ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: On Sept 2, 1985, Hurricane Elena struck the Gulf Coast of Mississippi. We conducted a retrospective review of Emergency Department logs for a one-week period before and a two-week period after the storm to determine what additional support would be needed to manage such a disaster. There was a significant increase in the number of patients treated for psychiatric problems and trauma. These findings are similar to the results obtained in a study at the same hospital after Hurricane Frederic in 1979.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: To ascertain our experience with traumatic perforations of the diaphragm, we reviewed the charts of 72 patients treated over a ten-year period. From January 1975 through June 1984, 58 male patients and 14 female patients, ranging in age from 6 to 72 years, were treated for traumatic perforations of the diaphragm. These injuries resulted from gunshot wounds in 44 patients (61%), stab wounds in 13 (18%), blunt trauma in 11 (15%), and shotgun wounds in four (6%). Seventy-three percent of the injuries were to the left hemidiaphragm, 26% to the right, and 1% to both. Signs and symptoms were unreliable for making the diagnosis of perforation. Diagnosis depended mainly on preoperative chest roentgenograms (especially for those caused by blunt trauma), thorough intraoperative exploration, and a high index of suspicion. Overall mortality was 7%, but death was usually more readily attributable to associated injuries than to the diphragmatic injuries.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: High-voltage electrical injuries, though uncommon, are not rare and make up approximately 3% of hospital admissions for burns. Our review of a seven-year experience including treatment of 60 patients indicates that the mortality for hospitalized patients is low, but the complication rate is significant. Sepsis or wound infection occurred in one third and neurologic impairment in one fourth of the patients. Despite this, most patients are able to return to gainful employment.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: A review of 228 cholecystectomies done over a two-year period revealed 15 cases (6.6%) in which gallstones were absent. These 15 patients were all characterized by colicky abdominal pain in the right upper quadrant, with a mean duration of eight months. Ultrasonographic examination was falsely positive for gallstones in one third (5/15) of the patients, and further diagnostic evaluation in the remaining two thirds (10/15) failed to define a clear-cut surgical problem. All 15 patients ultimately had operation on the basis of symptoms. Every patient reported resolution of preoperative symptoms at short-term follow-up (four to eight weeks). Seven patients available for long-term follow-up (ten to 27 months) reported complete symptomatic resolution. The postoperative outcome failed to correlate reliably with gallbladder histology, bile cultures, and results of diagnostic testing. There was no mortality, and morbidity was limited to three patients. This series confirms previous reports of a small set of relatively young, healthy patients having chronic disabling symptoms of gallbladder disease in the absence of gallstones. Our results suggest that the most reliable factor predicting a successful outcome of cholecystectomy in these patients was the presence of severe biliary colic.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTTo assess antibiotic usage and the value of routine intraoperative bile cultures, we retrospectively reviewed 79 patients who had elective cholecystectomy from January to December 1986. Forty patients (57%) received perioperative antibiotics, and 15 (19%) had positive intraoperative bile cultures. During follow-up, the only septic complications identified were wound infections in two patients (3%); one of them had received antibiotics and one had not. Each bile culture cost $60 to $80, and the cultures were not clinically useful. In the absence of risk factors associated with positive bile cultures, the incidence of wound infections or septic complications after cholecystectomy is low. We conclude that routine intraoperative bile cultures and prophylactic antibiotics are not indicated for elective cholecystectomy in low-risk patients.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: We did a prospective study of two groups of patients having elective cholecystectomy through a right subcostal incision to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS). Of 64 patients, 30 received TENS postoperatively and 34 did not. Narcotic use in total dose or on a weight basis was not statistically different between the two groups, nor was there any difference in the occurrence of pulmonary or gastrointestinal complications. The use of TENS after this particular operation did not appear to lessen narcotic use or pain-related complications.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: We report a retrospective evaluation of the role of panretinal photocoagulation in the primary treatment of neovascular glaucoma. Thirty-six eyes (32 patients) received aggressive argon laser panretinal photocoagulation beginning as soon as feasible after diagnosis of the developing neovascular glaucoma. Thirty eyes were stabilized by photocoagulation, though 25 required long-term glaucoma medications. Six eyes required additional procedures. Vision deteriorated in 21 of the 36 eyes (nine eyes finally having “no light perception”) during the 32.8-month follow-up. Intraocular pressure averaged 39.0 mm Hg before photocoagulation and 21.2 mm Hg at study's end. All 36 eyes were retained and remain comfortable. We conclude that panretinal photocoagulation plays an important role in the management of neovascular glaucoma.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: We examined treatment and outcome variables in patients who had laryngeal cancer without clinical evidence of spread to the neck. In our patient population, there was a 24% overall recurrence rate for N0laryngcal cancer. Initial manifestations, including stage and location of tumor, did not influence recurrence (P> .1). Initial treatment of the primary T3or T4tumor with radiotherapy alone was positively correlated with recurrence (P< .0 for T3P< .0 for T4), but initial treatment of the neck did not appear to affect chance of regional or distant recurrence (P> .1). Approximately half of the patients who had recurrent disease were salvaged. Neither chance of salvage nor final disease-free status was significantly associated with any of the variables (P> .1).

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACT: Over a 2.8-year period, I did 112 vaginal hysterectomies using five different techniques of cuff closure to examine the preservation of vaginal length associated with each closure. I conclude that all five methods are acceptable as long as there is proper vault support. Morbidity was minimal, vaginal depth was retained, and there were no deaths.

ISSN:0038-4348    

出版商:OVID    

年代:1988

数据来源: OVID