Maryland medical journal (Baltimore, Md. : 1985)
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Case Reports
Postmortem cesarean section with infant survival: a case report of an HIV-infected patient.
Postmortem cesarean sections are rare events, but modern technology is forcing society to explore the definition of viability and the legal rights of both mother and fetus that ultimately will affect the frequency and use of this rare operation. Since the Human Immunodeficiency Virus (HIV) prevalence rate and the number of critically ill obstetrical patients with Acquired Immunodeficiency Syndrome (AIDS) continues to rise, it is reasonable to assume more patients and physicians may be confronted by issues concerning fetal and maternal rights and other considerations in perimortem delivery. A 33-year-old woman, at 27 weeks' gestation, with fulminant AIDS was admitted to the intensive care unit (ICU) in respiratory distress. ⋯ Eventually a peri/postmortem cesarean section was performed on the mother when she suffered an acute fatal cardiorespiratory arrest. With the prevalence of AIDS increasing and with most women not being tested prior to pregnancy, many obstetricians will be confronted with new medical and legal challenges. Establishing comprehensive medical management for the critically ill obstetrical patient and understanding the legal rights of both patients (mother and fetus) will help avoid conflicts and potentially improve survival.
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Biography Historical Article
Helen Brooke Taussig, M.D.: the original pediatric cardiologist.
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This article focuses on recent developments in anesthesiology, including the expanded perioperative role of the anesthesiologist and the value these services add to an integrated delivery system by improving efficiencies and providing significant cost savings. Research activities are concerned with specific receptor mechanisms of drug action, as well as mechanisms of cell injury and post ischemia death.
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Review Case Reports
Small cell carcinoma of the prostate: a case report and review of the literature.
Primary small cell carcinoma of the prostate is rare. A case of primary small cell prostate cancer treated with radiation and chemotherapy is presented, and 33 previously published case reports are reviewed. Most of the patients (61%) had mixed tumors (small cell and adenocarcinoma) at diagnosis or had a history of adenocarcinoma of the prostate. ⋯ Visceral metastases were common. Only one of seven patients responded to hormonal therapy, and two of eight patients responded to chemotherapy. Overall prognosis was poor.
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An outbreak of dengue fever occurred among a small group of Maryland and Pennsylvania residents following a trip to the British Virgin Islands in January 1996. Dengue fever is a mosquito-borne viral illness that occurs primarily in tropical urban areas. ⋯ Physicians should consider dengue in the differential diagnosis of a patient with a febrile illness and a history of recent travel to a tropical area. Travelers to endemic areas should be advised to take precautions to prevent mosquito bites.