ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718425

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryClostridium difficileintestinal infection is a major nosocomial hazard in patients receiving antimicrobial therapy. Rationale for rapid diagnosis include lifesaving antimicrobial therapy in patients with severe colitis and early isolation measures for transmission control. We have therefore analysed the sensitivity, specificity and predictive value of GLC identification of isocaproic acid in diarrheic stools from adult hospitalized patients in comparison with selective fecal culture on Cycloserine Cefoxitin Fructose Agar. During the study period, the prevalence of positive culture forC. difficilewas 38/595 fecal specimens (6.4%). Compared with culture, GLC had a sensitivity of 24/38 (63%) and a specificity of 524/557 (94%). The predictive value of a positive GLC was 24/57 (42%) and of a negative GLC was 524/538 (97%). Measurement of the isocaproic acid peak height did not allow determination of a cutt-off value improving the lest accuracy. The sensitivity of detection of isocaproic acid in stools by GLC is too low to be used as screening test forC. difficileinfection. However, in a low prevalence population, a positive GLC test increased the pre-test probability of infection sevenfold.

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11735705

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Summary

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718427

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryIn the past decade, immediate hypersensitivity to latex has been accepted as a serious problem. The proteins that are present in natural rubber are considered to be the responsible antigens, and the hypersensitivity responses induced include contact and generalized urticaria, angiocdema, rhinitis, conjunctivitis, bronchospasm, life threatening anaphylaxis and death. So far, children with spina bifida or severe urogenital defects, health care workers, and rubber industry employees appear to be at greater risk than the general population. Since 1991 several reports and cross-reactivity studies have demonstrated an association between latex allergy and allergy to certain fruits, especially banana, avocado and kiwi. Because our knowledge of the major allergens is still incomplete, standardised in vitro and in vivo tests are not vei readily available. Therefore, the clinician should rely on a medical history, physical examination, and reliable serological tests to confirm diagnosis of latex anaphylaxis. Because of possible systemic reaction? to skin prick testing and provocation tests, these methods should be restricted to patients with a compelling history and an inconclusive serologic test result. Preventive measures are the key to succesful and safe management of patients with latex anaphylaxis.

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718428

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryThe pulmonary-renal syndrome is defined by the association of alveolar hemorrhage and rapidly progressive glomerulonephritis. Goodpasture syndrome and necrotizing vasculitides are the most frequent causes. New serologic markers are currently more rapidly available (anti-glomerular basement membrane-anti-GBM-and antineutrophil cytoplasmicantibodies-ANCA), allowing clinicians to identify and distinguish these 2 entities, and to hasten the initiation of a pulse therapy, now well standardized, which improves the outcome of patients. However, these 2 serologic markers have limitations so thai clinical assessment and renal biopsy remains essential in the diagnosis of pulmonary-renal syndrome. The authors propose an algorithmic approach for those confronted with such a condition.

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718429

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryThe mechanisms, clinical presentation and therapy of supraventricular tachycardias are discussed.The therapy has changed from palliation by means of anti-arrhythmic drugs into definitive cure by ablation of the arrhythmia substrate.Radiofrequency energy causes tissue damage by heating and appears to be a safe method for catheter ablation of supraventricular tachycardias.We report a 97% success rate for radiofrequency ablation of 195 accessory atrioventricular pathways thereby curing these patients from circusmovement tachycardia and paroxysmal atrial fibrillation. Complications occurred in 3% of patients.One hundred seventy-two patients with atrioventricular nodal reentrant tachycardia, caused by reentry within dual AV-nodal pathways, were treated by selectively ablating one of the pathways with non-inducibility of the arrhythmia afterwards in 97% of the cases. Nine percent of patients had a recurrence but were succesfully treated in a second session. The procedure was complicated by complete AV-block in 4% of paitients.The disappointing medical treatment of atrial fibrillation and the fact that atrial fibrillation can be the cause of a reversible form of heart failure (tachycardiomyopathy), induced the clinical application of alternative forms of treatment. Ablation of the normal atrioventricular conduction system by using radiofrequency energy was performed with a 100% success rate in 121 patients. After implantation of a ventricular pacemaker it is possible to control and regularize the ventricular rhythm leading to rate control and amelioration of ventricular performance.

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718430

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryDue to ihe growing incidence and the severity of infections due to vancomycin resistant enterococci, it is now recommended to treat mild to moderate cases ofClostridium difficile-associaieddiarrhoea with metronidazole while maintaining the use of oral vancomycin in serious or life-threatening colitis.Clostridium difficileis a common cause of diarThoea after antibiotic therapy and induces a spectrum of diseases ranging from mild diarrhoea to pseudomembranous colitis (PMC). It is considered to be the first cause of diarrhoea occurring among hospitalized patients (1).

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718431

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryThe authors report 3 cases of azygos continuation of the inferior vena cava. This congenital malformation is due to the atresia of inferior vena cava in the retrohepatic segment. The abnormalities encountered on the chest film are described. The interest of TDM, ultrasound and cavography is discussed.

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718432

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryT-cells are only rarely involved in chronic myeloid leukemia. We report an unusual case of T-lymphoid extramedullary (lymphadenopaihic) blast crisis in a 66-year-old patient with Philadelphia positive chronic myeloid leukemia. The lymph node morphological picture resembled that of a peripheral T-cell lymphoma. Immunohistochemical stainings showed most lymph node blasts to have T-phenotype (positivity for CD-2, CD-3 and CD-5). Row cytometric phenotyping confirmed T-phenotype, with positivity for CD-7, CD-38 and TdT. Cytogenetic analysis of lymph node cells revealed Philadelphia chromosome with an additional chromosomal abnormality (add(6p)). The BCR-gene rearrangement in the lymph node blasts was identical to that in the bone marrow. This case adds to the growing evidence that CML may be a disorder of the common stem cell from which T-, Band myeloid progenitors originate.

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718433

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

SummaryTeratomas of the mediastinum are rare, accounting for 8% to 13% of the tumours in this region. They primarily occur in the anterior mediastinum of young adults. Surgery should be performed whenever complications, such as atelectasis of lung tissue, adhesion to or compression of adjacent structures, or malignant transformation, are likely to be present. Results after surgical resection are excellent.

ISSN:1784-3286    

DOI:10.1080/17843286.1995.11718434

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor