The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
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In children, as in adults, tuberculosis is much commoner among minority population groups, in Louisiana particularly among blacks. Since 1986 tuberculosis in some states has increased notably; in Louisiana the increase is only now, in 1992, becoming apparent. Eighteen new cases in children under 20 were reported in 1991. ⋯ Treatment has changed markedly to a more intensive 6 month course including three or four drugs. Preventive treatment of tuberculin positive children is particularly emphasized because it will play an important role in achieving the stated public health goal of elimination of tuberculosis by the year 2010. With the increasing number of children exposed to tuberculosis, the increasing number of HIV-positive children at risk, and the rising number of multiresistant tubercle bacilli, vaccination with BCG must be considered.
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During a 12-year period, 59 patients with sickle cell disease underwent a total of 73 operative procedures. There was a total of 30 non-sickle-cell-related and 7 sickle-cell-related complications for an incidence of 41% and 10% respectively. There were no deaths. ⋯ A higher incidence of non-sickle-cell-related complications (46% versus 32%) was noted in the transfused group, with atelectasis being the most common complication (p = .29). The type of transfusion therapy did not influence morbidity, since the complication rates in the simple and exchange transfusion groups were similar. In conclusion, our data indicate that routine preoperative blood transfusion does not appear to be beneficial in the surgical sickle cell patient, since preoperative blood transfusions did not reduce the incidence of sickle-cell-related complications.
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Pain and suffering are the most common, and distressing, complaints of patients. Opiates remain the drugs of choice for severe pain. A review of the current information known about these drugs is essential not only for any anesthesiologist, but for any physician. ⋯ Understanding each of the receptor's activities and side-effects is essential for proper use of available opiates. This review will provide current information of the opioid receptors. Not only will understanding result in better patient care but it will encourage greater research in this field.
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Peripartum cardiomyopathy occurs in from 1 in 3,000 to 1 in 4,000 pregnancies in the United States. Its clinical and hemodynamic findings are similar to idiopathic dilated cardiomyopathy; however, peripartum cardiomyopathy shows a high incidence of myocarditis. Future studies will define the role of immune factors associated with the development of this disorder and will help in a better outcome for these patients.