ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Two hundred four volunteer blood donors with hepatitis B surface antigen found in their blood were followed for 3 to 44 months. The annual clearance rate of this antigen was 1.7%. Liver enzyme levels (aminotransferase) were elevated in 45 (22.1%) on at least one occasion, in 26 (12.7%) for one month or more, and in 13 for more than six months. Liver biopsies were performed on 17 chronic carriers with normal enzymes and nonspecific histologic abnormalities were found in 14 and mild diffuse hepatitis in three. Seventeen carriers with abnormal enzymes were biopsied, and specimens revealed chronic active hepatitis (CAH) in seven, including two with bridging necrosis and three with cirrhosis. CAH was found in 7 of 26 (26.9%) carriers with abnormal liver enzymes persisting for at least one month and 4 of 13 (30.8%) with abnormal liver enzymes for more than six months

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Preoperative localization of an insulinoma was possible using a technique of transhepatic pancreatic venography, with measurement of insulin levels in six pancreatic veins. Surgical exploration confirmed the presence of an insulinoma at the site predicted by venography. Peripheral plasma insulin levels were only minimally elevated at the time of hypoglycemia. However, complete suppression of ketogenesis during a 74-hour fast was observed, and felt to be a biological marker for hyperinsulinism. These observations suggest that transhepatic pancreatic venography and the measurement of plasma ketones in addition to glucose and insulin during fasting, may be useful supplementary studies in the evaluation of patients with fasting hypoglycemia.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Of 58 patients with Paget's disease treated with disodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) in doses of 20 and 10 mg/kg/day, a group of 20 patients with the oligostotic form of the disease showed a significantly greater incidence of complications, such as worsening of bone pains, when compared with a group of 38 patients with the polyostotic disease (P< 0.05). The group of 32 patients that received 20 mg/kg/day showed a greater although not significant incidence of clinical complications than the group of 26 patients treated with 10 mg/kg/day. Bone biopsies performed in one polyostotic and three oligostotic cases who suffered episodes of bone pain worsening during treatment with 20 mg/kg/day disclosed a severe osteomalacia. Both groups treated with 20 and 10 mg/kg showed a highly significant decrease of urinary hydroxyproline (THP) excretion and of serum alkaline phosphatase (P< 0.01) after two and six months of treatment although the trend comparison between doses was not significant. It is suggested that the dose of EHDP should be related to the extent of the disease.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Central retinal vein occlusion (CRVO) occurred in 3 of 15 maintenance hemodialysis patients over a two-week period. There have been no previous reports of this ophthalmologic catastrophe observed in the dialysis setting. Lupus nephritis, Henoch-Schönlein purpura and nephrosclerosis constituted the patients' major underlying diseases. Moderate hypertension was also present. Impaired vision of the left eye noted 24 to 36 hours following dialysis was the presenting symptom in all cases. Findings included decreased visual acuity, retinal vein engorgement, hemorrhage, and disc edema. All three patients subsequently lost the vision in their left eye (two received anticoagulation therapy). With the exception of hypertension, there were no known underlying predisposing conditions present. Although we are unable to offer a definite explanation for these unusual cases of CRVO, we feel a hypercoagulable state may have been responsible. Because our three cases occurred during a two-week period, some transient unidentified procoagulant factor associated with hemodialysis could have been present.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

One hundred three (4.1%) of 2,499 patients hospitalized in a general medical ward were admitted because of an adverse drug reaction (ADR). Of 60 drugs involved, the most common were cardiac, antibiotic, and antineoplastic agents. The main reactions included skin rashes, bone marrow depression, arrhythmia, bleeding, and heart failure. Five (4.9%) of the patients died and 11 (10.7%) had life-threatening reactions. Risk factors predisposing to admissions due to ADR were: female sex, decreased renal function, polypragmasia, and the underlying disease. Twenty-seven percent of the admissions could have been avoided by a more careful choice and dosage of drug.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Acinetobacter calcoaceticusvaranitratusis an increasing nosocomial problem in some institutions. During a recent 16-month period, we observed 15 patients with blood isolates of this organism. Thirteen of these patients acquired the organism from the hospital environment. Eleven of these represented real disease and concurrent growth of the organism from another site was predictive of infection (P< 0.03). A review of laboratory records showed that there was a threefold increase in nonblood isolates of this organism from hospitalized patients in 1975 and 1976, as compared to 1972 (P< 0.0001), and a marked seasonal effect was noted, with increased isolations during the summer. Aminoglycoside resistance had increased considerably with 25% of nonblood isolates being resistant to gentamicin and 16% resistant to tobramycin despite its restriction; blood isolates were uniformly susceptible to gentamicin and tobramycin. Reporting ofA anitratusas a nosocomial pathogen and serotyping of isolates may be useful to further define its role in nosocomial infections.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A 19-month study of group B streptococcal infection was performed to investigate the spectrum of such infections in adult males, the relation of serotypes to clinical illnesses, the effects of previous antibiotic therapy on infection and colonization, and the antibiotic susceptibility pattern of these organisms.Twenty-four patients had definite or possible infections while 41 patients were colonized with group B streptococci. The most frequent infections encountered were pneumonia (ten cases) and soft tissue infections (nine cases). Five infections (21%) were nosocomial in origin. The most frequent serotypes were la and II. No correlation of serotype and type of infection was observed. Patients receiving previous antibiotic therapy were significantly more likely to be colonized than infected with group B streptococci. Penicillin was the antibiotic to which these organisms were most susceptible; tetracycline and gentamicin showed the least activity.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Ten patients with thrombotic thrombocytopenic purpura (TTP) were studied retrospectively. The male:female ratio was 2:3 and the median age was 27 years. Six patients are alive one-half to 18 years after the onset of the disease. Four of these patients underwent emergency splenectomy and received antiplatelet drugs. Of the remaining two, one responded to splenectomy and the other had received a short course of aspirin therapy. The study supports the usefulness of splenectomy and/or antiplatelet agents in the treatment of TTP.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Granulocytic-monocytic colony-forming activity of marrow cells was evaluated at presentation in 20 patients with acute nonlymphocytic leukemia (ANLL). A double-layer agar culture was employed to determine colony- and cluster-forming activity. All patients underwent induction chemotherapy with cytosine arabinoside and daunorubicin. Five patients died during induction. Eight of the 11 patients entering complete remission had absent or decreased colony and cluster growth of marrow cells. Four patients who failed to obtain a complete remission produced increased or only cluster growth in culture. Our data support the conclusions of others that decreased colony and cluster formationin vitrois associated with a more favorable response to induction chemotherapy for ANLL.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID