摘要:

An analysis is presented of the duration of hospitalization of the patients with acute bacterial (purulent) meningitis which occurred at Boston City Hospital during 12 selected years between 1935 and 1972. Considerable differences in the length of stay in the hospital were noted depending on the bacterial etiology, whether the infection was present on admission or acquired within the hospital, and, of course, whether the patient survived or died. Most of the deaths occurred within the first few days after admission or after the diagnosis was first established, but even among fatal cases, the survival time differed depending on the etiology and site of acquisition of the infection. During the years after effective antibiotics became available the hospital stay of patients who survived after admission for meningococcal, influenzal, or pneumococcal meningitis was shorter than before. The same has not been true for meningitis caused by other gram-positive cocci, gram-negative rods, or mixed infections, probably reflecting the relative ineffectiveness of antimicrobial therapy in such patients.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Surveillance of bacteremic patients within one week of the detection of a positive blood culture provides information of great clinical utility for relatively little effort. In this report one year's experience is reviewed to illustrate that an individual hospital's experience with bacteremia may diverge from national norms. Such reviews may also detect recurring errors in medical judgment which may be corrected through proper education.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

A prospective study was performed in a community hospital to determine the specific diseases responsible for “fever of unknown origin.” Thirty-four adults with persistent unexplained fever were subjected to extensive diagnostic evaluations. Alcoholic hepatitis and recurrent pulmonary emboli were found to be frequent causes of “fever of unknown origin” in this patient population. Approximately a third of the patients had no disease identified which would have explained the persistent fever. This group of patients, for whom no diagnosis was established, shared an important characteristic: failure to lose more than two pounds/week during the hospitalization.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Near-maximal isometric exercise (IHG) was employed to provoke new, or alter pre-existing fourth heart sounds (S4s) in ambulatory middle-aged normal subjects (N), hypertensive patients (HMD), and patients with coronary disease (CAD). S4amplitudes and systolic time intervals (STIs) were measured blindly. No subjects without a resting S4developed a new S4during IHG. Increases and decreases of pre-existing S4provoked by IHG were not statistically different among all groups. Among subjects matched for presence of S4, STIs during IHG showed significant shortening of the ejection time index and prolongation of Q-Im in the HHD group only. When the subjects who increased a resting S4during IHG were compared with the subjects who decreased their resting S4during IHG there were no significant differences in the responses of STIs. Thus, in these ambulatory, hypertensive patients, coronary patients, and normal subjects, near-maximal IHG did not induce new S4s and had variable effects on pre-existing S4s. Neither type of S4-response could be associated with corresponding changes in systolic time intervals.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Data derived from four major prospective epidemiological studies in the U.S. and Britain indicate that persistent cigarette smoking in later life carries an appreciable hazard. In two of these studies men aged over 65 years who smoked cigarettes had a significantly higher mortality from coronary heart disease than men who had ceased to smoke cigarettes, and in all four studies their overall mortality was significantly higher than that of ex-smokers. At 65–74 years the overall mortality of men still smoking cigarettes was higher by 24 percent or more than that of ex-smokers, and at 75–84 years it was higher by 12 to 18 percent. The absolute difference in overall mortality was 9 to 13/1000 person-years in both age-groups. A comparison of data on men who had given up smoking at different ages suggests that while the benefit is greater if smoking is stopped earlier in life, men in their sixties and (especially in the case of heavy smokers) their early seventies may still increase their longevity by giving up smoking cigarettes.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Increasing evidence suggests that the renin-renin substrate reaction is regulated by factors other than the concentrations of enzyme and substrate. Partially purified human renin and renin substrate extracted from the plasma of each of eight human subjects were used to construct substrate-velocity curves comparing the rate of substrate cleavage in the whole serum of each individual with the rate in a corresponding system containing purified autologous substrate, or purified substrate plus a small amount of autologous serum. Linear regression analysis of the double reciprocal plots were used to compare the kinetic constants in paired experiments. Maximal reaction velocity (Vmax) was significantly lower (p > .05) when the reaction rate was measured in whole serum, in seven of the eight patients, while Km did not differ significantly, suggesting the presence of noncompetitive inhibition by human serum. The mean Michaelis constant in serum was 449 ng/ml while the average native substrate concentration of the five normal subjects was 629 ng/ml, an excess of less than twofold. The data suggest that plasma renin activity in man depends upon the concentrations of inhibitor and substrate, as well as upon the concentration of renin.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

In order to determine the mechanism of elevated serum inositol in renal failure, the clearance values of inositol and of creatinine were measured in patients with normal kidney function and in those whose renal function was impaired due to varying causes. Mean serum inositol level in controls was 5.6 μg/ml, and in patients with renal failure 28.6μg/ml. In control patients, inositol clearance was 2.8 ml/min, and tubular reabsorption of inositol was found to be over 97 percent. The inositol clearance of patients in renal failure varied from 0.62 to 17 ml/min. The ratio inositol clearance/creatinine clearance was elevated in uremic patients. Total amounts of inositol excreted in the urine of uremic patients were consistently higher than those excreted by control patients. The elevated serum inositol levels seen in renal failure were therefore not primarily caused by inability of the diseased kidney to excrete inositol.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Electron microscope examination of the liver biopsies of 33 patients revealed the presence of intramitochondrial crystalline inclusions (IMCI) in ten of them. Three patients suffered from iron deficiency anemia, porphyria, and malignant melanoma, conditions not reported to be associated with IMCI. Comparison of the clinical and laboratory findings of patients with and without IMCI did not show significant difference, or a clue for clarifying the nature of this phenomenon. Although these inclusions were reported in normal individuals, the possibility that they are the result of liver damage is not excluded.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

A patient with a relatively localized occult carcinoma of the lung and hemorrhage secondary to chronic disseminated intravascular coagulation (DIC) which continued for eight months is described. Despite continuing DIC two major operations were performed without excessive blood loss. Preoperative heparinization,in vitroclotting of the arterial graft, and temporary postoperative reversal of systemic heparin were utilized for abdominal aortic aneurysm resection. Blood product replacement therapy facilitated an emergency laparotomy. The patient was also managed successfully for several months without anticoagulant therapy. A hypothesis that vascular thrombi are not a necessary prerequisite for DIC is proposed. This hypothesis is based on the absence of thrombi or evidence of ischemia in this patient and in others and is supported by experimental observations made by other investigators.

ISSN:0002-9629    

出版商:OVID    

年代:1977

数据来源: OVID