California medicine
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Rupture of the uterus, cesarean section and uterine atony were the major causes of maternal death associated with hemorrhage of late pregnancy for the five years 1945 to 1949 in New York County. Shock occurred earliest in rupture of the uterus and cesarean section, while in uterine atony there was some delay before shock was evident. ⋯ Ten per cent of the maternal deaths reviewed were associated with severe transfusion reactions. Early recognition of a serious situation, rapid blood replacement and hysterectomy might have salvaged most of the patients.
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The most important postoperative fluid considerations are maintenance of adequate urinary output, of blood volume, and of extracellular and interstitial cell water and electrolytes. Normal urinary output is between 1,000 and 1,500 cc. daily. A fluid intake of 2,000 cc. of 5 per cent dextrose in distilled water, plus 500 cc. of normal saline solution, will insure this amount of urinary output. ⋯ The role of the potassium ion is ordinarily not a consideration in postoperative fluid management. It becomes a consideration in the presence of a large amount of drainage from wounds or abscess cavities, nasogastric suction, or intestinal fistulae. It also must be given attention in cases in which parenteral administration of fluids is necessary for a prolonged period.
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Laryngeal spasm is a problem constantly confronting the anesthetist. It can be serious and may produce fatal cerebral or cardiac complications. Etiologic agents include primary vagal hypertonicity, anoxemia, and painful stimulation of whatever source. ⋯ Proper checking of the patient before anesthesia and adequate premedication with atropine or scopolamine are preventive measures of great value. Once spasm has developed the etiologic agent should be removed if possible. Other measures include intravenous administration of atropine or curare, tracheal intubation, and tracheotomy.
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California medicine · Jan 1949
Rapid healing of peptic ulcers in patients receiving fresh cabbage juice.
Thirteen patients with peptic ulcer were treated with fresh cabbage juice, which, experiments have indicated, contains an antipeptic ulcer factor. This factor (vitamin U) prevents the development of histamin-induced peptic ulcers in guinea pigs. ⋯ The average crater healing time for six patients with gastric ulcer treated with cabbage juice was only 7.3 days, compared with 42 days, as reported in the literature, for six patients treated by standard therapy. The rapid healing of peptic ulcers observed radiologically and gastroscopically in 13 patients treated with fresh cabbage juice indicates that the anti-peptic ulcer dietary factor may play an important role in the genesis of peptic ulcer in man.