Primary care
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Flexible fiberoptic bronchoscopy continues to be an important tool in the diagnosis of pulmonary disease. This article reviews the history, technology, methodology, applications, and complications of this diagnostic tool.
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This article has emphasized a basic approach to coma. First, the patient must have airway, breathing, and circulation protected. If the etiology of coma is in doubt, a broad metabolic screen is necessary. ⋯ If history or neurologic examination suggests a structural cause for the coma, then a cranial CT scan is mandatory. An electroencephalogram is often helpful, particularly in metabolic coma, and at times may even show structural abnormalities not demonstrated by CT scan. Rapid assessment and treatment is critical because coma is the clinical manifestation of brain failure, and often irreversible injury will occur if treatment is slow or incorrect.
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Vasculitis is reviewed as a continuum of disease from asymptomatic to life-threatening. Therapeutic intervention predicated upon assessment of the significance of organ system involvement and the relative risks of the various forms of therapeutic intervention are discussed.
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Most shoulder injuries in the athlete can be managed nonoperatively; prior to any management, however, they require careful evaluation for accurate diagnosis. Once the diagnosis has been made, few of these injuries will actually require surgery and most will obtain an excellent result with full return to function. Several specific shoulder injuries are discussed and their treatment is outlined.
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The results of pancreas transplantation at the University of Minnesota according to technique, donor source, and immunosuppressive therapy are discussed. Preliminary evidence suggests that not only prevention but reversal of lesions resulting from diabetes may be possible with pancreas transplantation.