The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
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Angioneurotic edema can involve the face and mucous membranes and can progress toward laryngeal obstruction and death. ACE inhibitors are the main etiology, followed by the hereditary forms and the acquired forms. Quantitative and qualitative measurements of C1 inhibitors are important to differentiate the common form of HAE from the variant form. ⋯ Fresh frozen plasma can be given for short-term therapy. Treatment of the acute attack is mainly supportive directed toward airway protection. Epinephrine, steroids, and antihistamine have not been proven to be efficacious.
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Louisiana has one of the highest rates in the nation of cervical spinal cord injuries to high school football players. When the national rate of these injuries is applied to the number of high school participants in Louisiana, we would expect there to be only one catastrophic neck injury every 14 years. Louisiana, however, has averaged 2.3 spinal cord injuries per year for the past seven football seasons. ⋯ Using the helmet as a battering ram must be discouraged. Education for officials, coaches, and players is needed to improve recognition of improper tackling. Proper training in tackling and blocking is an important means of minimizing the possibility of catastrophic injury.
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Review Case Reports
Lupus aortitis: a case report and review of the literature.
Systemic lupus erythematosus is a complex immunological and rheumatological disease that has numerous complications. Central to the pathogenesis of systemic lupus erythematosus is immune complex formation and deposition in blood vessels and end organs. This is a case report of an autopsy of a patient with systemic lupus erythematosus, end stage renal disease, peripheral vascular occlusive disease, pancreatitis, and aortitis. ⋯ The hypercoagulable state of the patient is discussed with particular emphasis on the role of anticardiolipin antibodies, antiphospholipid antibodies, and anti-beta-2-glycoprotein I in the pathogenesis. This case is unique in that the immune complex mediated aortitis has not been described in the literature over the past 25 years. We recommend that the diagnosis of immune complex mediated aortitis be considered in the differential diagnosis of aortitis, particularly in the background of a patient with systemic lupus erythematosus.
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Local anesthetics or narcotic analgesics introduced into surgical wounds have been noted to provide pain relief. These agents are typically infused into the postoperative joint or wound using a standard beveled needle or by pressing the syringe hub against the incision without a needle. We present an alternative method of administering these agents to provide pain relief in the orthopedic patient. A blunt needle is used to infiltrate the postoperative joint or wound with local anesthetics or narcotic analgesics.
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Management of Emergency Medical Services has been sadly forgotten over the years in the state of Louisiana. A new task force which was formed over a year ago is now beginning to formulate a direction for the future of EMS in this state. At its last Annual Meeting, the LSMS adopted a resolution to support the work and decisions made by that task force. ⋯ Good out-of-hospital care will determine whether a person gets early thrombolytic care, whether early defibrillation is available at their sides, and whether their child is treated with "pediatric appropriate" approaches to medical care. The life saved could be important to any one of us. The purpose of this article is to acquaint the membership with what EMS is, what the condition of EMS in Louisiana is, and what the progress of the EMS task force has been.