摘要:

In a study of 57 actual or impending pathologic fractures of the humerus in 52 patients with inoperable cancer treated between 1972 and 1982, we retrospectivelyreviewed the charts for analysis and comparison of the functional result and pain relief afforded by the various treatments used. Function of the extremity and relief of pain were each graded as excellent, good, fair, or poor using a modification of Perez's rating system. Seven pathologic fractures were treated nonoperatively. These patients generally had only fair pain relief and a poor functional result. Forty-six pathologic fractures were treated with intramedullary fixation using a Rush rod (n=16), a Kiintscher rod (n=29), or an Ender rod (n=1); the Neer endoprosthesis was used in four patients. Thirty-one patients received radiation to the humerus. There were seven operative complications, the most common (n=3) being prominence of an intramedullary rod at the insertion site which required a second minor procedure for advancement of the rod. From this series, we conclude that any patient who has a pathologic fracture or impending fracture of the humerus and a predicted survival of six weeks or more is likely to benefit from rigid internal fixation with an appropriately selected device, adjunctive use of methylmethacrylate, and postoperative local irradiation therapy as needed.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The findings presented here are from the first reported comparison and double-blind evaluation of 20 patients randomly assigned to either chlordiazepoxide (n=10) or clonidine (n=10) for the treatment of acute alcohol withdrawal syndrome. Analysis of the study data demonstrated more favorable scores on tests of alcohol withdrawal symptoms (AWS), and better control of blood pressure, pulse, and respiratory rate with clonidine than with chlordiazepoxide therapy. In all other comparisons, clonidine was at least as efficacious. Clonidine may represent a new and possibly even superior pharmacologic treatment in the management of acute alcohol withdrawal syndrome.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Multiple food allergies required a group of seven patients with elevated serum cholesterol levels to follow a diet in which most of the calories came from beef fat. Their diets contained no sucrose, milk, or grains. They were given nutritional supplements. This is the only group of people in recent times to follow such a diet. During the study, the patients' triglyceride levels decreased from an average of 113 mg/dl to an average of 74 mg/dl; at the same time, their serum cholesterol levels fell from an average of 263 mg/dl to an average of 189 mg/dl. At the beginning of the study, six of the patients had an average high-density lipoprotein percentage of 21%. At the end of the study, the average had risen to 32%. These findings raise an interesting question: are elevated serum cholesterol levels caused in part not by eating animal fat (an extremely “old food”), but by some factor in grains, sucrose, or milk (“new foods”) that interferes with cholesterol metabolism?

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Chest pain is a frequent patient complaint that requires a careful history and physical examination to determine its cause. Cardiac and esophageal causes of chest pain are common, but musculoskeletal disorders such as Tietze's syndrome, chest wall pain syndromes, fibrositis, inflammatory arthritic conditions, cervical osteoarthritis, and disease of the thoracic spine may also result in chest pain. Musculoskeletal diseases must be differentiated from other causes of chest pain, since specific treatment of these rheumatic conditions often produces good results.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Idiopathic thrombocytopenic purpura (ITP) is a primary immune thrombocytopenia that is typically manifested in adults by acute bleeding, severe thrombocytopenia, and normal to increased megakaryocytes in the bone marrow. Labeling studies suggest that most patients with ITP have an IgG antibody directed against the platelet membrane resulting in sequestration in the spleen, and that sequestration in other organs such as the liver bodes a popr prognosis. Splenectomy and/or corticosteroids remain the mainstay of therapy, with permanent remissions induced in 75% of patients. We review alternative forms of therapy such as immunosuppressive agents, high-dose γ-globulin, and others to enable the practicing physician to select the best treatment for patients refractory to standard therapy. Age appears to influence response to therapy and morbidity, with advancing age imparting a poorer prognosis.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID