摘要:

Serum and red blood cell (RBC) levels of vitamin B12and folic acid together with serum iron and total iron binding capacity were followed in 142 patients with partial gastrectomy. Follow-up period was from two months to 25 years after surgery. Anemia was the primary hematologic alteration documented as a complication of surgery. Of the parameters followed, RBC depletion of vitamin B12occurred before a significant decrease in circulating serum values. We believe we are the first to report on the separation of RBC depletion of vitamin B12and folic acid in the presence of iron deficiency.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Diseases of the thyroid gland which have a genetic basis are discussed. Common disorders such as hyperthyroidism and chronic thyroiditis are seen in familial aggregation, but the data available do not conform to a simple Mendelian pattern of inheritance. The genetics of the multiple endocrine syndromes and the clinical application of this information as it relates to early diagnosis of asymptomatic endocrine disease in family members are emphasized. Any patient with abnormal endocrine function of one gland should be followed for the appearance of dysfunction in other endocrine glands.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Arterial oxygen tension (PaO2) was determined on 49 patients within 24 hours of their admissions to a coronary care unit with chest pain. The response of the resting PaO2was tested to the use of 30 per cent oxygen (O2) by nasal cannula and additionally, in 14 patients, to the intravenous administration of furosemide. Twenty-two patients had acute myocardial infarcts (MI); 22, coronary insufficiency or unstable angina (CI); and five, nonischemic chest pain (NIP). Those with NIP had normal values. Most patients with ischemic pain had mild resting hypoxemia with no difference in values between the group having a MI versus those without MI. Although O2by nasal cannula raised PaO2to normal, significant pulmonary arteriovenous shunting (AVS) was suggested by the less than expected level of PaO2reached in both groups. Most patients given furosemide after O2raised their PaO2still further. The degree of hypoxemia and of AVS seemed related to clinical signs of heart failure although even those without overt signs demonstrated AVS. This study suggests that hypoxemia in acute ischemic heart disease is secondary to left ventricular failure. Thus, no distinction could be made on the basis of arterial hypoxemia and response to O2between the patients having an acute ischemic episode, with or without MI.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Of 14,344 hospitalized medical patients monitored in a drug surveillance program, 173 (1.2 percent) received intravenous diazepam in total doses of 2 to 110 mg. The indication for therapy was anxiety or agitation in 94 patients, seizures in 42, and premedication prior to endoscopy or cardioversion in 32. Many patients had advanced or terminal organic disease; the overall mortality was nearly 25 per cent. Adverse reactions were attributed to intravenous diazepam in six patients (3.5 per cent). Three reactions (confusion or obtundation in two patients, transient hypotension in one) were minor. The other three adverse reactions were life-threatening (apnea and coma in two patients, hypotension and coma in one); these occurred in two patients with terminal disease and in another who received large doses of chlordiazepoxide and amobarbital concurrently with diazepam. The results suggest that serious adverse reactions to intravenous diazepam are uncommon even in the seriously ill. However, intravenous sedatives and tranquilizers should always be administered with caution, particularly in patients with hepatic decompensation, advanced cardiac or pulmonary disease, and in those receiving other central nervous system depressant drugs concurrently.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The number of erythrocytes in the sickle form decreased in parallel with the decrease in salt concentration when deoxygenated blood from homozygous sickle cell (SS) anemia patients was mixed with hypotonic solutions of NaCl. This occurred without evidence of red cell hemolysis. There was no change in the proportion of sickle cells when oxygenated erythrocytes were similarly mixed with hypotonic saline solutions, indicating that it was the reversibly rather than the irreversibly sickled cell which unsickled as osmolality decreased. The rapid administration of 0.45 per cent saline solution to patients with SS and SC disease in painful crisis was followed in seven of nine trials by a lowering of serum osmolality; a decrease in the proportion of circulating sickle cells increased 10 to 24 hours after starting therapy, even with lowered osmolality, suggesting release of trapped cells from areas poorly perfused before therapy. When osmolality did not decrease, there was no significant decrease in the proportion of circulating sickle cells. This study indicates (1) lower osmolality reverses the sickling of reversibly sickled cells, and (2) the administration of sufficient hypotonic saline to lower serum osmolality decreases the proportion of circulating sickle cells and may be beneficial for the emergency treatment of painful sickle cell crises.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

A 56-year-old man presented with plasma cell leukemia. He developed acute renal failure and was anuric for three weeks. With the use of peritoneal dialyses and cyclophosphamide therapy, the patient recovered from the acute renal failure, only to die from infection several weeks later. Recovery from acute renal failure has been described in patients with multiple myeloma; we believe this case to be the first documentation of such recovery in a patient with plasma cell leukemia.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Candida osteomyelitis has been recorded occasionally in association with underlying disorders including mucocutaneous candidiasis, leukocyte myeloperoxidase deficiency, neonatal disseminated candidiasis, and heroin addiction. An additional case in a 62-year-old male with postoperative sternal wound infection is reported following a median sternotomy. Apparent cure was achieved with amphotericin B, 720 mg administered intravenously over 30 days, together with 8 grams of 5-fluorocytosine administered daily for eight weeks. It is clear that Candida organisms are potential etiologic agents in osteomyelitis and should not be regarded as contaminants when isolated in predominance or pure culture.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

A 65-year-old man with Laennec's cirrhosis and chronic-active peritonitis died ofPasteurella multocidasepticemia shortly after admission to the hospital. The organism was presumably introduced by multiple dog bites inflicted five months previously. On the basis of current knowledge of factors predisposing to infection in cirrhotic patients, possible pathogenetic mechanisms are proposed to account for the findings in this case.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID