ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The increasing national and regional incidence of Rocky Mountain spotted fever (RMSF) during the past two decades led us to look at nationally collected epidemiologic data on reported cases of RMSF for 1975 through 1978, paying special attention to age-specific incidence in the states where the disease is most common. The group aged 5 to 9 years was the cohort at highest risk of contracting RMSF, but it was the 40− to 59-year age group that had the highest case fatality rate (CFR), 11.3%. Control efforts should include an educational program aimed at school-aged children and their parents, as well as instructions for physicians (particularly family practitioners and internists) on the early recognition and proper treatment of this illness.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A study was designed to measure the inter-pathologist consistency of histopathologic diagnosis of cervical intraepithelial neoplasia (CIN) among four pathologists. Intra-pathologist reliability over time was also determined. Between-pathologist comparisons resulted in agreement only 50% of the time; however, 81% of pairs were within one CIN grade of each other. Seventy-one percent of first and second diagnoses of the same pathologist were identical and 93% of pairs were within one CIN grade. In seven cases, however, pairs of evaluations of the same slide were remarkably disparate, two considered normal and CIN III by the same pathologist at different times. The findings of this study, using the CIN grading system, are consistent with other studies using different classification schemes. Inconsistency of diagnoses and discrepancies between pathologists must be considered when conservative therapy is elected for a patient with cervical intraepithelial neoplasia.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Between 1944 and 1969, 192 women with carcinoma of the breast were treated at The University of Texas System Cancer Center M. D. Anderson Hospital and Tumor Institute by standard radical mastectomy for small outer quadrant lesions and pathologically negative axillary lymph nodes. Twenty percent of these patients with “localized disease” eventually had disseminated breast cancer. Various patient, hormonal, genetic, and pathologic factors were found to have little influence on the prognosis. Patterns of metastatic disease revealed that these patients did not have a unique form of breast cancer, but apparently an earlier stage in the spectrum of advancing disease. The results of this study appear to represent the best that can be obtained with regional therapy for carcinoma of the breast and emphasize the need for reliable adjuvant therapy.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

In immunologic studies of 20 children with severe facial birth defects, all were evaluated for quantity of T and B cells, immunoglobulins, and the third component of complement. Only 18 patients could be evaluated for blastogenesis and 16 for chemotaxis. Forty percent of the children had a decreased quantity of B cells. Eighty-three percent had a decrease in pokeweed-stimulated blastogenesis, and 75% showed decreased levels of one or more immunoglobulins. T cells were decreased in 60% of the patients, while 33% and 28% had decreased phytohemagglutinin-stimulated and concanavallin-A-stimulated blastogenesis, respectively. Chemotaxis was diminished in the polymorphonuclear leukocytes of 56% and the mononuclear leukocytes of 75% of the patients evaluated. The association of immune abnormalities and facial birth defects may be more common than is presently recognized.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Refusal to walk is a common complaint in childhood. Its etiology was investigated by reviewing the charts of children who were admitted to the hospital with this problem in a one-year period. Bacterial infections produced 22 of the 55 episodes and were more likely to be associated with fever than were noninfectious disorders. Elevation in sedimentation rate and white blood cell counts were not helpful in differentiating infections from noninfectious disorders. Refusal to walk usually is associated with a serious underlying disease and this symptom should prompt a diligent search for its cause.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Four young healthy adults were studied physiologically after accidental inhalation of chlorine gas. All patients were symptomatic with cough, tightness in the chest, and shortness of breath. All had restrictive ventilatory defect with impaired diffusing capacity. There was evidence of some obstruction in small airways. There was inconsistent evidence of obstruction in large airways. All lung function impairment was temporary and cleared entirely within one month. There was no residual lung damage.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

We investigated the occurrence of anesthetic ventricular cardiac arrhythmia (CA) in 104 systemically healthy consecutive patients undergoing general anesthesia, to evaluate the possibility of recognizing preoperatively those patients prone to CA. In 19 (18%) patients, control strips taken before anesthesia showed CA. During anesthesia CA developed in 34 (33%), including 16 during induction, ten during endotracheal intubation, and eight during both events. Older patients had a higher incidence of CA than younger ones (P < 0.01), and patients with preoperative CA showed a greater trend toward anesthetic CA. There were no anesthetic deaths in this group. Early detection and treatment avoided complications and sequelae of CA. A second anesthetist in the operating room, to monitor the cardiac rhythm during induction and intubation, possibly contributed to early detection of CA and is strongly recommended.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Forty-four renal transplant patients were given radiation therapy for severe rejection phenomena. The 29 patients who had only one course of irradiation had a 52.3% successful function rate. Fifteen patients received from two to four courses of irradiation with an ultimate 60% rate of sustained function. Fifty patients who received only steroid and other medical management but no irradiation had a 60% rate of successful renal function. In the irradiation group, no patient whose creatinine level did not respond to radiation therapy maintained a functioning kidney. The data indicate that the overall successful function rate is maintained by radiation therapy in patients who show severe allograft rejection phenomena.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Recorded mortality from hypertension and stroke has decreased dramatically in most countries during the last 50 to 75 years. The reported reduction in mortality may be due to changes in diagnostic fashions or coding procedures. However, the magnitude and consistency of the decline suggests the occurrence of a true decrease. The possibility that better treatment of hypertension is responsible for the reduction in mortality is attractive. However, based on temporal relationships, it seems more likely that much of the fall has resulted from an alteration in the determinants of blood pressure. Increasing use of antihypertensive drug therapy may account for an acceleration in the decline of stroke mortality during the last decade. If so, this represents one of the first tangible benefits of the massive public health efforts to detect and treat hypertension in the community.

ISSN:0038-4348    

出版商:OVID    

年代:1982

数据来源: OVID