1/4. Novel cases of blastomycosis acquired in Toronto, ontario.blastomycosis a potentially fatal fungal disease, is well known from defined areas of endemicity in ontario, primarily in the northern part of the province. We present 2 unusual cases that appear to extend the area of endemicity into urban southern ontario, specifically Toronto. Both patients presented to a dermatology clinic with skin lesions. Chest radiography, history and general physical evaluation indicated no disease at other body sites. Both cases appeared to represent "inoculation blastomycosis" connected with minor gardening injuries and a cat scratch respectively. Atypical dissemination could not be completely excluded in either case. Neither patient had travelled recently to a known area of high endemicity for blastomycosis, nor had the cat that was involved in one of the cases. physicians must become aware that blastomycosis may mimic other diseases, including dermal infections, and may occur in patients whose travel histories would not normally suggest this infection.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. Wound care for burn patients in acute rehabilitation settings.Caring for patients who are recovering from severe burns is not common in most inpatient rehabilitation settings. nursing challenges include patients' physical and psychological changes and their high care demands. Harborview Medical Center (HMC), a regional Level 1 burn and trauma center in Seattle, WA, accepted these nursing challenges and developed a successful plan of care consistent with current evidence. This article describes HMC's nursing experiences while caring for patients with burns. Our experiences may assist other rehabilitation units that serve burn patients. Says one burn survivor: "nurses make a huge difference in recovery, as they are there 24 hours a day. It is their touch, their caring, and their listening that aids the patient in his journey from fire victim to burn survivor."- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/4. Perforation of the jejunum from blunt abdominal trauma.Thirteen cases of jejunal perforation from blunt trauma are presented. There are no reliable signs or symptoms, and a normal physical examination may be seen. Free intraperitoneal air on plain radiograms is characteristically absent. Simple debridement and closure is adequate. mortality is usually associated with other serious concomitant injuries, and complications are associated with diagnostic delays. Diagnostic peritoneal lavage is a safe and reliable procedure for establishing an early diagnosis of serious intraperitoneal injury. Its routine use in all cases of serious blunt abdominal trauma is advocated.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. Wound botulism.Wound botulism is a rare infectious and toxicologic complication of trauma and i.v. drug abuse. Only 39 cases have been reported in detail in the English literature. This case report describes a patient with wound botulism who presented to four medical facilities before receiving definitive diagnosis and treatment. Although his history and physical examination were consistent with wound botulism, diagnosis and therapy were delayed because this rare disease was not considered initially in the differential diagnosis. Wound botulism should be considered in trauma patients and i.v. drug abusers who present with cranial nerve palsies and descending paresis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |