551
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Dolan MJ, Lattuada CP, Melcher GP, Zellmer R, Allendoerfer R, Rinaldi MG. Coccidioides immitis presenting as a mycelial pathogen with empyema and hydropneumothorax. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1992; 30:249-55. [PMID: 1517961 DOI: 10.1080/02681219280000311] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A previously healthy Caucasian male developed hydropneumothorax and a pleural peel filled with pleomorphic, septate hyphae. The only organism grown from cultures of the lung and pleural fluid was Coccidioides immitis, confirmed by exoantigen testing. Spherule-endospore forms were produced, however, following injection of the arthroconidial tissue isolate into BALB/c mice. The patient had a positive immunodiffusion complement-fixation test and developed a positive coccidioidin skin test during therapy. He recovered following thoracotomy and wedge resection of the ruptured coccidioidal cavity, and therapy with amphotericin B followed by fluconazole. The sole presence of the mycelial form of the dimorphic fungus C. immitis in the pleural space may have been due to a low CO2 partial pressure at that site secondary to a bronchopleural fistula. The case shows a distinctive and uncommon presentation of coccidioidomycosis which demonstrates the specificity of both the immunodiffusion complement-fixation assay in diagnosing this disease and the exoantigen test in confirming culture results.
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552
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Ueda H, Shibata K, Kusano T. Postoperative pyothorax. Surg Today 1992; 22:115-9. [PMID: 1498489 DOI: 10.1007/bf00311334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Twenty-five cases of pyothorax occurred in a series of 1281 thoracotomies. Almost all cases of pyothorax without bronchopleural fistula were successfully treated by closed drainage and irrigation alone. On the other hand, patients with pyothorax and fistula who were treated only with closed drainage almost all had a poor outcome. When pyothorax with fistula was treated by closed drainage and irrigation followed by further procedures such as open window thoracostomy, muscle plombage and/or omentopexy, treatment was successful. It is concluded that pyothorax without fistula may be cured by closed drainage and irrigation alone, but that pyothorax with fistula requires operative intervention such as open window thoracostomy or omental flap as soon as possible.
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553
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Sanna CM, Corrias A, Congiu G, Dessì S, Versace R, Corda R. [Empyema due to an anaerobic Streptococcus in childhood]. LA PEDIATRIA MEDICA E CHIRURGICA 1991; 13:645-7. [PMID: 1806927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Anaerobic infections are quite rare in pediatric age, being that, they affect only neonates and immunodepressed patients. We think to be somewhat interesting to describe the case of our patient, a 9 year old boy, unaffected by any predisposing factor, came under our observation because of a severe respiratory distress. He showed evident clinical and radiological signs of pleural effusion in the right lung, together with a gas coil in the upper field and a left mediastinal shifting. A thoracentesis was then performed, giving rise to 600 ml of foul smelling purulent material; this procedure promptly improved his respiratory function. A permanent drainage trough the chest wall was set and an antibiotic therapy, based on the clinical picture and the character of the exudate, begun. In effect, the typical smell of the purulent material led us to suspect an anaerobic infection, and for this reason we employed the teicoplanin iv, a rarely used in the pediatric age drug. While blood cultures were negative for any organism, exudate cultures yielded Peptostreptococcus anaerobius; the last one resulted highly sensible following antibiogram to the previously chosen drug. The x-ray pattern and the rapid disappearing of the gas coil induced us to exclude further either congenital or acquired lung diseases. We conclude that, in absence of other proved sources of entry, the air presence in the pleural space was secondary to gas formation by the anaerobic micro-organism. The clinical course was very satisfactory allowing the patient to be dismissed on the 28th hospital day, with no need of further surgical therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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554
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Tsubota N, Hatta T, Yoshimura M, Yanagawa M. A case of empyema developing thirteen years after a pneumonectomy treated using pedicled omentum which was followed by intestinal obstruction. THE JAPANESE JOURNAL OF SURGERY 1991; 21:703-5. [PMID: 1787621 DOI: 10.1007/bf02471060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Postpneumonectomy empyema is one of the most difficult complications for the thoracic surgeon to treat. We report herein a case of a 62 year old diabetic man who developed empyema 13 years after a pneumonectomy for cancer, which was successfully treated using an omental pedicle flap. Postoperatively, the chest would healed uneventfully, however, a bowel obstruction developed which was subsequently treated by removing the remnant omentum that had adhered to the bowel.
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555
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Abstract
Five patients with tracheobronchial injuries secondary to blunt thoracic trauma were reviewed over a 9-year period. Bronchial disruption occurred in four cases and tracheal disruption in one. Of the four patients with bronchial disruption, a major airway injury was suspected early because of a large air leak or persistent pulmonary atelectasis. However, definitive diagnosis by bronchoscopy was delayed from 4 to 16 days due to initial response to conservative management. Bronchial repair was achieved in every case: additional lobectomy was required in only one instance. Postoperative bronchial stenosis occurred in one patient and responded well to dilatation. The child with a blowout perforation of the trachea was diagnosed early by bronchoscopy and was successfully managed without surgery. Tracheobronchial injury is one of the most severe injuries caused by blunt trauma and requires a high index of suspicion for early diagnosis and surgery. Bronchial repair is successful in most instances.
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556
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Tatsumi A, Kitano M, Huang C, Tanaka F, Nagasawa M. [Role of surgical treatment in thoracic empyema with bronchopleural and/or thoracic empyema]. KEKKAKU : [TUBERCULOSIS] 1991; 66:775-9. [PMID: 1766159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sixty-nine patients with thoracic empyema treated surgically were experienced from May, 1978 through December, 1990. Thirty-nine cases had bronchopleural and/or thoracic fistula. Thirty-two patients were associated with pulmonary tuberculosis, of whom fourteen had tuberculous empyema and eighteen were sequelae of pulmonary tuberculosis or tuberculous pleurisy. The remainder were postoperative, postpneumonic, and posttraumatic empyemas. Of fourteen patients who developed postoperative bronchopleural fistula, there were ten patients who had lobectomy or pneumonectomy for lung cancers. Omental pedicle flap method, in which empyema space was filled with the omentum and pedicled muscle flap, was performed on 19 patients with bronchopleural or thoracic fistula or both. Fifteen patients were cured successfully by single-stage procedure, though there was one operative death due to aspiration pneumonia, and two recurrences which were treated by muscle plombages. There was another patient who had multiple surgical procedures in the past resulting in partial recurrences, but the fistula of this patient subsequently closed without reoperation. Postoperative decrease of %VC, FEV1.0/PVC were minimal. Treatment of long standing bronchopleural fistula is a difficult problem, and our omental pedicle flap method is relatively simple and safe which can be most suitably applied to those patients in whom other procedures have failed and to those with poor pulmonary functions.
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557
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Dillehay DL, Paul KS, DiGiacomo RF, Chengappa MM. Pathogenicity of Pasteurella multocida A:3 in Flemish giant and New Zealand white rabbits. Lab Anim 1991; 25:337-41. [PMID: 1753694 DOI: 10.1258/002367791780810056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pasteurella multocida A:3 was isolated during an outbreak of pasteurellosis in Flemish Giant (FG) rabbits. Since New Zealand White (NZW) rabbits housed in the same room were not as severely affected as FG rabbits, experimental inoculation was undertaken to determine if FG rabbits were more susceptible than NZW rabbits to pasteurellosis induced by this isolate. Rabbits of each breed were inoculated with P. multocida A:3 and observed for 3 weeks. Four of 5 FG rabbits developed severe clinical disease on days 6, 9, 12 and 14 after inoculation; whereas, the one affected NZW rabbit became ill 14 days after inoculation. All rabbits with clinical disease developed fibrinosuppurative pleuritis, pyothorax and pneumonia which was more severe in FG than NZW rabbits. At necropsy, P. multocida A:3 was isolated from multiple sites of the diseased rabbits. No significant difference (P = 0.099) in the prevalence of lesions between the two breeds was found; however, the score of pneumonia and pleuritis was 3 times greater in FG rabbits than NZW rabbits.
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558
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Grubnik VV, Shipulin PP, Potapenkov MA, Poliak SD, So Bon HO. [Hazards and complications of endoscopic laser operations in thoracic surgery]. GRUDNAIA I SERDECHNO-SOSUDISTAIA KHIRURGIIA 1991:44-6. [PMID: 1782032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The danger and complications of endoscopic operations with the use of IAN- and argon lasers are characterized. Among 327 bronchoscopic laser interventions carried out for tumors of the respiratory tract, 7 (3.1%) were attended by complications in the form of perforation, hemorrhage, and laryngospasm. One case with empyema of the pleura was encountered among 35 patients after laser photocoagulation of the lung through a thoracoscope. Measures for the prevention and management of these complications were developed.
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559
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Balogh G. [Current treatment of thoracic empyema in adults]. Orv Hetil 1991; 132:2075-80. [PMID: 1923479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Experiences obtained with 400 cases of thoracal empyema are described. The fact that the rate of lethality was 18.7% until present points out to the severity of the disease. The semi-conservative therapeutical methods used by the author (drainage, drainage and pleura lavage, pleura lavage and thoracoscopy, balance drainage) are presented. With their sensibly more frequent use the rate of operation could be reduced by 8% (from 36.5% to 28.5%) and the lethality rate by 7.6% (from 18.7% to 11.1). Further improvement of the results may be expected of the increased number of early detection (basic care), concentration of empyemic patients in special institutes (departments, wards) and due to it of a more efficient special treatment of uniform contemplation.
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560
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Molina JM, Leport C, Bure A, Wolff M, Michon C, Vilde JL. Clinical and bacterial features of infections caused by Streptococcus milleri. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1991; 23:659-66. [PMID: 1815325 DOI: 10.3109/00365549109024289] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The clinical and bacteriological features of 51 infections due to Streptococcus milleri observed in 43 patients over a 2-year period were reviewed. Clinical syndromes included bacteremia in 6 cases, endocarditis in 4 cases, cellulitis and subcutaneous abscesses in 8 cases, pleural empyema in 8 cases, brain abscesses in 5 cases, abdominal infections in 5 cases, and other miscellaneous infections in 15 cases. An underlying condition was associated with infection in 33/43 patients (77%). S. milleri was the only pathogen isolated in 19 patients (44%). All strains of S. milleri were susceptible to penicillin. Surgery was combined with antimicrobial therapy in 27 (63%) patients. Nine patients died during hospitalization, and death was directly related to S. milleri infection in 4 patients (9%). These results confirm that S. milleri frequently causes serious suppurative infections and that species identification is a clinically useful procedure.
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MESH Headings
- Abscess/drug therapy
- Abscess/etiology
- Abscess/microbiology
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Bacteremia/drug therapy
- Bacteremia/etiology
- Bacteremia/microbiology
- Brain Abscess/drug therapy
- Brain Abscess/etiology
- Brain Abscess/microbiology
- Cellulitis/drug therapy
- Cellulitis/etiology
- Cellulitis/microbiology
- Child
- Empyema, Pleural/drug therapy
- Empyema, Pleural/etiology
- Empyema, Pleural/microbiology
- Endocarditis, Bacterial/drug therapy
- Endocarditis, Bacterial/etiology
- Endocarditis, Bacterial/microbiology
- Female
- Humans
- Liver Abscess/drug therapy
- Liver Abscess/etiology
- Liver Abscess/microbiology
- Male
- Meningitis, Bacterial/drug therapy
- Meningitis, Bacterial/etiology
- Meningitis, Bacterial/microbiology
- Middle Aged
- Peritonitis/drug therapy
- Peritonitis/etiology
- Peritonitis/microbiology
- Retrospective Studies
- Streptococcal Infections/drug therapy
- Streptococcal Infections/etiology
- Streptococcal Infections/microbiology
- Streptococcus/drug effects
- Streptococcus/isolation & purification
- Treatment Outcome
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561
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Thetter O, Habekost M, Izbicki JR. [Rethoracotomy after lung resection]. LANGENBECKS ARCHIV FUR CHIRURGIE. SUPPLEMENT. KONGRESSBAND. DEUTSCHE GESELLSCHAFT FUR CHIRURGIE. KONGRESS 1991:161-5. [PMID: 1793903 DOI: 10.1007/978-3-642-95662-1_78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Postoperative complications after lung resection necessitating rethoracotomy are rare. The most common early complication is hemorrhage. Reintervention is indicated if bloody secretion of more than 250 ml/h persists over a period of hours. Any large intrapleural hematoma should be removed to avoid infection or development of pleural callosity. Further indications for rethoracotomy are: persistent parenchyma fistula, pneumothorax, residual cavity, pleural empyema, leakage of the bronchial stump and mechanical bronchial obstruction.
