摘要:

A therapeutic protocol utilizing debridement, antibiotics, tetanus toxoid and antitoxin, early tracheostomy, positive pressure respiration, frequent suctioning, and large doses of diazepam is outlined. Diazepam proved adequate to interrupt the violent muscular spasms and recurring convulsions in this disease. Eight of 11 patients suffering from severe tetanus recovered to resume fully active lives after receiving treatment according to the protocol. It is emphasized that this treatment protocol is within the physical capabilities of most hospitals.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The addition of carbenicillin or cephalothinin vitroto either tobramycin or gentamicin did not broaden significantly the antibacterial spectrum of tobramycin or gentamicin against most species of gram-negative rods tested with the exception ofPseudomonas aeruginosaand Providence. Synergism has been found between tobramycin or gentamicin and cephalothin or carbenicillin against 62 to 68 per cent of 60 strains which were not inhibited by 1.5 µg/ml of these drugs. The combination of cephalothin plus tobramycin was synergistic on 68 per cent of the strains tested owing presumably to its activity on Providence strains. Some antibacterial advantage of tobramycin over gentamicin has been observed for 17 of 32 strains ofPseudomonas aeruginosain which minimum inhibitory concentrations for tobramycin and gentamicin were higher than 1.5 µg/ml. However, cross-resistance between these antibiotics has been observed for several strains.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Factitious hypoglycemia is a condition in which a person produces hypoglycemia by self-administration of insulin or oral hypoglycemic agents. The subject of this report is a young woman with factitious hypoglycemia established by the introduction of radioactive iodine into her concealed bottles of insulin and by the use of the 24-hour continuous glucose monitor. This is the first patient for whom the continuous glucose monitor was used in this manner. There are published reports of at least 12 patients with insulin-provoked factitious hypoglycemia but none of these explores in depth why an individual would feign a condition which could lead to unnecessary pain, life-threatening procedures, and dangerously imbalanced body chemistries. It is our purpose to describe a patient with this interesting entity, to briefly review the literature concerning such patients, and to present the first detailed psychiatric evaluation of such a patient. We believe this entity is commoner than the case reports would have us believe, and that the physician must always keep this diagnosis in mind when evaluating a patient with hypoglycemia.

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:

In five obese patients the glomerular filtration rate was determined before and after a 14-day fasting period during which the patients were supplemented with sodium bicarbonate. In spite of the absence of metabolic acidosis in three of the five patients, a significant reduction in the glomerular filtration rate was observed, showing that metabolic acidosis is not responsible for the reduction in this renal function parameter observed during fasting.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

His bundle electrography was performed in three patients with bilateral bundle branch block who manifested similar QRS complexes during atrioventricular (A-V) dissociation and intact A-V conduction. In two such patients ventricular depolarizations (V) were not preceded by His bundle potentials (H) at regular H-V intervals, suggesting a ventricular origin for the subsidiary pacemaker. In the third patient, H preceded V at shortened H-V intervals, indicating a proximal bundle branch rhythm with retrograde His bundle depolarization. It is concluded that the presence of similar QRS complexes during A-V conduction and A-V dissociation does not always indicate an A-V junctional origin of the subsidiary pacemaker. Under these conditions, His bundle electrography is a useful method for determining the site of lower impulse formation.

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:

Two patients withErysipelothrix rhusopathiaeendocarditis are described. In one of the patients, extensive destruction of a previously normal aortic valve resulted in intractable heart failure and required emergency valve replacement during active infection. In the second, progressive azotemia and diffuse glomerulonephritis documented by renal biopsy developed during protracted infection and then cleared after antibiotic therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Two patients with classical coarctation and complete luminal obstruction of the aorta are presented. In each patient, physical examination and roentgenography suggested classical coarctation of the aorta, but neither patient had the characteristic interscapular or left upper precordial murmur. We believe that this atypical physical finding suggests the presence of total aortic obstruction. The technique of surgical repair was not altered by this malformation.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

This paper describes a patient who had the unusual association of idiopathic hypertrophic subaortic stenosis with a post-antrectomy dumping syndrome. Angina pectoris occurs when the patient is having dumping only. Hemodynamic correlates and actual objective demonstration of increase of murmur, decrease of stroke volume, and decrease of pulse pressure during a test meal are presented as evidence that the pain is secondary to outflow obstruction. The mechanisms of angina pectoris in outflow tract obstruction are discussed and related to this patient who also demonstrated severe segmental coronary disease on coronary cineangiography but in whom pain did not occur with exertion.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID