ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A man with stenosis of the aortic valve acquired endocarditis after abdominal surgery.Klebsiella pneumoniaeandAcinetobacter calcoaceticuswere cultured from his blood. The blood cultures remained positive despite intravenous gentamicin and cephalothin to which the organisms were sensitive in vitro. Ultimately, the blood was sterilized by a combination of gentamicin and trimethoprim-sulfamethoxazole taken orally. The course of the patient was complicated by cardiac arrest and pericardial tamponade caused by a valve ring abscess and a dissecting mycotic aneurysm of the coronary sinus of Valsalva. Aortic valve replacement and right coronary artery bypass were performed. A prolonged course of trimethoprim-sulfamethoxazole was given postoperatively, and the patient has had no evidence of recurrent infection after five years. Trimethoprim-sulfamethoxazole, in combination with other antibiotics, has been successfully used to treat other patients with bacterial endocarditis and thus may be an alternative for patients in whom conventional therapy has failed.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Between July 1970 and December 1979, 92 patients with atypical mycobacterial infections of the lung were hospitalized 110 times at Blue Ridge Hospital (Charlottesville, Va). These patients comprised less than 3% of all patients hospitalized for active mycobacterial disease. Sixteen hadMycobacterium kansasiior group I disease, three had group II disease (twoM scrofulaceum, oneM szulgai), 70 had group III disease (68M avium-intracellulare, twoM xenopi), and three hadM fortuitumor group IV disease.M kansasiiinfections comprised 23% of the total during the first five years, but only 6% during the second half of the decade. Clinical and roentgenographic findings were similar to those in patients with tuberculosis. As anticipated, most of theM kansasiiorganisms were sensitive to antimycobacterial drugs, and these patients generally responded well to chemotherapy. In contrast, most of the group III organisms, including one of theM xenopi, exhibited resistance to several drugs. Despite the high incidence of resistance, 59% of the patients with group III infections who were treated for at least three months in the hospital had sputum cultures converted to negative.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Forty-four patients with undifferentiated small cell carcinoma of the lung (SCCL) were diagnosed and treated at community hospitals. Patients with limited disease were treated with surgical resection or primary radiation therapy (RT) followed by chemotherapy; those with extensive disease received chemotherapy followed by RT if there was not a complete primary response. The chemotherapy used was a combination of methotrexate, doxorubicin, cyclophosphamide, and lomustine. Median survival for patients with both limited and extensive disease was 12 months, with a six-month survival of 89%. Half of the patients had recurrence in the lung. The toxicity was moderate and tolerable. We conclude that this combination chemotherapy plus radiation therapy carries acceptable toxicity and can be used in a community hospital to achieve response rates and survival of SCCL equivalent to that obtained in large cancer centers.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Carcinoma of the lung, fairly common in middle aged men, may be silent and have its first manifestation as a metastatic lesion. In 25% to 35% of such cases the metastases are to the nervous system. Management is dependent upon many factors but satisfactory results can be obtained with proper screening. Three cases of nervous system metastases are presented—one occurred in an unusual site; one had an unusual clinical syndrome and one had prolonged latency.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The hospital and departmental records of the University of Virginia Medical Center from 1976 to 1980 show an increasing frequency of ventilation studies relative to perfusion studies and a decrease in frequency of ventilation-perfusion diagnosis of pulmonary embolus. Pulmonary angiograms have increased from one per 68 nuclear studies to one per 14. A review of 70 patients with correlating angiography or autopsy shows that 89% of nuclear studies were accurate. We have revised our interpretation criteria and indications for pulmonary angiography.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Between 1975 and 1978, over 200 knee arthroscopies were performed at the Emory University Hospitals; the findings were totally correct in 91%. During the same period, arthrograms were performed on 79 different patients, 39 of whom had confirming arthrotomies. The arthrograms were totally correct in 38%. Fifteen totally incorrect arthrograms were reviewed without knowledge of the operative findings; 12 were considered by the radiologist to be technically acceptable for review. Of these, five correlated partially, but none completely, with findings at arthrotomy. We discuss the difficulty in arthrographic reading of lateral meniscus tears, anterior cruciate tears, and osteochondral loose bodies. We conclude that, although arthroscopy and arthrography can be complementary, arthrography must be used only with the best equipment and technic by a motivated, experienced, and enthusiastic radiologist.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Over a 56-month period (January 1976 to August 1980), we treated 605 patients for wounds, burns, and ulcers with granulated sugar and povidone-iodine. Rapid healing ensued, due to a reduction in bacterial contamination, rapid debridement of eschar, probable nourishment of surface cells, filling of defects with granulation tissue, and covering of granulation tissue with epithelium. The requirements for skin grafting and antibiotics were greatly reduced, as were hospital costs for wound, burn, and ulcer care.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Of 475 consecutive meniscectomies evaluated, only nine were in patients 14 years old or younger. These nine cases were studied as to the mechanism of injury to the knee, type of lesion of the meniscus, concomitant lesions of the knee, rehabilitation, and final result. Traumatic lesions of the meniscus in children are rare, the mechanism of injury is varied, longitudinal tears are most common, anterior cruciate lesions were sometimes present, and early rehabilitation is less difficult than in adults, but the final result is compromised.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID