ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

We present five case reports to illustrate the late effects of acute paralytic poliomyelitis occurring many years after recovery. We emphasize the importance of ruling out common medical causes for the symptoms and address the question of a “postpolio syndrome.” The cause of progressive muscle weakness 30 to 40 years after recovery from poliomyelitis remains unknown.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

We present the results of a survey on the late effects of poliomyelitis in 201 persons. The most common new problems were fatigue, weakness in previously affected and unaffected muscles, muscle pain, and joint pain. The median time from poliomyelitis to onset of new problems ranged from 30 to 40 years. Factors at onset of polio most strongly associated with development of these late effects of polio were (1) hospitalization (P< 0.00001), (2) age > 10 years (P< 0.00001), (3) ventilator use (P< 0.0029), and (4) paralytic involvement of all four limbs (P< 0.0240). The differential diagnosis of these new problems, implications for treatment, and areas for future research are discussed.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Rocky Mountain spotted fever, a serious systemic infectious illness, is common in the southeastern United States. Approximately one fourth of the cases in the United States occur in North Carolina. Widespread organ involvement occurs, with central nervous system involvement being common and occasionally severe. Since the onset of treatment with drugs such as tetracycline or chloramphenicol, the mortality has been 4%. Residual deficits are rare, but the disease retains potentially serious neurologic manifestations that must be considered and aggressively treated. A high index of suspicion should be maintained during the tick season in endemic areas. The simultaneous occurrence of illnesses such as influenza, mycoplasmal infection, and aseptic meningitis makes diagnosis a challenge.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

We evaluated the outcome of 100 consecutive patients with chronic benign low back pain admitted for comprehensive interdisciplinary rehabilitation at the Pain Therapy Center. The average patient had been disabled for nearly two years and had had two unsuccessful operations for pain relief. Seventy-two percent of the patients treated had open claims against their workmen's compensation carriers. Significant improvements were demonstrated in physical strength, stamina, endurance and overall level of physical activity, drug reduction, subjective pain intensity, and return to employment.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A prospective study disclosed eight patients (three children and five adults) with anterior herniation of the nucleus pulposus (AHNP); in five of the eight, AHNP was an incidental finding. Radiologic findings included erosion and/or fracture of the anterior aspect of the vertebra, usually with interspace narrowing. The complete blood count and erythrocyte sedimentation rate were normal in children with AHNP. A five-year clinical follow-up of six of the eight patients showed minimal morbidity in five; one patient had surgery with good results. AHNP is usually confused with fracture (old or acute) or infection; the correct radiologic diagnosis obviates the need for invasive diagnostic tests. Computerized tomography and nuclear magnetic resonance may prove to be useful in the diagnosis of AHNP.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

To assess the reliability and accuracy of the Papanicolaou smear for the detection of cervicalChlamydia trachomatisinfections, we obtained chlamydial cultures and cervical smears from 252 patients attending a gynecologic service during an eight-month time period. In 12 of these patients (4.8%), the cervical culture was positive for chlamydiae but the cytologic smear was negative for chlamydial inclusions. Five smears (2.2%) were cytologically positive for chlamydiae but were negative by culture. In none of the patients were both culture and smear positive for chlamydiae. In our experience the smear was a completely unreliable test for the diagnosis of cervicalC trachomatisinfections. The cytologic smear should not replace culture for the detection of chlamydial infections.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

When surgery is demanded by the course of a patient with ulcerative colitis, the sphincter mechanism can be spared. The straight ileoanal anastomosis without a reservoir has not been satisfactory for adults because of frequent diarrheal stools. The ileorectal anastomosis has the advantage of minimal morbidity, but the patient is not totally cured, because the diseased rectum is still in place. The pouch pull-through procedure has an increased morbidity, but the patient is cured of ulcerative colitis. The anastomotic stricture rate is 7% to 15% and the failure rate, 2% to 6%. Inflammation of the pouch or reservoir occurs in 5% to 19%. There have been no deaths in the reviewed series. As the details of the pouch pull-through procedure are refined, this operation will become the choice for treatment of ulcerative colitis.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Between 1970 and 1983, 46 patients were hospitalized in the Vanderbilt University Medical Center and the Metropolitan Nashville General Hospital for treatment of achalasia. All patients had been symptomatic for at least two years. Efforts were made initially to manage most of these patients (40) with periodic esophageal dilatation. This was successful in only six cases (15%). In four instances' (10%), patients had esophageal perforation. Thirty patients have had esophagomyotomy (Heller procedure), and 14 of these had an associated antireflux procedure. Three had proximal gastric vagotomy for associated duodenal ulcer disease. Twenty-seven (90%) have had a good result, three died postoperatively, and two elderly patients had postoperative myocardial infarction. The other patient had sepsis after repair of a perforated esophagus. While periodic esophageal dilatation is necessary in patients who may not tolerate an operative procedure, most patients with achalasia are best treated with Heller esophagomyotomy.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The jejunoileal bypass (JIB) has met with increasing disfavor as a result of its unacceptably high complication rate. JIB reversal was done in 54 patients at the University of Florida, with a gastric partition done concomitantly to avoid regaining weight. Weight control was generally adequate up to six months after conversion to gastric partition. However, mean weight gain progressed steadily afterward to a mean increase of 40% at three years. Six months after conversion to gastric partition, 55% of the patients (15/27) had gained weight, contrasted with 3% of 100 patients who had a gastric partition as a primary procedure. The percentage of patients gaining weight progressed until at three-year follow-up 30 of the 38 patients (79%) in this subpopulation showed a failure to control weight. It is apparent from these data that jejunoileal bypass has created a nutritional life-style that predisposes patients to hyperphagia. Conversion to a gastric partition has a much higher incidence of failure than gastric partition done de novo.

ISSN:0038-4348    

出版商:OVID    

年代:1985

数据来源: OVID