Southern medical journal
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Southern medical journal · Apr 2010
Multicenter StudyCommunity-based application of mild therapeutic hypothermia for survivors of cardiac arrest.
To demonstrate that the application of therapeutic hypothermia is technically feasible in a community-based setting. ⋯ A simple protocol of mild therapeutic hypothermia using locally available resources is technically feasible and safe in a community-based setting.
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Southern medical journal · Apr 2010
Multicenter StudyPredictors of poor neurologic outcome in patients undergoing therapeutic hypothermia after cardiac arrest.
Therapeutic hypothermia (TH) has been shown to reduce the degree of anoxic brain injury, decrease mortality, and improve neurologic recovery in patients surviving cardiac arrest. However, there is a paucity of data on potential markers of neurologic outcome that physicians can use in this setting. ⋯ Several simple, reproducible clinical markers can help predict neurologic recovery, during and after treatment, in patients managed with TH for cardiac arrest.
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Southern medical journal · Apr 2010
ReviewTransition medicine: a review of current theory and practice.
Every year more than 500,000 children with special health care needs (CSHCN), patients who need more consistent medical care or face significant consequences and complications, transition to adult-oriented providers. Yet these patients may encounter even greater difficulty in transitions of care than healthy adolescents and young adults, whether it is finding a provider who is comfortable managing their condition, re-establishing trust with a new provider, having providers address their unique psychosocial needs, or maintaining sufficient insurance coverage. ⋯ However, little evidence exists as to the actual impact of these programs on patient outcomes. This review highlights current understanding and expectations of transition for young adults with special health care needs, describes the state of transition medicine in South Carolina, and outlines areas for research and improvement on the local, regional, and national level.
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Southern medical journal · Apr 2010
Case ReportsSubcutaneous emphysema, muscular necrosis, and necrotizing fasciitis: an unusual presentation of perforated sigmoid diverticulitis.
With advancing age and the affluent, low-fiber Western diet, the incidence of diverticular disease is increasing. Fortunately, most cases can be managed conservatively without resorting to surgical intervention. ⋯ A posterior perforated sigmoid diverticulitis associated with myofascial necrosis and generalized pelvic emphysema was identified. In cases where perforation occurs posteriorly and the only external manifestation is surgical emphysema, the outcome is generally favorable.
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Southern medical journal · Apr 2010
Case ReportsBiliary fascioliasis mimicking sphincter of Oddi dysfunction.
Fasciola hepatica, a liver fluke of livestock, rarely presents as chronic biliary tract infection in humans. We report a 38-year-old woman from Ethiopia who presented with right upper quadrant pain and a dilated common bile duct on ultrasound and magnetic resonance cholangiopancreatography (MRCP) without other abnormalities. ⋯ She underwent endoscopic retrograde cholangiopancreatography (ERCP) and had a fluke, diagnosed as Fasciola hepatica, in the common hepatic duct. This report confirms the diagnostic and therapeutic role of ERCP in the management of biliary fascioliasis, and highlights the need to include fascioliasis in the differential diagnosis of biliary pain in patients emigrating from areas where this infection is endemic.