摘要:

A new Pulmonary Medicine–Thoracic Surgery service was established in a community hospital in July 1974. This report details the experience of 409 bronchoscopies performed from July 1, 1974 through Dec 31, 1976. There were no deaths and four complications—one aspiration and three pneumothoraces resulting from transbronchial lung biopsy. Final diagnoses for which bronchoscopy was done were as follows: cancer—141; infectious disease—97; interstitial disease—33; obstructive lung disease—58; hemoptysis—35; miscellaneous—45. In the cancer group, a cytohistologic diagnosis was made in 82 patients by bronchoscopy alone, 31 additional diagnoses were made by scalene node biopsy or mediastinoscopy, and the remainder by surgical exploration and/or resection. In 268 patients with benign disease, bronchoscopy established the diagnosis in 87% of the cases. Pulmonary Medicine tended not to repeat nondiagnostic bronchoscopy but rather to refer immediately for a definitive surgical procedure. Thoracic Surgery tended not to reduplicate bronchoscopy for the purpose of “confirmation.” A conjoint medical-surgical approach to bronchial disease, at the community level and based on a mutual understanding of capability and limitation, is feasible, productive, and economical.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

We reviewed the records of 100 consecutive patients who had gastroscopy. All endoscopic work was done by our four-man surgical group. Roentgenographic and endoscopic diagnoses are compared with reference to degree of accuracy. The expanded uses of gastroscopy in surgical practice are illustrated and a plea is made for increased involvement of surgeons in the rapidly expanding field of endoscopy.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The diagnostic and therapeutic approaches to malignant pleural effusions are reviewed, and data on the retrospective study of 37 patients are presented with respect to diagnosis and management. All patients with stable effusions should be managed with systemic therapy for the primary tumor when an effective agent is available. When it becomes necessary to use local therapeutic measures, thoracostomy tube drainage with local instillation of tetracycline is recommended.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Levamisole (Decaris, Belgium) was tested in Iran, Brazil, and in Mississippi and Louisiana for its efficacy as a single-dose oral treatment forAscarisinfections. Subjects were children ages 2 to 15 years, and numbers treated with levamisole and comparative anthelminitics are as follows: 453 with levamisole; 461 with piperazine citrate; 17 with pyrantel pamoate; and 19 with a placebo. Cure rates and total reduction in mean egg counts observed were 92% and 98% respectively for levamisole and 66% and 90% for piperazine. Sixteen of 17 treated with pyrantel pamoate were cured. In none of the drugs were there notable side reactions, but in all four studies side effects were more frequent with piperazine than with levamisole. Levamisole was found to be a well-tolerated, highly effective single-dose ascaricide. It should prove to be particularly useful for mass chemotherapy inAscariscontrol programs.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

There were 150 patients with mycologically proven vulvovaginal candidiasis in a randomized, non-cross-over study which compared seven- and 14-day treatment courses of clotrimazole vaginal tablets (Gyne-Lotrimin) with a 14-day treatment course of miconazole nitrate 2% vaginal cream (Monistat). Adequate data for analyses were obtained for 117 patients. When patients were reexamined four or more weeks after completion of therapy, success rates, based on clinical and mycologic criteria, were: 88% for patients treated with clotrimazole for seven days, 84% for clotrimazole 14-day treatment, and 78% for miconazole nitrate 14-day treatment. There were no drug-related adverse reactions. Thus a seven-day course of therapy with clotrimazole is effective as is a 14-day course of either clotrimazole or miconazole nitrate 2% for the treatment ofCandidavaginitis. Statistical analysis revealed no significant differences among the clotrimazole seven- and 14-day treatment groups and the miconazole nitrate 14-day treatment group. The shorter period of administration required for this new antifungal agent should result in better patient compliance and an improved success rate in the treatment of this frequently encountered infection.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Occurrence of the carpal tunnel syndrome in pregnancy was studied by examining 100 consecutive obstetric admissions. Twenty-one patients reported paresthesias or hypesthesia in the median nerve sensory distribution of the hand during the pregnancy; eight of these had decreased sensation subjectively at the time of examination one to three days after delivery; two had trophic changes, loss of sudomotor function, thenar atrophy, and decreased two-point discrimination; and one had a delay in motor conduction time across the carpal tunnel. Of the 21 patients, 18 became asymptomatic before or shortly after delivery. The remaining three were asymptomatic three months after delivery. We conclude that the incidence of symptoms is probably greater than usually appreciated, but that few patients require treatment. Steroid injection may occasionally be necessary, but the need for surgical intervention is rare.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Nineteen subtrochanteric fractures were treated at Charlotte Memorial Hospital and Medical Center between March 1973 and March 1976 by open reduction and internal fixation using the Zickel nail. Postoperative roentgenograms showed the cross-nail exiting the femoral neck in three of the cases, but this later proved not to be significant. Of the 16 patients available for follow-up, all were ambulatory unassisted or with a walker within two months of surgery. Radiographically evident healing averaged 4.1 months. There were no nonunions and no infections. Our data support the use of the Zickel nail in the treatment of subtrochanteric fractures.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Pulmonary emphysema was the disease entity from which we derived a definition for microcardia in males. After the fourth decade, a cardiothoracic ratio of 38% or less is considered to represent a small heart. Among male Veterans Hospital patients between the ages of 41 and 83, the probability of an individual without emphysema having a cardiothoracic ratio of 38% or less was under 1%. Microcardia, even as an isolated sign, should make one suspect strongly the presence of subclinical emphysema and to consider instituting a prophylactic regimen. Hearts should be measured to judge not only increased size but decreased size in both patient and examinee groups.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID