Chest
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A patient with endocarditis due to Streptococcus faecalis on an aortic valvular prosthesis was successfully treated using large oral doses of amoxicillin concurrently with intramuscular administration of streptomycin. Oral therapy was employed because of a persistent reaction to intravenously administered antibiotics. Oral therapy for bacterial endocarditis occurring on an artificial valve may be attempted as a last resort when all other accepted therapeutic measures have failed.
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A new cannula with a system of intermittent nasal flow was evaluated and compared with a standard constant-flow nasal cannula in 15 patients with chronic obstructive pulmonary disease. The intermittent-demand cannula released oxygen only when a negative pressure was detected in the nose (negative mode) or when a a positive pressure ceased to be detected in the nose (positive mode). At rates of flow varying from 0.63 to 5.60 L/min, the continuous-flow mode used 9 percent more oxygen than the negative mode and 31 percent more oxygen than the positive mode to achieve comparable improvement in arterial oxygen tension. The system using the intermittent-demand cannula was sensitive and reliable in over 150 hours of testing.
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Case Reports
Bilateral ductus arteriosus in d-transposition of the great arteries with right aortic arch.
The rare anomaly of a right aortic arch, distal origin of the left subclavian artery, and posterior left ductus arteriosus (forming a vascular ring) plus a right ductus arteriosus is described in an infant with d-transposition of the great arteries with an intact septum. The presence of a right aortic arch and distal left subclavian artery with bilateral ductus arteriosus has not been described previously.