1/9. Pedal manifestations of disseminated intravascular coagulation.disseminated intravascular coagulation is a complex hemostatic imbalance associated with many disease states. The potentially lethal systemic consequences of this disease mandate that the podiatric physician obtain a complete detailed history in addition to proceeding with appropriate consultations from other specialties. If haste is utilized and surgical intervention is undertaken without careful consideration, a potentially fatal situation may ensue. A comprehensive case report highlighting the pedal presentation and complications, and an overview of this disease process are presented.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/9. Pharmacist facilitation of a home IV therapy treatment program.A pharmacist's knowledge and experience had strong impact on the success of a home intravenous (IV) infusion treatment program, as stated in the following case study. After reviewing the patient's medical history, clinical course, and drug therapy plan, the pharmacist made recommendations that simplified the home IV self-care program, without compromising the results. The article describes how the pharmacist's liaison between patient and physician resulted in successful treatment and avoided significant costs to the hospital and the State medical assistance Program (pennsylvania Department of Public Welfare). As diagnosis Related Groups (DRGs) become fully implemented, the pharmacist's services will become an even more important component of discharge planning.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/9. Human pythiosis in Srinagarind Hospital: one year's experience.We have reported four cases of human pythiosis arteritis from Srinagarind Hospital, Khon Kaen, thailand. This unusual human infection occurring perhaps exclusively in thalassemia and hemoglobinopathy patients, should be noted by physicians, who work in areas with a high incidence of hemoglobinopathy, and for patients who present with unexplained arterial insufficiency. As our reported cases occurred within only one year, this condition may be more common than originally suspected and found more frequently if actively searched for.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/9. noma-like gangrenous cheilitis in a child with cyclic neutropenia associated with myeloperoxidase deficiency.An unusual case of cyclic neutropenia and hereditary myeloperoxidase deficiency complicated by noma-like gangrenous cheilitis is described. klebsiella pneumoniae and candida albicans were cultured from the involved area. We present this case to increase physician awareness of the possible association of both quantitative and qualitative defects of neutrophils and to stress the importance of the early and effective management of skin infections that can rapidly progress to severe sequelae when associated with profound neutropenia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/9. pyoderma gangrenosum in a kindred. Precipitation by surgery or mild physical trauma.Five cases of pyoderma gangrenosum occurring in a kindred are presented. Three of the cases occurred after abdominal surgery and tended to be confused with postoperative wound infections. Two cases occurred after superficial injury to the leg and were also thought to represent a peculiar form of cellulitis. None of the patients are known to have any of the underlying diseases usually associated with pyoderma gangrenosum. The cases are presented to alert the physician to this entity and to document the unusual familial occurrence.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/9. Intralesional steroid therapy of pyoderma gangrenosum.Treatment of pyoderma gangrenosum complicating ulcerative colitis has in the past been frustrating and usually unsuccessful, frequently resulting in colectomy. Intralesional steroid therapy has been used off and on in a few patients, but the treatment is not widely known to gastroenterologists. We report two patients successfully treated for early pyoderma gangrenosum by intralesional injection of triamcinolone acetonide (Kenalog, 40 mg injection) together with conventional doses of systemic steroids. A single series of injections was sufficient to bring about healing of the lesions in both patients. The treatment permitted early discharge of patients from the hospital, and the skin lesions were completely healed within 2 months. The lesions have not recurred in follow-up examinations of 11/2 and 21/2 years, respectively. We hope that other physicians will find this approach equally effective.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/9. stroke and gangrene: complications of therapeutic plasma exchange therapy.Two patients underwent therapeutic plasma exchange therapy. One patient with advanced rheumatoid arthritis developed a stroke after his fifth exchange. The other patient, with progressive systemic sclerosis, required a below the knee amputation secondary to shunt problems. These cases are presented to caution physicians in selecting patients for pheresis procedures and suggest that major complications can occur with this technique.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/9. Atheromatous embolism: an unusual case of acute lower extremity ischemia.A case is presented of lower extremity ischemia related to atheromatous embolization that presumably occurred as a result of passage of an angiographic catheter through the aorta. The patient presented with signs and symptoms pathognomonic for this entity. Emergency physicians need to be aware of this unusual etiology for an ischemic lower extremity.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/9. cocaine-associated intestinal gangrene in a pregnant woman.A 31-year-old pregnant woman who was an active cocaine abuser presented to our emergency department five times in 1 week for abdominal pain and vomiting. She continued to use cocaine regularly despite having abdominal pain. Her fifth admission was for seizures. There were no objective signs of peritoneal inflammation and the rectal guiac examination was repeatedly negative. The patient progressed to severe septic shock. Intraabdominal sepsis and/or bowel perforation was suspected. Exploratory laporatomy revealed gangrene and perforation of the small intestine and fecal peritonitis. She rapidly developed multiorgan failure and died. Gastrointestinal complications resulting from cocaine use are uncommon. Our case is unique in that the patient was pregnant, used cocaine by the intranasal route, and lacked objective signs of acute abdomen. Emergency physicians should be aware of the morbidity associated with the use of cocaine.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |