The Nebraska medical journal
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We have presented the case of a 34 year old male patient who was admitted with severe metabolic alkalosis (MA). Peak serum HCO3 was 96 mg/dl and compensatory PCO2 was 95 which, to our knowledge, has never been reported before in a patient with MA. MA was probably generated by consumption of high amount of NaHCO3 and renal impairment and maintained by impaired renal function due to volume depletion hypokalemia and hyochloremia. The patient was successfully treated with IV administration of saline and KCL.
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Transtracheal oxygen represents an important advance in the technology of long-term oxygen therapy. As an oxygen conserving technique, it allows increased physical activity with smaller ambulatory and portable units and facilitates the management of patients with refractory hypoxemia outside of the hospital. ⋯ Careful patient screening and patient education is important to avoid complications. The program is best administered through regional centers with a team approach to patient care.
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A surgical approach to cervical spine instability associated with odontoid fracture is described. Internal fixation of the odontoid (IFO) has advantages over traditional posterior surgical treatments currently employed. This approach to the odontoid process is easier for the surgeon comfortable with anterior discectomy to perform than other techniques described in the spine literature.
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Randomized Controlled Trial Comparative Study Clinical Trial
Sinemet CR in Parkinson's disease.
Sinemet CR, a controlled release carbidopa/levodopa preparation, was compared to conventional carbidopa/levodopa in a double blind, placebo-controlled trial. Comparable clinical benefits and adverse effects were noted with the two medications. However significantly less frequent dosing was necessary with Sinemet CR.