ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

This study scrutinizes supralevator fistula and evaluates a method of successful management. We reviewed 3,190 anorectal operations done between January 1970 and July 1976; 370 of these were for fistula, an incidence of 11.7%. Our data of 350 low or midlevel fistulas and 17 supralevator fistulas (seven deep ischiorectal sinuses and ten high intermuscular abscesses intraluminally drained) are correlated with those from another series. Three extrasphincteric fistulas were studied. The initial origin of these fistulas is cryptoglandular disease with the extrasphincteric supralevator fistula probably resulting from surgery. Surgical technics are described. Improper management of supralevator abscesses can result in an iatrogenically produced extrasphincteric fistula, a difficult and sometimes impossible fistula to cure.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Rebound hypertension occurred in two patients upon clonidine withdrawal. Treatment of the hypertensive crisis consists of both alpha- and beta-adrenergic receptor blockade, reserpine, or the reintroduction of clonidine. With effective control of pressure during the crisis, long-term antihypertensive therapy must be resumed.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Over a period of one year, 75 patients with jaundice were evaluated by grey scale ultrasonography. Intravenous cholangiography was attempted in 26 instances (bilirubin value greater than 4.3 mg/100 ml) and was diagnostic in only four. Ultrasound, on the other hand, was diagnostic for surgical jaundice in 62 of the 75 cases (82%). In 52 of the 62 patients a cause for the extrahepatic obstruction was demonstrated: 40 had cholelithiasis and choledocholithiasis, and 12 had tumors (11 pancreatic tumors, one lymphoma). In the remaining ten instances, obstruction was sonographically demonstrated but the cause was not. Of these, four patients were subsequently proven to have distal common duct stones, five had carcinoma of the pancreas and one had cholangiocarcinoma. This evidence indicates that ultrasound should be the noninvasive procedure of choice in the clinical assessment of obstructive jaundice.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Pneumococcal pyarthrosis was documented in seven and ten joints, respectively, in two patients with rheumatoid arthritis. The recognition of multiple pyarthrosis superimposed upon rheumatoid arthritis can be difficult. The present cases are compared with eight previously reported cases of pneumococcal arthritis in patients with rheumatoid arthritis.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Two cases of late cutaneous syphilis are presented. After treatment for secondary syphilis in 1957 and retreatment for rising VDRL titers ten years later, one patient had developed a nodular syphilid. The other patient had several gummas. He had two quantitative nonreactive VDRL tests and a negativeTreponema pallidumimmobilization (TPI) test, but two reactive fluorescent treponemal antibody absorption (FTA-ABS) tests. Syphilis was suspected histologically and was confirmed by the specific serologic testing, the characteristic clinical presentation, and the prompt response to penicillin treatment. The clinical, serologic, histologic, therapeutic, and pathogenetic aspects of late benign syphilis of the skin are discussed.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

All physicians should know the basics of care for the alleged rape victim. In a systematized approach, the procedure is presented for treating the patient and for collecting testimonial evidence in the event the assailant is apprehended and the crime becomes a legal case.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Although sulfonamide therapy has reduced the case fatality rate in infection due toNocardia asteroidesfrom nearly 100% to 25% to 45% there remains a need for a still more effective chemotherapeutic regimen. We describe three cases of serious infection due toN asteroidestreated successfully with trimethoprim-sulfamethoxazole (TMP-SMX) and review an additional 15 cases from the world literature. Trimethoprim and sulfamethoxazole exhibit a synergistic interaction in vitro againstN asteroides, and the agent reaches antibacterial concentrations in blood, lung, and the central nervous system. Clinical results have been satisfactory in the limited number of patients treated to date.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID