摘要:

This study examines the statistical relationship between potential influencing factors and the rank that prospective intern applicants assigned to Boston City Hospital in the National Internship and Residency Matching Program. Types of factors examined include personal considerations, the applicant's experience during the personal interview, hospital attributes, the academic program itself, and perceived house officer experience. A brief questionnaire was mailed to prospective interns ranked by the Department of Medicine. Analysis of questionnaire data indicates that personal reasons and two hospital characteristics, ancillary staff and type of hospital, were predominant influencing factors.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Seven euthyroid and four hypothyroid patients with central nervous system (CNS) disease had blunted thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) compared with corresponding control subjects who had no neural pathology. There was no significant difference in circulating thyronines (T3and T4) among the groups. As the CNS pathology was the only detectable difference between the patients and their neurologically intact controls, we concluded that this blunted TSH response to TRH is a result of neural dysfunction.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Based on a renin-sodium nomogram, patients with essential hypertension can be divided into low, normal and high renin subgroups. To define more clearly the clinical and biochemical characteristics of the two extreme groups, data from 83 patients with low renin essential hypertension were compared with those from 42 patients with high renin essential hypertension. In a further analysis, data of 27 age-and sex-matched patients from these two groups were compared with data from 27 matched subjects from a normotensive control group.Compared with high renin patients, low renin patients more frequently are female, older, and have higher systolic blood pressures and pulse pressures. The latter two characteristics are age-related. The similarity of duration of hypertension in both groups and the lack of correlation between age and plasma renin activity suggest that low renin hypertension is a separate entity rather than just a later phase of the same disease. Patients with low renin hypertension had better renal function than high renin patients or normotensive control subjects. High renin patients showed signs of hemoconcentration: hemoglobin, hematocrit, and total protein were higher than in low renin patients and normotensive controls.A significant difference between the slopes of the regression lines relating renin activity and sodium excretion for the two renin subgroups indicates that renin release in low renin patients is less sensitive to alterations in sodium balance. Both groups of patients had similarly elevated aldosterone levels, suggesting an increased sensitivity of aldosterone secretion to angiotensin II in low renin hypertensives. The relationship between aldosterone and potassium excretion was similar in both groups, indicating a comparable mineralocorticoid sensitivity.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

There are few quantitative guidelines for the interpretation of serologic tests for histoplasmois. Furthermore, guidelines that have been proposed are not accepted generally. This report reviews experiences with complement fixation and latex agglutination tests performed in a large acute-care hospital in an endemic area, and depicts the relationship between the proportion of false-positive reactions and the titer at which the serologic tests were reactive. We noted a considerable number of false-positive reactions for these widely-used tests. Use of a battery of standard tests for histoplasmosis resulted in a 90% decrease in false-positive reactions. Reliance upon multiple positive results in such a battery of tests would result in failure to detect 50% of cases of disseminated histoplasmosis, but would eliminate most false positives.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A 35-year-old woman was seen because of a two-year history of exertional dyspnea. She had a high-pitched systolic and diastolic murmur and evidence of left ventricular hypertrophy. Increased hemoglobin oxygen saturation was noted at the level of the pulmonary trunk, and indocyanine green dye curves were characteristic of a left-to-right shunt. Aortic root angiography revealed that the right coronary artery arose from the pulmonary trunk and that blood flow was reversed. The incidence, clinical manifestations, and therapy of this rare syndrome are reviewed.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A clinically euthyroid woman had substernal goiter and thrombocyto-penia. There was a striking elevation in serum thyroxine (T4) level when the level of triiodothyronine (T3) was low, reverse T3(rT3) was normal, I131uptake was suppressed, and thyroid stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) was blunted. The elevation of T4was transient and required no treatment. Postmortem examination revealed a thyroid gland that showed only multinodular goiter. Multiple factors contributed to the dissociation between T4and T3levels. There was a lack of clinical symptoms in the face of high T4and normal T3. The report stresses the need for thorough evaluation of thyroid function in such cases before instituting treatment.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

This article reports a case of cefamandole-induced nephrotoxicity in a patient with previously normal renal function and underlyingHemophilus parainfluenzaeendocarditis. Open renal biopsy performed during the period of acute renal failure revealed extensive acute tubular necrosis. Despite prolonged and severe impairment of renal function, full recovery was achieved after discontinuing cefamandole therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A 23-year-old woman was receiving bromocriptine (CB-154), 7.5–10 mg/day, for a hyperprolactinemic galactorrhea-amenorrhea syndrome. She also had insulin-dependent diabetes. After three months the bromocriptine therapy was stopped because she developed severe leukopenia (leukocyte counts about 1,800/cu mm) and mild thrombocytopenia (platelet count about 130,000/cu mm). Five months after stopping the bromocriptine therapy, the leukocyte count returned to normal (4,400/cu mm), as did the platelet count (238,000/cu mm). Prior to bromocriptine therapy, the patient's leukocyte and platelet counts ranged between 5,500 and 6,000/cu mm and 250,000 and 300,000/cu mm, respectively. While taking bromocriptine she was on insulin maintenance therapy and took no other drugs. Regular menses had returned and spontaneous galactorrhea had disappeared during bromocriptine therapy, and serum prolactin levels became normal. After stopping bromocriptine therapy the patient again became basally hyperprolactinemic and amenorrheic, with spontaneous galactorrhea. The article discusses possible mechanisms of this hematologic reaction.

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1981

数据来源: OVID