摘要:

The diagnosis of multiple sclerosis (MS) still rests on the time-honored twin criteria of dissemination in time and space. The disease shows a predilection for certain parts of the central nervous system: the optic nerves and chiasm, the brain stem and cerebellum, as well as the spinal cord, but the cortex and other nuclear masses may also be involved. It does not affect the peripheral nervous system. Diagnostic criteria, combining historical, clinical and paraclinical information, have been developed which now have been almost universally adopted and found reliable. Paraclinical tests (evoked-potential studies, magnetic resonance imaging) and abnormalities of cerebrospinal fluid (oligoclonal bands, elevated IgG levels) are nonspecific and therefore, by themselves, not diagnostic. The increasing availability of such tests has unfortunately led to their use as a substitute for a careful history and neurological examination in establishing the diagnosis. Reliable, generally accepted, specific treatment for MS is not available. Immunomodulatory therapy has been a failure; corticosteroids and ACTH are the mainstay for the treatment of exacerbations; and interferon-β appears effective in decreasing the number and severity of relapses. There are, however, many ways of relieving or diminishing the severity of the symptoms of the disease. A sympathetic attitude on the part of the physician is essential in treatment

ISSN:1011-7571    

DOI:10.1159/000157438

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The efficacy of diclofenac sodium, a potent inhibitor of prostaglandin synthetase, was compared with the efficacy of a spasmolytic agent, hyoscine butylbromide, in the treatment of 78 patients (53 men and 25 women) suffering from acute ureteral colic. Forty-two patients (group A) received diclofenac sodium intramuscularly and 36 (group B) hyoscine butylbromide intramuscularly. Both groups were comparable for weight, age and sex. Diclofenac sodium relieved the colic effect in 38 out of 42 patients (90%) within 30 min after the injection and 7 of 36 patients in the hyoscine butylbromide group (19%). In 4 patients of group A, a second injection of diclofenac sodium, given 30 min later, completely relieved the pain within 30 min. In group A, side effects, such as nausea, vomiting, and headache, occurred in 4 patients. In conclusion, diclofenac sodium, administered intramuscularly, is more effective in treating ureteral colic than hyoscine butylbromide and has fewer side effects.

ISSN:1011-7571    

DOI:10.1159/000157439

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The effects of diprivan bolus dose on intracranial pressure (ICP) were studied in 10 male patients with head injuries and brain oedema. Diprivan 2.0 mg/kg injected intravenously over 60 s caused statistically significant reduction (p < 0.05) in ICP and cerebral perfusion pressure (CPP) with maximum reduction at 3.0 min. CPP was maintained above 50 mm Hg in all measurements. Arterial blood pressure was decreased significantly (p < 0.05) with the lowest values occurring at 3.0 min for both systolic and mean blood pressure and at 7.0 min for diastolic blood pressure. Heart rate showed no significant change, except at 1-min intervals, where a significant increase was found (p < 0.05). We conclude that diprivan is effective in lowering ICP, while its lowering effect on CCP needs further investigation.

ISSN:1011-7571    

DOI:10.1159/000157440

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

After upper abdominal surgery, 40 patients were randomly allocated to receive either nalbuphine hydrochloride or morphine sulfate in doses sufficient to ameliorate pain. Using the linear analogue score, pain assessment showed no difference in the first hour, but after 3,6, and 20 h, there was more pain relief in the morphine group than in the nalbuphine group. During physiotherapy, pain was significantly less in the morphine group (p < 0.01); however, there was no significant difference in the ability to cough in both groups. Also there was no significant difference in the observed and the patient assessed pain relief. There was more sedation in the nalbuphine group. Respiratory rate was significantly lower in the morphine group (p < 0.05), and the PaCO2 rose significantly in the morphine group (p < 0.01). A larger dose of nalbuphine was required to obtain satisfactory pain relief than with morphine (p < 0.01).

