ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We reviewed the clinical data and pathologic material on 46 patients with lesions originally interpreted as appendiceal mucocele or mucinous adenocarcinoma from two medical centers. The mucoceles, characterized by accumulation of mucus in a dilated lumen, could be divided into three distinct entities: nonneoplastic retention mucoceles (eight cases), cystadenomas (26 cases), and cystadenocarcinomas (eight cases). There were four mucinous adenocarcinomas. Retention mucoceles are associated with little morbidity and are cured by appendectomy. Cystadenomas and cystadenocarcinomas mimic the behavior of ovarian neoplasms of borderline malignant potential. Some of these lesions were associated with pseudomyxoma peritonei, but did not have systemic metastases. Mucinous adenocarcinomas without mucocele mimic the behavior of ordinary large bowel carcinoma.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We reviewed the clinical data and pathologic material from 30 patients with appendiceal carcinoids. Most of the tumors were discovered incidentally in appendectomy specimens. Approximately two thirds were tiny lesions identified only by microscopic examination. One tumor metastasized to a regional lymph node. Five histologic patterns were identified. Problems in differential diagnosis may arise in interpreting the variant patterns, but these patterns appear to have no bearing on prognosis. In reviewing the literature we found that appendiceal carcinoids infrequently metastasize widely and only rarely produce the carcinoid syndrome.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Renal cell carcinoma is not an uncommon finding in our population. Since the symptoms of renal cell carcinoma may mimic those of other abdominal disease, we strongly advocate ultrasonic evaluation of the entire abdomen when screening patients with pain. Whether our three patients' symptoms were due to gallbladder disease or the incidentally detected renal cell carcinoma is relatively inconsequential, as long as detection of the potentially life-threatening lesion is achieved.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Ultrasonic examination is useful to detect and localize empyema within the thoracic cavity in order to perform fine-needle aspiration. In six cases in which we used these procedures no complications were detected. Three of them are presented to illustrate the usefulness of ultrasonographically guided fine-needle aspiration of thoracic empyema in the clinical management of such patients. Ultrasonography provides a safe and rapid method for early detection and diagnosis of thoracic empyema so that appropriate therapy may be initiated.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A new form of substance abuse in adolescents is the inhalation of fumes from typewriter correction fluids (Liquid Paper, Wite-Out, Snopake, etc), which are composed of various chlorinated solvents, to induce euphoria. Medical complications of such abuse and medical management of acute toxic episodes are discussed herein, along with suggestions for controlling this substance abuse.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Propoxyphene dependence presents a difficult treatment problem: the patients' subjective discomfort and concomitant craving during gradual withdrawal of the drug is more intense and more poorly tolerated than that observed with other narcotic analgesic agents. Of the six patients we describe, only one has achieved successful detoxification.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We studied antibiotic intake in 97 abusers of alcohol, sedatives, or parenteral heroin or cocaine. Thirteen patients, all abusers of parenteral heroin or cocaine, had taken antibiotics without prescription, obtained from friends, from old prescriptions, or by purchase on the street. Past or present street purchase of antibiotics was noted in 27 patients and was more common (P<.02) in parenteral substance abusers. Four parenteral substance abusers had infection or colonization with methicillin-resistantStaphylococcus aureus, and three of them had purchased antibiotics on the street before the present or a recent past hospitalization. Physicians treating abusers of parenteral heroin or cocaine should be aware that such patients may be taking antibiotics without medical supervision. This practice may be an important factor in the development and spread of methicillin-resistantS aureus.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We describe two patients whose initial clinical presentation was that of nephrolithiasis. Eventually, an incontrovertible diagnosis of factitious illness was established. We describe this syndrome, review the underlying psychodynamics, and suggest an approach to treatment, with a plea to physicians to recognize the compulsive behavior as a sign of a disordered psyche and the need for some form of psychotherapy.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The speed and accuracy of diagnosis of tuberculosis on general medical teaching services were retrospectively compared to that on a designated publicly funded tuberculosis service and to recent discouraging reports in the literature. The diagnosis was confirmed in all patients on the designated service and in 78.8% of patients not on the designated service within one week. No patient was discharged undiagnosed. Acid-fast smears done by the hospital laboratory showed a sensitivity of 82.5% and a specificity of 98.4%. Radiologic reports indicated the presence of tuberculosis or cavities in 85% of chest x-ray films in patients with pulmonary disease. These results may indicate that a publicly funded tuberculosis service, by providing emphasis on tuberculosis, allows more rapid and accurate diagnosis of tuberculosis in all patients. The impact of such training on future health care delivery should be recognized when decisions regarding allocation of public funds are made.

ISSN:0038-4348    

出版商:OVID    

年代:1984

数据来源: OVID