摘要:

From January 1979 to July 1980, methicillin and tobramycin resistantStaphylococcus aureuswas isolated from 45 patients at a Veteran's Administration hospital. Of these 45, 36 (80%) had clinical infections involving non-surgical wounds (16), urinary tract (10), blood (8), surgical wounds (7), and sputum (5). The epidemic strain had a single phage type (47/54/75/77/83A), a single, 16.4 Md plasmid, and produced an amino-glycoside inactivating enzyme (AAD[4‘]). Compared to a control group of patients with nosocomial antibiotic susceptibleS. aureusinfections, patients with the epidemic strain had more hospital days before a positive culture (p=.004), more severe underlying disease (p=.006), received antibiotics more often (p=.0018), and underwent physiotherapy more often (p = .00007). Although selected environmental and personnel cultures were negative for the epidemic strain, epidemiologic investigation suggested that hospital-wide dissemination ofS. aureusmay have occurred through patient contacts in the physiotherapy department with subsequent clusters of cases occurring on several wards.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Sodium morrhuate and sodium tetradecylsulfate are injected during endoscopic scle-rotherapy to control variceal bleeding. When administered to sheep they cause transient pulmonary hypertension and increase protein poor lung lymph flow. To determine the etiology of these alterations, we studied three groups of sheep after establishing acute lung lymph fistulas. In Group 1, indomethacin or ibuprofen was infused. In Group 2, 2.5 cc of sodium morrhuate was injected alone (2A) or after indomethacin or ibuprofen pretreatment (2B.) In Group 3, 2.5 cc of sodium tetradecylsulfate was given intravenously either alone (3A) or after indomethacin or ibuprofen (3B). When sclerosing agents were given alone (Group 2A and 3A) pulmonary artery pressures increased three-fold at 30 seconds postinjection to 37 · 4.4 and 39 · 5.7 mmHg respectively with a slow return to baseline over two hours. Lymph flow increased significantly from 1.3 · 1.5 to 2.7 · 1.5 cc/30 minutes after sodium morrhuate and from 1.2 ± .62 to 2.7 · 1.7 cc/30 mins at 30 minutes after sodium tetradecylsulfate and the lymph/plasma albumin ratio fell. Increased lymph flow persisted through 120 minutes. In those animals receiving a sclerosing agent after indomethacin or ibuprofen (2B and 3B) there was no change in pulmonary artery pressure, lymph flow, lymph plasma albumin ratio, or lung wet weight to dry weight ratios. We conclude that the pulmonary hypertension and increased protein poor lymph flow are mediated by prostaglandins.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Pergolide, an experimental dopamine agonist, was administered to 56 patients with advanced Parkinson disease who were no longer satisfactorily responding to levodopa, including 45 patients with diurnal oscillations in performance: “on-off” phenomena. Lisuride, an experimental dopamine agonist was administered to 63 patients with advanced Parkinson disease. Pergolide or lisuride, when added to levodopa, resulted in a significant decrease in disability in both the “on” and the “off” period, and an increase in the number of hours in which patients were “on”. Forty-one of 56 patients (73%) improved on Pergolide. Thirty-seven of 63 patients (59%) improved on lisuride. Mean dose of pergolide was 2.5mg. (range 0.2 to 10.0mg.). Mean dose of lisuride was 2.6mg. (range 0.2 to 5.0mg.). Pergolide was discontinued in 18 patients because of adverse effects, including an organic confusional syndrome (six patients), dyskinesias (four patients) and cardiovascular abnormalities (three patients). Lisuride was discontinued in 26 patients because of adverse effects, including an organic confusional syndrome (15 patients), dyskinesias (five patients) and vasospasm (two patients). Pergolide was discontinued in nine patients and lisuride in 12 because of a lack of effect or a declining effect. Both drugs are equally useful in patients with advanced Parkinson disease.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Endocrine tumors may produce secondary or “ectopic” hormones that cause paraneo-plastic syndromes. Such syndromes may be confused with more common complications related to a patient's tumor, and thus escape detection and appropriate treatment. The secondary hormone secretion responsible for these syndromes often occurs late in the course of such diseases and presents in an insidious manner. Two patients are presented that illustrate these points. The first, a woman with medullary carcinoma of the thyroid (MCT), developed a syndrome secondary to ACTH secretion that was confused initially with the changes caused by the massive diarrhea that accompanies MCT. The second, a man with malignant glucagonoma, is the first with this disease to have developed symptomatic hyperin-sullnemia as a late complication. We stress the clinical courses of these patients and note that treatment of these syndromes may improve the quality of patients' lives.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Two cases of mediastinitis and bacteremia caused byBacteroidesspecies following median sternotomy are described. In both patients, purulent sternal drainage and signs of systemic toxicity led to the diagnosis. Surgical reexploration and administration of appropriate antibiotics effected clinical cure. Although there is only a single previous case of anaerobic mediastinitis following median sternotomy incision reported, these two cases suggest that this unusual infection may not be so rare as previously thought.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

IgA lambda multiple myeloma was diagnosed in a 58-year-old white woman after the onset of nephrotic syndrome. Serial renal histology demonstrated progressive mesangial proliferative glomerulonephritis. Electron microscopy revealed subepithelial electron dense deposits. Immunofluorescence microscopy demonstrated granular staining of peripheral capillary loops with IgG and C3. No IgA was present. No evidence of deposition of the myeloma protein in the glomeruli was found. The temporal relationship of occurrence of the two diseases and the progression of glomerular disease suggest that multiple myeloma be added to the list of malignancies causing immune complex glomerulone-phritis.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID