SMJ // February 1989, Volume 82 - Issue 2
Article
Eye Injury Prevalence and Prognosis by Setting
ABSTRACTAlthough an estimated 1 million Americans suffer ocular injuries each year, the setting of injury and its prognostic implications have not been closely examined. Using data compiled by the Eye Injury Registry of Alabama (EIRA) from 514 cases of serious eye injury, we examined the demographics and prognosis of ocular…
Article
Keratoconjunctivitis Due to Adenovirus Type 8 A Local Outbreak
ABSTRACTAn outbreak of acute keratoconjunctivitis occurred in 24 patients who had visited a private ophthalmology office between July and October 1986. The median from there of the five patients in whom cultures were done. This outbreak illustrates the highly contagious nature of adenovirus infection and the potential for transmission during…
Article
Sleep Apnea Morbidity and Mortality of Surgical Treatment
ABSTRACTWe have analyzed the complications in 132 patients who had surgical treatment of sleep apnea or excessive snoring. In this series there were 34 (26%) complications and two patients (1.5%) died. Complications related to hemorrhage (6%). In the 41 patients who had tracheostomy, complications included hemorrhage from tracheostomy (5%), tracheomalacia…
Article
Evaluation of Antibacterial Sensitivity Testing Methods for Methicillin-Resistant Staphylococcus aureus in a Dermatology Outpatient Population
ABSTRACTOver a period of one year, 1986–1987, 116 strains of Staphylococcus aureus were isolated from patients attending two outpatient dermatology clinics in Houston, Texas. The purpose of this study was to evaluate the adequacy of routine antibiotic sensitivity testing methods for detecting methicillin-resistant Staphylococcus aureus (MRSA). The Kirby-Bauer disk diffusion…
Article
Obstruction of the Small Bowel in the Early Postoperative Period
ABSTRACTTo analyze factors related to etiology, diagnosis, and outcome, we reviewed the records of 26 patients in whom a clinical picture of small bowel obstruction developed within one month after abdominal surgery, The initial operation was an emergency procedure in 20 cases and an exploratory laparotomy after trauma in 11….
Article
Total Joint Replacement Where Are We Today, and Where Are We Headed?
ABSTRACTWith the advent of noncemented total joint prostheses, todays orthopedic surgeons are asking question about the predictability and performance of newer biologically fixed implants. Reported experience to date has failed to document any improved parameters of performance; instead, problems of prolonged convalescence, postoperative pain, and difficulties in revision procedures have…
Article
Lower Limb Embolus A Near-Lethal Disease After Age 75 Years
ABSTRACTBecause it has been suggested that embolectomy increases morbidity and mortality, we reviewed our experience with lower-extremity embolectomy in an elderly high-risk population. Of 153 consecutive patient records reviewed, 69 were sufficiently complete for analysis. Of these patients, 45 were men with an mean age of 80.7 years (range, 75…
Article
Reduction Mammaplasty Central Cone Technique for Maximal Preservation of Vascular and Nerve Supply
ABSTRACTMany types of breast reduction procedures have been described and are now being used. Before 1984, we used variations of the Wise technique, with free grafting of the nipple-areola complex; because of problems with inadequate nipple projection, squareness of the breasts, and decreased nipple sensation, however, we have subsequently used…
Article
Immediate Prediction of Blood Requirements in Trauma Victims
ABSTRACTCurrent recommendations for the management of trauma victims include immediate crossmatching of 4 to 6 units of blood. Unused crossmatched blood is withdrawn from the available blood pool for 48 hours and costs the patient $33 per unit. Growing blood shortages and increasing laboratory costs demands reexamination of this practice….
Article
Significance of a Positive Papanicolaou Smear in a Well Screened Population
ABSTRACTOf 35,937 gynecologic cytology specimens obtained from the cervix or vagina at our institute during a three-year period, 18 (0.05%) were reported as malignant; ten to these 18 (56%) positive results were due to carcinoma arising from sites other than the cervix or vagina. The site of the primary lesion…
Article
Oxytocin, Vasopressin, and Prolactin Responses Associated With Nipple Stimulation
ABSTRACTNipple stimulation by pregnant women close to term results in oxytocin release, as reflected by increased levels of oxytocin in peripheral plasma. This appears to be a specific response, and it does not involve either vasopressin to prolactin release.
Article
Barium Enema Examination Sensitivity in Detecting Colonic Polyps and Carcinomas
ABSTRACTWe analyzed the sensitivity of the barium enema examination in 128 patients with 191 endoscopically proven colonic polyps and 12 carcinomas, relative to patients age, indications, and the type of examination used. Seventy-seven patients (60%) has rectal bleeding, and 51 (40%) patients with 87 lesions, including six carcinomas, did not….
Article
Radionuclide Thyroid Studies Analysis of Use and Correlation With Physical Findings
ABSTRACTWe assessed all thyroid radionuclide studies done at a single institution during one year and evaluated the indication for ordering each study as well as the concordance of study results with those of physical examination. We found that thyroid radionuclide imaging was overused, with at most 66% of scans being…
Article
Autonomously Functioning Thyroid Nodule
ABSTRACTWe report 408 cases of autonomously functioning thyroid nodule (AFTN); 85.5% occurred in female patients, for a male-female ratio of 1:6. Eighty-nine patients (21.8%) were hyperthyroid, 76 of then being female, also yielding a male-female ratio of 1:6. There was a linear increase in the incidence of hyperthyroidism with age…
Article
Factitious Disorder With Physical Manifestations Pitfalls of Diagnosis and Management
ABSTRACTMünchausens syndrome is a chronic form of factitious disorder in which fabricated physical manifestations are used to attain multiple hospital admissions. Patients with this disorder are exposed to unnecessary invasive studies, and their entire life may come to revolve around attainment of hospitalization. In addition, medical personnel are subjected to…
Review Article
Intussusception Revisited Clinicopathologic Analysis of 261 Cases, With Emphasis on Pathogenesis
ABSTRACTIn the ten-year period from 1978 through 1987, 261 patients with intussusception were admitted to Chang Gung Memorial Hospital. The diagnosis was established by barium enema or at laparotomy. The patients were divided into two groups; there were 228 children ranging in age from 1 month to 14 years, and…
Current Concepts
Antenatal Diagnosis of Renal Abnormalities A Review of the State of the Art
ABSTRACTAntenatal diagnosis of fetal abnormalities is an important component of genetic counseling. This paper reviews the indications and techniques of antenatal diagnosis of renal and urinary tract abnormalities, and outlines their follow-up and modes of treatment.