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Headache following a lumbar puncture is a common and often debilitating syndrome. Continued leakage of cerebrospinal fluid from a puncture site decreases intracranial pressure, which leads to traction on pain-sensitive intracranial structures. ⋯ Although usually self-limited after a few days, severe postural pain can incapacitate the patient. Management is mainly symptomatic, but definitive treatment with the epidural blood patching technique is safe and effective when done by an expert operator.
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Comparative Study
Magnetic resonance imaging for musculoskeletal disorders.
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The magnitude of the human immunodeficiency virus (HIV) pandemic and its broad impact have been seriously underestimated and underappreciated. The Special Programme on AIDS (acquired immunodeficiency syndrome) of the World Health Organization (WHO) was created on February 1, 1987, as the architect and keystone of the global AIDS plan. The Special Programme on AIDS has designed the global strategy, has raised sufficient funds to begin implementing the strategy and, for this effort, has marshalled the support of every nation in the world. ⋯ National AIDS programs are being rapidly established throughout the world with the technical and financial support of WHO's Special Programme on AIDS. At the global level, the Special Programme is responsible for strategic leadership, developing consensus, coordinating scientific research, exchanging information, assuring technical cooperation and mobilizing and coordinating resources. National AIDS committees have already been established in more than 150 countries and, by the end of 1988, the Special Programme will support every country in the world that requests collaboration.
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In a pilot project sponsored by the California State Emergency Medical Services Authority, validated, verifiable criteria were developed for the vertical categorization of hospital emergency services in 11 different groupings of medical and surgical emergencies. We describe the development of an assessment process and categorization criteria to identify the most appropriate receiving facility for interfacility transfer and, in selected instances, field triage of patients with different levels of severity of illness or injury. We propose that this facility assessment project be used in the critical care planning process for the eventual vertical categorization of hospital emergency services in California and as a template for similar projects in other states.