ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In determining infection control policy, it is essential to quantitatively assess the risk of transmission of human immunodeficiency virus (HIV) to health care workers and their families. The risk should be placed in perspective by comparing it with other occupational hazards. The risk of seroconversion from a needlestick injury can be calculated from the probability of a needlestick occurrence, the probability that the source patient is infected, and the probability of seroconversion, given an exposure. The risk of seroconversion due to drawing 1000 blood specimens from seropositive patients is between 86 and 470 in 100 000. The risk to surgeons from performing 25 operations on infected patients is approximately 272 in 100 000. The risk of fatal injury in the course of one year's work on a Louisiana oil rig is between 188 and 283 per 100 000

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Patients who are to have elective operations project varying degrees of anxiety, and many spontaneously express fear (without basis) that their operation involves a diagnosis of malignancy. To measure total, covert, and overt anxiety objectively, we gave the Institute for Personality and Ability Testing anxiety test to 125 consecutive patients admitted for elective general surgical procedures. A simple survey of cancer fear was also completed. Chi-square and Fisher's exact test were used to compare categoric data, and linear regression and analysis of variance were used where appropriate. Total anxiety scores were in the upper quartile compared to the general population. Scores indicating fear of cancer were elevated in 75% of patients who had no history of or reason to suspect malignancy. Covert anxiety scores correlated with cancer fear scores, and both significantly decreased as age increased (P < .05). Also, as age increased, the cancer fear scores decreased (P < .002). Obese patients had higher scores of cancer fear than all other patients (P < .0001)

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We investigated psyllium fiber supplementation as a means of enhancing the cholesterol-lowering effect of the phase I American Heart Association diet. Fifty-nine subjects with total serum cholesterol (TC) levels ranging from 5.56 to 10.24 mmol/L (215 to 396 mg/dL) were given a 2-month dietary lead-in followed by 3 months of diet only (29 subjects) or diet supplemented with 20.4 g of psyllium daily (30 subjects). Unlike women, men had a significant decrease in levels of both TC ( -8.0%) and low-density lipoprotein cholesterol (LDL-C) ( - 10.1%) during the dietary lead-in. Psyllium supplementation resulted in an additional 5.5% reduction in the TC level as compared to diet alone. Psyllium supplementation combined with dietary lead-in resulted in an overall 17.3% decrease in the TC and a 20.0% decrease in LDL-C for men, with decreases of 7.7% and 11.6%, respectively, for women. Psyllium effectively enhances the cholesterol-lowering effect of the phase I diet

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Hyperhidrosis is an idiopathic pathologic condition characterized by excessive sweating beyond that required to cool the body. Disturbance of the central nervous system, endocrine system, or obesity has been associated with this condition. Patients have a history of several years of occupational or social embarrassment. Individuals of Japanese ancestry and Jews of Northern African, Yemeni, or Balkan descent are predisposed to the condition. Nonoperative therapy is merely temporizing and unacceptable because of lack of efficacy or side effects. Surgical intervention provides effective and permanent control. The key to surgical correction appears to be the division of the sympathetic chain above the T-2 ganglion and below the T-3 ganglion of the involved side with removal of the entire T2-3 segment with its corresponding spinal nerves. This paper presents our experience with the dorsal thoracic approach for interruption of sympathetic innervation for severe palmar hyperhidrosis. We also review surgical efficacy of various approaches to the sympathetic chain, as well as possible side effects of operative intervention

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Angiotensin-I converting enzyme (ACE) inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs) can be nephrotoxic and may synergistically compromise renal function. A computer-assisted study was done to assess the prevalence of compromised renal function and the clinical importance of this drug interaction. A search of the records of all patients seen in the University of Nebraska Medical Center Internal Medicine Clinic was conducted to identify cases involving renal insufficiency, therapy with ACE inhibitors, or therapy with NSAIDs. Records of cases meeting these criteria were reviewed for clinical correlation and revealed 2278 patients treated with NSAIDs, 328 with ACE inhibitors, and 162 with both. No nephrotoxicity was found in conjunction with monotherapy, but three cases of reversible renal failure were found in conjunction with combination therapy. Significant nephrotoxicity during the concomitant use of ACE inhibitors and NSAIDs is not uncommon, and attention should be drawn to this potentially important interaction

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We conducted a prospective, double-blind, randomized trial of gentamicin and tobramycin to evaluate differences in nephrotoxicity. We evaluated levels of creatinine, creatinine clearance, β2-microglobulin, andN-acetyl-beta-D-glucosaminidase (NAG) as indicators of nephrotoxicity, and attempted to correlate them. Forty patients met the criteria for evaluation; 14 were given tobramycin and the remaining 26 received gentamicin. Significant nephrotoxicity, as defined by an increase in creatinine of 0.5 mg/dL, did not occur in either group. Increases in β2-microglobulin values were seen in 67% of the patients in the tobramycin group, and 52% of those in the gentamicin group. Elevations in NAG levels occurred in 54% of those in the tobramycin group and 52% of those in the gentamicin group. Elevation of NAG and β2-microglobulin levels was congruent in only 40% of the cases. We conclude that there was no significant difference in nephrotoxicity between gentamicin and tobramycin. Elevations of NAG and β2-microglobulin occurred at rates similar to those reported in the literature, but they did not correlate with significant nephrotoxicity

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We measured epinephrine and norepinephrine levels simultaneously using two methods of detection of catecholamines in plasma—radioenzymatic assay and high-performance liquid chromatography with electrochemical detection. Measurements were made in 15 stable patients during hemodialysis. No statistical differences in intradialysis plasma concentrations were found for epinephrine or norepinephrine, and no statistical differences were found between the values of epinephrine and norepinephrine using the two different methods. No significant decrement in epinephrine or norepinephrine concentrations during the dialysis procedure was detected regardless of the method used. We conclude that the hemodialysis procedure does not affect the concentration of plasma catecholamines and that the two methods of detecting plasma catecholamines in patients with renal failure are equally accurate

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

From 1976 to 1989, 21 adult patients with previously untreated acute promyelocytic leukemia were seen at the University of Virginia Hospital. We reviewed their cases retrospectively to determine the impact of hemorrhagic complications and other factors on treatment outcome. We observed a complete remission rate of 35%; the median survival in complete responders was 15 months. Evidence of disseminated intravascular coagulation was found in 13 (62%) of the 21 cases at diagnosis. Fatal intracranial hemorrhage was the leading cause of death, occurring in eight (40%) of the 20 patients evaluated. Initial leukocyte count > 4.0 x 109/L and platelet count < 20 x 109/L were significantly associated with an increased risk of intracranial hemorrhage. In patients with disseminated intravascular coagulation, the rate of intracranial hemorrhage was reduced by treatment with heparin. The high mortality of 40% (8/20) due to intracranial hemorrhage during induction was a major contributor to the low complete remission rate of 35% (7/20) in this series of consecutive unselected patients with newly diagnosed acute promyelocytic leukemia

ISSN:0038-4348    

出版商:OVID    

年代:1990

数据来源: OVID