The West Virginia medical journal
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Case Reports
Prolonged mechanical ventilation: are your ventilator patients ready to be cared for outside ICU?
A significant number of patients in the ICU require prolonged periods of ventilator support. We present here, four such patients and incorporate the recent recommendations of a consensus conference on prolonged mechanical ventilation. We hope our case studies will enable physicians to better manage and care for this challenging group of patients.
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Staffing of rural emergency departments (ED) with residency-trained, board certified emergency physicians has been an ongoing challenge in the field of Emergency Medicine. ⋯ Just over half of all physicians staffing WV's EDs are residency trained or board certified in EM, a number that lags well behind the national average. Rural EDs report even lower numbers, although the proportion has increased since the 1996 WV study. WV EM practitioners, particularly in more rural locations, continue to provide emergency care with less formal training, certification credentials, and specialty back-up.
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Case Reports
Steptococcus bovis meningitis and sepsis associated with Strongyloidiasis in an immunocompetent patient.
We report the case of a 69-year-old female who presented with headache, stiff neck, and decreased level of consciousness. Lumbar puncture results were typical of bacterial meningitis. ⋯ The patient responded to treatment of both infections. She refused to undergo colonoscopy despite a known association between Streptococcus bovis and colonic carcinoma.