SMJ // June 1981, Volume 74 - Issue 6
Announcement
GENERAL ANNOUNCEMENTS
Primary Article
Major Hepatic Resection
ABSTRACT:Among 75 major hepatic resections from 1968 to 1978, 58 were done for severe, devitalizing hepatic trauma, two thirds of which was blunt trauma. Anatomic lobectomies were done in 32 of the trauma cases. Of the 42 patients who survived, 17 had complications postoperatively. Five patients died intraoperatively of exsanguinating…
Primary Article
Hepatic Resection
ABSTRACT:From our retrospective review of 30 patients having hepatic resection, we have made the following conclusions: (1) Hepatic resection is an uncommon procedure. (2) The majority of liver injuries require only drainage or suture ligation and drainage. (3) Midline incision, early arterial occlusion, and resectional debridement should be used for…
Primary Article
Gangrene of the Gallbladder A Complication of Acute Cholecystitis
ABSTRACT:Eighteen cases of gangrenous cholecystitis were reviewed to better define causes of morbidity and mortality. All patients in the series presented with signs and symptoms of acute cholecystitis. Cholecystectomy was done as an emergency procedure in 12 patients, while in six patients cholecystectomy followed a failure of nonoperative therapy. Gangrenous…
Primary Article
Angiography in Patients With Abdominal Aortic Aneurysms
We obtained angiograms on 61 consecutive patients being evaluated for elective aneurysmorrhaphy at the Gainesville VA Medical Center, Gainesville, Florida. Renal artery stenosis was documented in 33% of cases, aberrant or multiple renal arteries in 26%, and other aneurysmal disease, most commonly in the iliac system, was present in 51%….
Primary Article
Manometric Evaluation of Esophageal Disease
Esophageal manometry has been helpful in delineating several aspects of the pathophysiology of esophageal disease. Its immediate contribution to patient care, however, is not clear. We reviewed our experience with 59 consecutive patients who had been referred to our laboratory specifically for this study. Manometry provided new information resulting in…
Primary Article
Hemoccult Screening in Selected Patients
ABSTRACT:One hundred patients, asymptomatic relative to gastrointestinal disease, who applied for elective hernia repair were tested as outpatients for occult blood in the stool. Twenty-six had one or more positive specimens. Among this group colonic disease was found in seven, including adenocarcinoma (Dukes stage A) in one, adenomatous polyps in…
Primary Article
Value of Purgation in Examining Stool for Parasites
ABSTRACT:Two methods of stool examination, routine and purgation, were used in 121 patients to evaluate the presence of upper intestinal parasites. Purgation stool proved statistically of greater reliability.
Primary Article
Squamous Carcinoma of the Uvula
ABSTRACTFrom a study of the clinical courses of nine patients with squamous carcinoma of the uvula and a review of the clinical literature involving such lesions, we have concluded that these tumors have a very poor prognosis when metastases occur, despite seemingly adequate initial therapy to the primary tumor. Consequently,…
Primary Article
Changes in Thyroid Function in Pregnancy and With Oral Contraceptive Use
ABSTRACTWe measured T4, T3, T3 uptake, and TSH in nonpregnant patients, pregnant patients in the early and late first, second, and third trimesters, and patients using oral contraceptives. Mean T4 levels increased and T3 uptake decreased during pregnancy. Concentrations of T3 decreased in early pregnancy, then increased during the rest…
Primary Article
Selective Delivery in High-risk Pregnancy
ABSTRACTUltrasonography, antepartum testing of the fetal heart rate, and amniotic fluid assays were used in a management protocol to select the optimal time for delivery of a group of 165 pregnancies complicated by diabetes mellitus or hypertensive disorders. Only six cases of intrauterine growth retardation were detected ante partum. Nonreactive…
Primary Article
Allergic Reactions to Local Anesthetics
ABSTRACTThe majority of adverse reactions to local anesthetics are due to high plasma levels from excessive quantities of a drug. These are often blamed on idiosyncrasy, sensitivity, or allergy. The incidence of reactions due to allergy to local anesthetics is low compared to that with other drugs. Allergic reactions may…
Primary Article
Effects of Antihypertensive Drug Therapy on Responses to Isometric Exercise
ABSTRACTThe increases in heart rate and blood pressure induced by a standard isometric handgrip (IHG) stress in normal men were similar in degree to the changes found in an age-matched group of men with untreated essential hypertension. In hypertensive patients whose blood pressure was controlled at normal levels with hydrochlorothiazide…
Errata
CORRECTION
Primary Article
Relationship Between Frequency of Sexual Intercourse and Urinary Tract Infections in Young Women
ABSTRACTWe compared personal and sexual behavior of a group of 32 young adult women who had a culture proven urinary tract infection (UTI) and a group of 28 women who had no urinary symptoms. All women were sexually active, and the two groups were similar for age, race, marital status,…
Acknowledgement
Books Received
Primary Article
Use of Calendar and Weather Data to Predict Walk-In Attendance
ABSTRACTHospital emergency rooms frequently provide routine health care to inner-city residents. Operating costs for such “walk-in” services might be reduced if staffing levels could be tailored to patient flow. To determine how calendar and meteorologic factors affect attendance, we matched the daily visit records of a large ambulatory care center…
Primary Article
Identifying the Acutely I11 Patient With Asthma
ABSTRACTWe studied 77 patients suffering acute asthma to identify those who needed hospitalization. Patients randomly received various doses of subcutaneous epinephrine. Peak expiratory flow rate (PEFR) was measured initially and at ten and 20 minutes after epinephrine administration. If adequate response was not noted from three doses of epinephrine, aminophylline…
Primary Article
Bacterial Colonization of Human Milk
ABSTRACTBecause human milk is being used more and more for feeding neonates, many hospitals are struggling with the issue of culturing. The literature indicates that human milk is hardly ever sterile. Since there has been much debate concerning protocols and frequency of culturing milk specimens, we evaluated our facilitys protocol,…
Current Concepts
Recent Developments in Brain Rehabilitation
ABSTRACTThis paper introduces the new area of neuropsychologic rehabilitation. Procedures have been developed that can improve some verbal and nonverbal skills impaired by stroke and other brain insults. Technics are described that are now available to remediate perceptual problems such as spatial neglect, cognition difficulties, and recent memory deficits in…
Current Concepts
Azoospermia Diagnosis and Management
ABSTRACTBy using a detailed history and physical examination, endrocrinologic studies, and, in some cases, testicular biopsy, we assign azoospermic men to three pathogenic groups: pretesticular, testicular, and posttesticular. This and further subclassification allow physicians to provide prognostic information. A few patients will have lesions amenable to surgical correction, or endocrinologic…
Article
Religion and Illness An Outline of Their Relationship
ABSTRACTReligion serves at least three functions for the sick or dying patient. (1) It provides a theoretical framework in which to make sense of illness and mortality by understanding them as punishment, education, purification, sacrifice, or mystery, and it does so without denying the reality of these experiences. (2) It…