ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Several studies have documented the common use of alcohol among medical students and the significant fraction of students (7% to 17%) who show a pattern of alcohol abuse. Many authors have pointed out the implications of physician impairment due to alcoholism, presently estimated at about 10%. We surveyed 263 junior and senior medical students, and our data support earlier surveys of the prevalence of alcohol abuse and indicate that students tend to drink less heavily and less frequently after entering medical school. The clinically proven CAGE questions used in the survey showed statistically significant associations between heavy or frequent drinking before and during medical school, but only 4.2% of respondents indicated that school officials had asked whether they had a drinking or drug abuse problem. Given these findings, we suggest the routine administration of screening instruments to medical students, using education and minimal intervention strategies with individuals at risk.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We surveyed 1528 first-year students at the University of Virginia, 1 month after their arrival on campus, who had used alcohol at some time in their lives. Our survey was designed to identify alcohol and cocaine use, and related psychosocial patterns. Men drank more and more often than women. Our data suggest that body weight should be considered in defining those who drink heavily and often. We define ‘frequent heavy drinking’ as five or more drinks in a row each week for men and three to four drinks or more in a row each week for women. Frequent heavy drinkers, cocaine users, and students with psychosocial problems appeared disproportionately among students planning to join fraternities and sororities. Although first-year students used cocaine infrequently, its users followed the patterns of frequent heavy drinkers. We believe efforts to correct alcohol and cocaine misuse by college students should be directed, in part, at social organizations such as Greek-letter societies. Also, we must attend to psychosocial features that predispose to alcohol and cocaine misuse.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We used a pharmacokinetically derived phenobarbital dosing protocol to treat alcohol withdrawal syndrome in patients admitted to a family medicine inpatient service. We describe the protocol and include two case reports documenting its efficacy. Although benzodiazepine agents are considered by many to be the primary agents of choice, based upon our experience and its ease of administration, relative safety, therapeutic efficacy, and lower cost, phenobarbital should be reconsidered as a promising alternative. Comparative trials between these two therapeutic classes will clarify their roles in the treatment of alcohol withdrawal syndrome.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

To determine the economic impact of acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) cases on North Carolina hospitals, we collected inpatient data from all North Carolina hospitals on charges and number of patients discharged with these diagnoses. More than 97% of the state's hospitals responded to the survey for the study year (1987–1988). There were 540 AIDS/ARC discharges from 58 North Carolina general hospitals and 125 AIDS/ARC discharges from 13 other types of hospitals, for a statewide total of 665 patients. The total general hospital charges for AIDS/ARC inpatients in North Carolina were approximately $7.7 million per year, and almost $2 million of these charges were uncompensated by any insurance. The greatest burden of cost for this care was borne disproportionately by 15 of the 58 general hospitals, accounting for 82% of the discharges.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Between January 1984 and December 1989, 102 indigenous cases of Lyme disease were reported in North Carolina. Lyme disease was reported in each of the three major geographic regions of the state: mountain, piedmont, and coastal plain. One or more diagnoses were made in 42 of 100 counties. Patients ranged in age from 5 months to 78 years (median, 27 years); 58 patients (57%) reported a history of tick exposure within 1 month of the onset of symptoms. Erythema migrans was reported by 93 patients (91%). Arthritis (30%), neurologic symptoms (10%), and cardiac abnormalities (7%) were observed. Thirty of the 102 cases were confirmed serologically by indirect fluorescence microscopy or enzyme-linked immunosorbent assay.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Collagenous colitis is characterized clinically by chronic watery diarrhea and pathologically by a distinctive band of collagen deposited below the colonic epithelium and an inflammatory cell infiltrate of the lamina propria. Since 1976, more than 100 cases have been described. We report an additional nine cases occurring in five women and four men ranging in age from 18 to 80 years. Diarrhea was present before diagnosis for 2 to 4 months in four cases and for 1 to 25 years in another four cases. One patient did not have diarrhea. Results of radiologic and stool studies were normal in all cases. All patients had flexible sigmoidoscopy or colonoscopy. Microscopic examination of biopsy material was interpreted as characteristic of collagenous colitis. Two cases resolved with psyllium mucilloid therapy alone. Of the five patients treated with azulfidine, three had marked improvement, one had partial response, and one had no change.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Few data exist concerning the ability of intraoperative colonic lavage to decrease colonic bacterial counts, and nothing is known about its effect on the recently described mucosa-associated bacteria. The goal of our study was to determine the impact of intraoperative colonic lavage on both the intraluminal and mucosal microflora. After intraoperative colonic washout in 10 adult male Sprague-Dawley rats, quantitative and qualitative aerobic and anaerobic cultures of the intraluminal and mucosal bacteria were obtained. Tissue was also removed for scanning electron microscopic examination of the colon wall. Whereas 1000-fold to 10 000-fold reductions of aerobic and anaerobic intraluminal flora were achieved with mechanical lavage, reductions of aerobic or anaerobic mucosal bacteria were not significant. Failure to diminish bacterial colonization in this ecologic niche may be partly responsible for the persistently high infection rate after emergency colorectal surgery.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID