ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

One hundred sixty-two adolescents being seen for sick or well visits at two suburban private pediatric practices completed an anonymous, written questionnaire about drug habits. The respondents' ages ranged from 14 to 17 years; all were white and from middle-class or upper-middle-class families. The adolescents reported high self-esteem, good general health, and few psychologic problems. The majority of respondents stated that they and their good friends never used drugs. Seven adolescents (4%), however, reported having used marijuana during the previous week, and 13 (8%) during the previous month. When asked about the frequency of marijuana use by their good friends, 13 respondents (8%) said their friends had smoked marijuana 51 to 100 times, and another ten (6%) replied 21 to 50 times. The most frequently cited source of drugs was another student at school, whereas places drugs were commonly used included parties, rock concerts, and friends' houses. Even among a population of middle-class adolescents having follow-up in a suburban pediatric practice, use of marijuana and other drugs may constitute a serious health and psychologic problem. Physicians caring for adolescents must be aware of patterns of drug availability and use in their community, and should be prepared to recognize and remediate drug-related problems occurring in their patients.

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

We present the morphologic and clinical features of large bowel carcinoma in 22 patients seen over 18 years at St. Jude Children's Research Hospital. We saw 18 cases of mucinous adenocarcinoma, three of well differentiated adenocarcinoma, and one case of poorly differentiated adenocarcinoma. The patients ranged in age from 9 to 19 years with a median age of 15. There were 12 female and ten male patients; 12 were black and ten were white. Eighteen patients had Dukes' stage C disease, with median survival of seven months and one patient alive 12 months after diagnosis. Three patients had Dukes' stage B disease, with two patients surviving 16 months each and one presently alive seven months after diagnosis. Only one patient had Dukes' stage A disease and is alive 121 months after diagnosis. Large bowel carcinoma in children is predominantly mucinous adenocarcinoma and occurs in the adolescent age group. Tumor distribution is fairly even throughout the large bowel, and all subtypes of the tumor are positive for carcinoembryonic antigen (CEA) on immunohistologic study. Active tumor and tumor regrowth are always accompanied by high serum levels of CEA. The tumor has no predilection for sex, but is significantly more frequent in blacks (P<.05). Discovery of the tumor in an early stage improves the prognosis.

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

To assess the relief of pain provided by a side-to-side lateral pancreaticojejunostomy (LPJ), we analyzed 19 patients with chronic pancreatitis operated on from 1973 to 1983. Fourteen patients were chronic alcoholics; abdominal pain was the indication for the operation in most patients; one patient died postoperatively. The pain was relieved in all 18 survivors, from 12 to 72 months in 15; in three the pain has recurred, suggesting that LPJ is effective in ablating the pain in patients with chronic pancreatitis, provided the pancreatic duct measures more than 6 mm in diameter, the length of the LPJ is at least 6 cm, and patients abstain from alcohol ingestion. CT adequately assesses pancreatic duct dilatation. One fourth of the patients also required choledochoduodenostomy to relieve biliary obstruction caused by the chronic pancreatitis.

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Twenty-four patients underwent endoscopic procedures under general anesthesia and mechanical ventilation by high-frequency jet ventilation, provided by a catheter inserted through the cricothyroid membrane and connected to an IDC-VS600 ventilator. The arterial blood gas values, arterial blood pressures, and heart rates observed were within acceptable clinical levels. In some patients, blockage of the airway by the surgeon required shutting off the ventilator to prevent a pneumothorax. With the rapid rate jet ventilation, we found that laryngeal bleeding after biopsy passed outward from the larynx into the hypopharynx. It was necessary for the surgeon to wear protective eye and face shielding when performing endoscopies to avoid getting blood and secretions on his face. The unobstructed surgical field is an advantage of the jet ventilation, which can be continued in the postoperative period until the patient is fully recovered.

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

An association of neurofibromatosis with diffuse interstitial lung disease is thought to exist, though there have been relatively few large studies of it. The pulmonary manifestations consist of diffuse interstitial fibrosis or formation of bullae, or a combination of both. Our experience with this disease process during a ten-year period shows slightly less than a 7% incidence of diffuse interstitial lung disease in our patients with neurofibromatosis. We include a case of neurofibromatosis and diffuse lung disease that is somewhat unusual in the formation of bullae in the lower lobe, in contradistinction to its marked upper lobe predominance.

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A controlled trial of treatment of chronic osteomyelitis caused by Staphylococcus aureus compared nafcillin alone with nafcillin plus rifampin for a six-week period. Treatment was well tolerated, the only adverse effect being mild neutropenia in four of 18 patients; no toxicity was observed from rifampin. Eight of ten patients in the combined treatment group had a favorable clinical response (with follow-up of two to four years) as compared to four of eight in the nafcillin group (P=.2). Despite the failure to show a statistically significant advantage of rifampin plus nafcillin, we conclude that the combination, along with appropriate surgery, should be considered for patients with chronic staphylococcal osteomyelitis.

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

β-Hemolytic streptococci (BHS) of Lancefield group F were isolated in moderate to heavy growth from throat cultures taken from 46 children and adolescents with symptomatic pharyngitis. In most instances, oxygen deprivation by means of an anaerobe jar was required for these β-hemolytic organisms to grow. In relation to a comparison group of children with throat cultures positive for group A BHS, children with group F isolates were more likely to be adolescents and less likely to have fever and cervical adenopathy. It appears that group F BHS are not a major cause of nonepidemic pharyngitis in the pediatric age group. More precise determination of how commonly these organisms cause pharyngitis will require either comparison of isolation rates of group F BHS from the throats of both sick and well children, or further elucidation of the serologic response to these organisms so as to distinguish invasive infection from asymptomatic carriage.

ISSN:0038-4348    

出版商:OVID    

年代:1986

数据来源: OVID