The Journal of the Kentucky Medical Association
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The finding of a massive unilateral segmental defect with normal ventilation upon lung scanning does not always secure the diagnosis of acute pulmonary embolus. We present a patient whose ventilation-perfusion lung scan suggested a significant embolic phenomenon, but who was subsequently found to have compression of her right pulmonary artery by a dissecting aortic aneurysm. Conditions that present with a unilateral perfusion defect merit further evaluation with pulmonary arteriography.
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Analysis of an aliquot of fluid from a pleural effusion will often provide the clinician with the information needed to establish a presumptive or definitive diagnosis of the patient's illness. A properly performed pleural fluid pH can maximize the diagnostic yield and provide guidelines for further clinical interventions.
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Intravenous local anesthestics administered to patients with chronic pain have been shown to provide significant levels of systemic analgesia. Furthermore, oral mexiletine which is similar in structure has been demonstrated to be efficacious in the treatment of diabetic neuropathy. It is recommended that this combined form of treatment be considered with those patients whose diabetic neuropathy is resistant to more conventional forms of treatment.