ISSN:1011-7571    

DOI:10.1159/000157441

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A histology-based retrospective study was carried out in Kuwait to determine the frequency and type of helminthic infestation of the appendix in this predominantly desert environment. In 1,674 consecutive appendectomies, 109 parasites (5.6%) of five species were detected: Schistosoma sp. 70 (4.1%), Enterobius vermicularís 36 (2.1%), and a single case each oíAscaris lumbricoides, Taenia sp. and Trichuris trichiura. Schistosomiasis was seen exclusively in immigrants of whom 12 had evidence of coexistent extra-appendiceal infestation of the urinary system. Suppuration in this group was common (79%) in addition to fibrosis (74%) and granulomata (43%). Enterobiasis seen in both natives and immigrants predominantly affected children. Suppuration in this group was uncommon (22%) but a fecalith or thick lumen contents containing the parasites were frequently seen (72%). It was concluded that parasite infestation of the appendix is important to report even in countries such as Kuwait which is nonendemic for many intestinal parasites. Such data contribute to further understanding of epidemiology, enable the diagnosis of easily treatable disease such as enterobiasis, or provokes a search for more significant extra-appendiceal infection as in schistosomiasis. Enterobiasis should be suspected in children and young adults with normal histology of the appendix. Examination of the lumen contents may improve the chances of detecting intraluminal parasite

ISSN:1011-7571    

DOI:10.1159/000157442

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

952 phlebographies of the lower extremity were performed in the symptomatic patients reviewed. 368 revealed deep-vein thromboses which were classified according to extent, distribution and age. Limited thrombosis (clot < 3 cm) occurred in 13 cases (3.5%). Acute venous thrombosis of the calf only without involvement of the popliteal segment occurred in 96 cases (26%). Extension of the thrombus above the inguinal ligament was seen in 12 cases (3.3%). In 159 cases, it was impossible to firmly diagnose the condition as acute since there was no visible clot but only signs of earlier thrombosis. When these signs coincide with missing venous segments, care must be taken to identify patients without acute thrombosis in order to avoid unnecessary anticoagulant, thrombolytic or surgical therapy.

ISSN:1011-7571    

DOI:10.1159/000157443

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Colicin typing, biotyping, phase typing and in vitro antimicrobial susceptibility testing were performed on clinical isolates of Shigella sonnei from three different geographical locations. Results of 93 strains from Kuwait, 61 strains from Saudi Arabia and 23 strains from Bangladesh were compared. Of 169 strains of S. sonnei tested, 75% belonged to colicin type 6/11. It was the most common colicin type in all three countries. However, differences in antimicrobial susceptibility patterns were observed. The resistance pattern in 62% of resistant strains from Kuwait was tetracycline – trimethoprim/sulpha-methoxazole – trimethoprim (TE-TMP/SMZ-TMP). Saudi Arabian strains were of the same resistance pattern with additional resistance to ampicillin (AM) AM-TE-TMP/SMZ-TMP (34%) which was seem more often than TE-TMP/SMZ-TMP (26%). Most of the strains (65%) from Bangladesh were sensitive to all the antimicrobial agents against which they were tested. Of the 8 strains which showed resistance, 50% were resistant to tetracycline alone. Study of carbohydrate fermentation of 12 sugars which were incubated for 21 days did not aid in discriminating different bioty

ISSN:1011-7571    

DOI:10.1159/000157444

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Lymphangitis carcinomatosa (LC) usually presents a typical clinical and radiological picture. However, diagnostic difficulty arises when the clinical presentation is complicated by other features or the radiological picture is atypical. This paper describes 5 atypical cases where diagnosis was established by transbronchial lung biopsy. In 2 of these cases immunohistological staining was used to determine the epithelial nature of the cancer cells or to differentiate between blood vessel capillaries and lymphatics. We believe this to be the first reported use of this staining method in LC.

ISSN:1011-7571    

DOI:10.1159/000157445

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Review of cases with meningitis in a general hospital in Kuwait showed high prevalence of relatively resistant Streptococcus pneumoniae (RRSP). During an observation period of 3 years, 6 cases of pneumococcal meningitis were encountered; 4 cases were caused by RRSP. The use of screening tests with 1 µg oxacillin in disc diffusion susceptibility tests helped to identify less susceptible strains which were then confirmed by determining their minimum inhibitory concentration. Appropriate antibiotic choices led to successful therapy in all instances. The importance of detecting RRSP in cases of meningitis is emphasized

ISSN:1011-7571    

DOI:10.1159/000157446

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Familial cases of congenital dyserythropoietic anemia are extremely rare. Described are a brother and sister with congenital dyserythropoietic anemia type I. Both had a history of neonatal jaundice, moderate anemia and hepatosplenomegaly. They were blood transfusion independent.

ISSN:1011-7571    

DOI:10.1159/000157447

出版商:S. Karger AG    

年代:1992

数据来源: Karger