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562
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Liam CK, Pendek R, Navaratnam P, Hassan H, Puthucheary SD, Abdul Majid A, Abdul Ghani S. Culture-positive thoracic empyema in adults. THE MEDICAL JOURNAL OF MALAYSIA 1990; 45:169-76. [PMID: 2152022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Twenty-nine adult patients with culture-positive thoracic empyema were seen at the University Hospital Kuala Lumpur from 1984 to 1988. Cough, fever, chest pain, dyspnoea and weight loss were the common presenting symptoms. The empyema in 16 patients was associated with primary bronchopulmonary infections, nine occurred following thoracentesis of culture-sterile pleural effusions, two occurred as post-thoracic surgery complications, one following a subdiaphragmatic abscess and one as a result of a stab wound. The most common culture isolates were Streptococcus milleri, Pseudomonas aeruginosa and Klebsiella pneumoniae. Closed tube thoracostomy, the most common form of drainage procedure employed, was able to effect a cure or control of the empyema in 11 out of 19 patients in whom it was used.
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563
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Baculard A, Tournier G, Grimfeld A, Couvreur J, Gerbeaux J. [Current aspects of the diagnosis and treatment of purulent pleurisy in children]. ANNALES DE PEDIATRIE 1976; 23:481-8. [PMID: 16104204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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564
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SAROT IA, LITTMAN ML, CERRUTI MM. Intrathoracic injection of amphotericin B in the treatment of monilial empyema. SEA VIEW HOSPITAL BULLETIN 1959; 17:95-100. [PMID: 13646674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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565
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VARTANIAN VE. [Prevention of bronchial fistula and pleural empyemas following pulmonary resection; experimental and clinical investigations]. Khirurgiia (Mosk) 1959; 35:36-42. [PMID: 13631858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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566
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567
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BRUCKEL KW. Zur Aktinomykose-Behandlung. Dtsch Med Wochenschr 1958; 83:1549-51. [PMID: 13573956 DOI: 10.1055/s-0028-1113827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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568
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RIPETTA LM, BREA CM. [Bronchial adenoma: case report]. REVISTA DE LA ASOCIACION MEDICA ARGENTINA 1958; 72:347-51. [PMID: 13614754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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569
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BLAHA H, ARNEMANN W. Iatrogenic pleural empyema. BRUNS' BEITRAGE ZUR KLINISCHEN CHIRURGIE 1958; 196:476-92. [PMID: 13560935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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570
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HALKIER E, AAGAARD P. [Pleural empyema caused by esophageal perforation]. Ugeskr Laeger 1958; 120:706-8. [PMID: 13569660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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571
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BOBRA ST. Chronic Empyema due to Salmonella Oranienburg *. CANADIAN MEDICAL ASSOCIATION JOURNAL 1958; 78:599-602. [PMID: 13536924 PMCID: PMC1829827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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572
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SOKOLOV SN. [Prevention of acute empyema after pneumonectomy]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 1958; 80:47-52. [PMID: 13557425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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573
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KARLHUBER F. [Treatment of empyema with trypsin, with special reference to thoracic surgery]. DIE MEDIZINISCHE 1958; 2:84-7. [PMID: 13516218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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574
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WACK H. [Influenza complications & prematurity]. ZEITSCHRIFT FUR GEBURTSHILFE UND GYNAKOLOGIE 1958; 150:29-41. [PMID: 13604397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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575
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SONZINI ASTUDILLO CP. [Decortication for empyema following a rupture of a pleural hydatid cyst]. PRENSA MEDICA ARGENTINA 1957; 44:3015-6. [PMID: 13527398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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