A case report of disseminated blastomycosis and adult respiratory distress syndrome.

Blastomycosis is a fungal disease endemic to the midwestern and southeastern United States. This is a case report of a 29-year-old woman who presented with weight loss, fever, fatigue, and pneumonia. She developed disseminated blastomycosis, adult respiratory distress syndrome (ARDS), and ulcerative skin lesions, requiring mechanical ventilation, amphotericin B, and multiple surgeries. Blastomycosis is endemic to a large portion of the United States. Family physicians should consider fungal infection in the differential diagnosis of an unresolving pneumonia.

Intravenous ethanol for alcohol detoxification in trauma patients.

Traumatic injury frequently follows alcohol abuse. Between October 1, 1988 and January 31, 1992, 2,219 patients were admitted to the Trauma Service at the University Medical Center of Eastern Carolina-Pitt County. Of the 1,602 who were tested for serum ethanol, 685 (43%) were found to have measurable levels. Thirty-seven patients had alcohol withdrawal and were treated with intravenous ethanol; 34 were male (21 black, 13 white) and 3 female (1 black, 2 white), with an average age of 46 years. Those who had withdrawal had an average serum ethanol level, on presentation, of 239 mg/dL (N = 34). Fourteen patients were involved in motor vehicle crashes, seven were pedestrians struck by cars, and the remaining 16 had various traumatic mechanisms of injury. The most common injuries were long-bone fractures and blunt abdominal trauma. The length of ethanol therapy averaged 4 days. A majority of patients had a favorable response to treatment. Relative contraindications to i.v. ethanol therapy were CNS trauma, liver disease, and pancreatitis. i.v. ethanol is a safe and effective method of alcohol detoxification in the trauma patient.

Charles Drew: dispelling the myth.

The name Charles Drew is synonymous with blood transfusions, but his life encompassed many other areas of work. A native of Washington, DC, Drew attended Dunbar High School and Amherst College, and went to medical school at McGill University in Montreal. All during his schooling he was a highly regarded athlete (track and football). Drew spent 2 years in postdoctoral training in Montreal and 3 years in Washington, DC, followed by 2 years in New York City, working on a doctorate in medicine in blood banking. He was instrumental in the Blood for Britain program in 1940 and helped establish the future Red Cross blood bank in the United States. Finally, at Howard University, where he taught from 1941 to 1950, he trained a generation of black surgeons. He died, at age 45, of injuries received in a car accident in 1950 in North Carolina. Controversy surrounding his death, involving numerous erroneous claims, has served unfortunately to detract from the significance of his achievements.