ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We conducted a statewide survey to identify physicians' experiences, attitudes, and practices related to HIV-infected patients. A random sample, stratified by medical specialty (primary care, surgery, emergency medicine), was drawn. Physicians were concerned about contagion and inadequate knowledge to care for HIV-infected patients; 40% reported refusing or referring new HIV-infected patients. Differences across medical specialty and respondents' interest in various medical education topics to remedy knowledge deficits are discussed.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Abnormalities of the skin are frequent and troubling problems for patients infected with the human immunodeficiency virus (HIV). A number of studies have assessed the frequency and severity of diseases of the skin and mucous membranes reported from other centers, but relationships between dermatologic signs and symptoms and either the lymphocyte count or the helper T-lymphocyte count have been infrequently noted. In a prospective study of 6 months' duration, one of us (A.F.) examined and questioned 61 HIV-seropositive patients at our infectious disease clinic. We found a significant association between the number and severity of cutaneous abnormalities and the helper T-cell (CD4) count. A trend toward significance was also shown between advanced HIV-disease status or decreased CD4 counts and pruritus. Our findings suggest that both the peripheral blood lymphocyte count and the helper T-cell count are predictive of the frequency, severity, and symptoms of skin diseases.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The results of recent studies have led to valuable new recommendations regarding optimal diagnosis and treatment of acute uncomplicated cystitis in women. To investigate to what degree these recommendations have been incorporated into clinical practice, we conducted a survey of all college health centers belonging to the American College Health Association regarding their current management of suspected uncomplicated cystitis. Sixty-one percent responded. The results confirm that acute cystitis is indeed frequent among college women. Nonetheless, our data show that there is a wide variation in the approach to this common problem and that many centers have not yet adopted the new recommendations for optimal diagnosis and treatment. If we are to improve the management of uncomplicated cystitis in women, we must not only learn the best medical approaches, but we must also find reliable ways of transmitting this information to clinicians.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We retrospectively reviewed 20 surgically confirmed tubo-ovarian abscesses in postmenopausal women for the period 1973 to 1989. Pain and bleeding were the two most common presenting symptoms. Nine of the 20 patients (45%) had recently had endometrial instrumentation. Fever and the presence of a pelvic mass and elevated white blood cell count, without evidence of peritonitis, were frequent findings on admission. At surgery, seven abscesses were already ruptured or leaking, 12 of 18 patients with both ovaries had unilateral abscesses, and dense adhesions were found in 11 patients. A common intraoperative complication was inadvertent bowel injury. Postoperative complications included fascial dehiscence, enterocutaneous fistula, deep venous thrombosis, and need for prolonged ventilatory support. Eight patients had a coexisting gynecologic malignancy. A high index of suspicion is required for early recognition of postmenopausal tubo-ovarian abscess. Prompt surgical exploration should be done to avoid occult rupture or sepsis.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Churg-Strauss vasculitis (CSV) is an interesting but uncommon pulmonary vasculitis. Cavitation in CSV is distinctly unusual and should prompt a work-up for other causes. We have described a case of CSV complicated by pulmonary cryptococcosis, which was treated with a novel antifungal regimen.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Human ehrlichiosis has a wide spectrum of presentation. This report presents two cases that demonstrate the diversity of the manifestation of ehrlichiosis, from life threatening to a mild viral-like illness. Diagnosis requires an understanding of the epidemiology and clinical manifestation of this infection and a high index of suspicion.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The role consultants play in detecting disease coincidental to the reason for consultation is unclear. We sought to elucidate this function in the setting of a specialty clinic for osteoporosis. Making no specific attempt to screen for general conditions, we evaluated 760 women; any new diagnosis was found in the course of thoroughly examining the patient for osteoporosis. A total of 274 new diagnoses were counted, encompassing 68 conditions. There were 211 women (28%) in whom a new diagnosis was detected; a higher percentage of older women than younger women had a new diagnosis. A diagnosis severity grouping scheme was devised, groups C and D being those in which further evaluation was clearly indicated. The diagnoses in groups C and D accounted for 70% of all new diagnoses made, suggesting that trivial conditions were not overrepresented. The history and physical examination alone was responsible for 50% of the various conditions diagnosed and 64% of the total number of new diagnoses. The consultant has an excellent opportunity to detect disease while performing a specialty consultation.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Stiff-man syndrome (SMS) is a rare disorder of the central nervous system characterized by painful involuntary stiffening of axial muscles accompanied by spasms. These are often precipitated by tactile or emotional stimuli, volitional movement, and startling noises. Until recently, little has been known about the pathogenesis of SMS. There is evidence now to support the hypothesis that SMS may be an autoimmune disease. This is leading to changes in the way this disease is diagnosed and treated. We describe two patients with SMS and review the pathogenesis, diagnosis, and treatment.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID