Acquired methemoglobinemia.

Cases of acquired methemoglobinemia have been identified with increasing frequency in Los Angeles during the last several years. Among 18 patients, both infants and adults, the most commonly incriminated agent was silver nitrate used for topical antibacterial prophylaxis of burn wounds. One burned child died from overwhelming septicemia complicated by hypoxia with a methemoglobin level of 5.

Duodenal villous adenoma.

Villous adenomas of the upper gastrointestinal tract, although rare, are difficult to diagnose and treat because of their location, invasiveness, and association with adenocarcinoma. Two patients with duodenal villous adenoma and upper abdominal pain as the presenting symptoms are described. Endoscopy is important for early diagnosis.

Prevention of upper gastrointestinal bleeding in burn patients: a role for 'elemental' diet.

In a retrospective study, the role of the elemental diet in preventing upper gastrointestinal (GI) bleeding was evaluated in 146 severely burned patients. The patients were divided into two groups. Group A consisted of 77 patients with 20% to 80% body-surface-area burns who received the usual diet.

Primary excision and grafting of burns located over an open fracture.

Early excision of the burn, immediate autografting, reduction of the fracture, and stabilization with a plaster-of-paris cast is offered as an alternative method for managing burns with associated long-bone fractures. The opportunity to excise and immediately autograft a burn wound requires rethinking of the entire problem of burns associated with a fracture.