The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
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Hymenopterid stings and subsequent allergic reactions are a common indication for emergency department visits worldwide. Unrecognized anaphylactic reactions to hymenopterid stings by apids, or bees, and vespids, or wasps, are a significant cause of sudden and unanticipated deaths outdoors in young people, with and without atopic histories. Insect bites and stings, often complicated by allergic reactions or skin infections, by community-acquired pathogens, such as methicillin-resistant Staphylococcus aureus, are common sources of morbidity following hurricanes, tropical storms, and prolonged flooding. This article will review and critically analyze the descriptive epidemiology and outcomes of hymenopterid bites, stings, and allergic reactions, especially following hurricanes and prolonged flooding disasters; stratify the immunologic reactions to hymenopterid stings by clinical severity and outcomes; and present current recommendations for management, prophylaxis, and prevention of hymenopterid stings and reactions.
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Historical Article
Ochsner Health System Department of Anesthesiology: the first thirty years.
The Department of Anesthesiology at Ochsner Clinic Foundation was founded in 1947 at the original Ochsner Hospital at Camp Plauche in New Orleans. An anesthesiology residency training program was accredited in 1953, making Ochsner one of the early and leading producers of anesthesiologists for the Gulf South region. Staff members over the years have held prominent national leadership positions, including two American Society of Anesthesiology presidents, the founder of the Society of Cardiovascular Anesthesiology, and the president of the Society for Obstetric Anesthesiology and Perinatology.
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Accurate scientific predictions of the true human health outcomes of global climate change are significantly confounded by several effect modifiers that cannot be adjusted for analytically. Nevertheless, with the documented increase in average global surface temperature of 0.6 C. since 1975, there is uniform consensus in the international scientific community that the earth is warming from a variety of climatic effects, including cyclical re-warming and the cascading effects of greenhouse gas emissions to support human activities.
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Occipito-atlantal dislocation (OAD) is a rare but often lethal type of spinal injury that can be found in up to 35% of traffic fatalities. Improved pre-hospital care, diagnosis, and immobilization of these patients have led to an increase in reported cases of survivors. Significant ligamentous disruption in OAD results in craniocervical instability. ⋯ Once this is established, immobilization followed by occipitocervical fusion is recommended. We present a case of a patient who survived for a brief period of time after being hit by a vehicle and who was found to have OAD. We discuss the pathophysiology, imaging, clinical findings, and treatment for this type of spinal injury.