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

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The origin, background, and mechanism of operation of the Maternal Mortality Study Committee in Wisconsin is outlined. Its value as a teaching vehicle is emphasized. Trends in maternal mortality in Wisconsin and the continued decline are presented, with 45 per 100,000 live births in 1953 to 9.2 per 100,000 live-births in 1975. An appeal for standardization of terms and definitions and a continuation of these studies in each state is made. Study committees in many states are inactive. It is suggested that chairmen of maternal mortality committees and representatives meet in geographic areas comparable to Districts of The American College of Obstetricians and Gynecologists to compare trends and statistics. Hemorrhage, once considered the important cause, has decreased from 56.4% of maternal loss to a low of 12.1% in 1975. Presently, a category listed as “other causes”—that is, other than hemorrhage, sepsis, and toxemia—account for approximately 60% of deaths. This group includes anesthesia, emboli and coincidental disease involving kidneys, heart, malignancy, and diabetes. An appeal is made to continue these studies.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Assessing the meaning of psychologic symptoms in adolescents can be a difficult task. Pediatricians, internists, and family practitioners are often the first professionals consulted by families worried that their teen-agers may be in psychologic distress. The practitioner is faced with the difficult decision of meeting the adolescent's need himself or referring the patient to an adolescent psychiatrist for further evaluation and possible treatment. In making this decision the practitioner must carry out a complex assessment task which requires the simultaneous evaluation of multiple clinical variables. This paper presents a conceptual scheme for evaluating the psychologic status of an adolescent patient.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Childhood enuresis has long been an enigmatic clinical entity. The purpose of this paper is to focus current psychologic thinking as it applies to etiology, diagnostic work-up, treatment, and follow-up. A large number of etiologic formulations are briefly mentioned, but our primary thrust is to emphasize the psychologic liabilities of urologic instrumentation and to encourage the early application of nonsurgical therapeutic approaches consisting of behavior modification and imipramine. Follow-up evaluation is suggested for children requiring diagnostic or therapeutic genitourinary instrumentation.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Retinal detachment complicating proliferative diabetic retinopathy is being recognized with increasing frequency. Although one type of detachment is tractional and requires vitrectomy for hopeful repair, the other variety of detachment is rhegmatogenous. The rhegmatogenous form of retinal detachment does not generally require the radical surgical approach of vitrectomy. However, because of the unusual nature of the retinal detachment, a standard encircling scleral buckling procedure does not suffice to correct the problem. The unusual characteristics of this form of retinal detachment are discussed, and the criteria for types of surgical repair are considered. A modification of scleral buckling procedure which has been successful in anatomically reattaching most rhegmatogenous retinal detachments is described. The complications resulting from surgery are reviewed along with methods to avoid complications.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A carcinoid tumor was discovered by chance in a 25-year-old woman with the dominant type of retinitis pigmentosa. Although a coincidental association cannot be ruled out, there is at least a possibility that the two diseases have a common embryologic origin.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Twenty-three patients bleeding from varices had mesocaval H-grafts using Dacron prosthetic material. There were 21 men and two women with ages ranging from 37 to 60 years. There were 11 elective and 12 emergency procedures. Five patients (17%) were classified as Child's class A, seven (34%) as class B, and 11 (49%) as class C. An operative mortality of 17% was noted in the entire group, with one late death due to hepatic failure. All deaths occurred in emergency cases belonging to class C. Technical difficulties were encountered more often in the hands of less experienced surgeons. A high rate of shunt patency and minimal problems with postoperative encephalopathy were noted despite abnormal results of ammonia tolerance tests postoperatively. Lack of hepatopedal flow was noted postoperatively compared with preoperative angiograms. There were no serious adverse effects from diversion of blood from the liver in our surviving patients. The interposition mesocaval shunt is a technically safe and easy procedure in the hands of experienced surgeons. We continue to recommend the mesocaval shunt until other methods prove better than this operation.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Seventeen patients with Crohn's disease requiring emergency operative procedures disclosed important factors leading to successful outcome. In seven of the ten patients not known to have Crohn's disease, the history strongly suggested this diagnosis. Two patients died; three others had major complications, including two anastomotic leaks and two postoperative intraperitoneal abscesses. Wide drainage of abscesses, preservation of intestinal absorptive surface, avoidance of anastomoses in the presence of acute infection, and vigorous supportive nutrition are important features of the management of patients requiring emergency operation for complications of regional enteritis.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID