Postgraduate medicine
-
Postgraduate medicine · Jul 1991
Sepsis and septic shock. Deadly complications that are on the rise.
Most patients are already hospitalized when sepsis and septic shock develop, and in spite of therapy, at least 50% die. Although newer therapeutic agents are being evaluated, current management consists of antibiotics, fluids for volume resuscitation, inotropic agents, and surgery for septic foci. Greater emphasis on preventive measures is recommended.
-
Postgraduate medicine · Jul 1991
Using anticoagulants safely. Guidelines for therapeutic and prophylactic regimens.
Heparin and warfarin sodium (Coumadin, Panwarfin, Sofarin) are used most often to treat acute and recurrent venous thromboembolic disease, arterial disease, valvular heart disease, and atrial fibrillation. These agents along with dextran, pneumatic compression devices, and gradient stockings are also used to prevent deep venous thrombosis and pulmonary embolism in patients at high risk (eg, those with venous stasis, lower limb or spinal cord trauma, clotting abnormalities). Anticoagulation therapy is monitored by maintaining the activated partial thromboplastin time and the prothrombin time in the therapeutic range.
-
Postgraduate medicine · Jul 1991
Case ReportsSerious bacterial infections in children. When can outpatient treatment be used?
Several studies now support outpatient treatment of many serious bacterial infections in children, such as periorbital or buccal cellulitis, urinary tract infection, pneumonia, and abscess. However, an appropriate agent, that is, a third-generation cephalosporin with a long half-life, must be available and its effectiveness properly researched. In addition, children must be free of other illnesses and able to ingest fluids and maintain hydration, and their parents must be willing and able to cooperate with an outpatient treatment regimen. Family physicians can maintain the close patient and family contact needed to facilitate this form of therapy.