Necrotizing streptococcal myositis of an extremity: a rare case report.

Necrotizing myositis is a severe and very rare streptococcal soft tissue infection involving the superficial fascia and muscle. Its clinical symptoms are nonspecific until the appearance of a fulminant clinical course with soft tissue destruction and septic shock. A high mortality and morbidity rate has been reported in the few cases over the last century.

Femoral arterial access management for endovascular aortic aneurysm repair: evolution and outcome.

Endovascular repair of abdominal and thoracic aortic aneurysms (AAAs and TAAs, respectively) has become the standard of care for anatomically appropriate patients. All the devices developed to date for endograft repair of AAAs and TAAs are deployed through relatively large (12F to 24F) sheaths. Traditionally, this access has required arterial exposure with open cut down, but with the development of suture-mediated arterial closure devices and decreasing profile of delivery sheaths of endografts, there is an increasing trend toward percutaneous endovascular repair of aortic aneurysms.

Stevens-Johnson syndrome associated with oral minoxidil: a case report.

Minoxidil is frequently used in patients with advanced renal disease who have been unresponsive to other antihypertensive agents. We describe a case of a 50-year-old man with chronic renal failure who was hospitalized complaining of a 2-week history of sore throat that had progressed to severe oral lesions and multiple pustular blisters on many sites of his body. The patient had been placed on oral minoxidil for uncontrolled hypertension one week prior to the onset of symptoms.

System errors in intrapartum electronic fetal monitoring: a case review.

Intrapartum electronic fetal monitoring (EFM) interpretation and management continue to be a common issue in litigation involving adverse outcomes in term pregnancies. This article uses a case study approach to illustrate system errors related to intrapartum EFM. Common system errors related to use of intrapartum EFM include knowledge deficits, communication failures, and fear of conflict.

Neurorehabilitation of spinal cord injuries following lightning and electrical trauma.

While spinal cord injuries caused by lightning strike or electrical shock are rare, their clinical manifestations pose unique challenges to the clinician who must anticipate the interaction of multiple system involvement with the altered physiology of spinal cord injury. Spinal cord damage may be secondary to the direct effects of electrical current passing through neural tissue producing immediate or delayed impairment. Alternatively, lightning strike and electrical shock may lead to spinal cord damage due to the secondary consequences of injury such as spinal fractures sustained after a fall.

Wegener's granulomatosis in a pediatric patient.

Wegener's Granulomatosis (WG) is characterized by the clinical triad of upper and lower respiratory disease, and renal insufficiency. Because WG masquerades as a syndrome, its diagnosis is often delayed. Astute clinicians should include WG in their differential diagnosis when a patient presents with these classic findings.

Wegener's granulomatosis in a pediatric patient.

Wegener's Granulomatosis (WG) is characterized by the clinical triad of upper and lower respiratory disease, and renal insufficiency. Because WG masquerades as a syndrome, its diagnosis is often delayed. Astute clinicians should include WG in their differential diagnosis when a patient presents with these classic findings.

Appendectomy at the time of cesarean section.

The current world literature estimates the incidence of appendicitis in pregnancy at approximately 1 case per 1500 normal deliveries. Observations of one physician and review of records from Saint Anthony Hospital in Oklahoma City have suggested potential benefit to routine examination of the appendix at the time of cesarean section and removal if it appears pathologic. The medical literature was reviewed regarding appendicitis in pregnancy and incidental or indicated appendectomy at the time of cesarean section.

Malaria: a case report in Oklahoma and a review of prophylaxis for travelers.

Most cases of malaria in the United States, including the case described below, are due to travelers not taking proper prophylactic medications. With a potentially long incubation period, patients are frequently misdiagnosed (often with viral syndrome or pharyngitis) and correct treatment is delayed. Effective preventative medicines include Malarone, mefloquine, and doxycycline.

Large ovarian cellular fibroma during pregnancy mimicking a lipid cell tumor.

Lipid cell tumors are extremely rare tumors of the ovary which are usually malignant when larger than eight centimeters. Fibromas, on the other hand, are the most common type of benign ovarian solid tumors. Neither one of these tumors are known to be accelerated by the pregnant state.

Automobile airbag impulse noise: otologic symptoms in six patients.

Automobile airbag safety systems have successfully reduced the number of occupant injuries from motor vehicle accidents. Unfortunately, airbags are also associated with some inherent risk, including a high-amplitude, short-duration noise from airbag deployment. A review of the available research in the automobile industry indicates that the peak amplitude of this noise may exceed 170 dB sound pressure level.

Three-dimensional reconstruction of an iliac artery aneurysm in a man with obstructive uropathy.

Reconstruction of three-dimensional images is performed either by scanner-based systems or by independent computers. The advantages of a stand-alone system include compatibility with multiple imaging modalities, more advanced technology, and increased user interaction. This report illustrates the use of a stand-alone system for the less commonly utilized purpose of three-dimensional reconstruction of abdominal soft tissues.

Magnetic resonance imaging: utilization in the management of central nervous system trauma.

Objective: To determine the availability, use, and perceived value of magnetic resonance imaging (MR) in the management of acute central nervous system (CNS) trauma in United States Level I (or equivalent) trauma centers (TCs).

Design, Materials, And Methods: One hundred sixty-nine American College of Surgeons, state or locally designated Level I (or equivalent) TCs were identified using compiled lists and telephone contacts. Surveys about MR use in CNS trauma were mailed to each institution.