SMJ // June 1989, Volume 82 - Issue 6
Commentary
SUBCLINICAL HYPOTHYROIDISM
Primary Article
Clinical Significance of Mildly Elevated Thyrotropin Levels With Normal Thyroxine Levels
ABSTRACT:The meaning of minor elevations in the thyrotropin level (< 10 mIU/ml) in association with a normal thyroxine level has been questioned. Although such findings are presumed to be indicative of subclinical hypothyroidism, consideration of other causes can pose problems with diagnosis. We investigated the clinical significance of equivocal elevation…
Primary Article
Normotension With Decreased Plasma Renin Activity and Low Serum Ionic Calcium Levels A Prehypertensive State?
ABSTRACT:We studied the relationships between the renin-angiotensin-aldosterone system and calcium and magnesium levels in both serum and urine in 51 volunteer normotensive subjects, divided into two groups. Group 1 was made up of the 25 subjects whose levels of plasma renin activity were the lowest (1.93 ± 0.70 ng/ml/hr). Group…
Primary Article
Are All Neonatal Seizures True Epileptic Seizures?
ABSTRACT:The study of neonatal seizures, using time-synchronized video and electroencephalographic/polygraphic monitoring, has challenged the concept that all abnormal stereotypic behavior and motor activities in neonates should be considered epileptic. The use of anticonvulsants for the treatment of nonepileptic phenomena is inappropriate. In recent years, the etiologic distribution has changed: cerebrovascular…
Primary Article
Extracorporeal Membrane Oxygenation as Treatment of Severe Meconium Aspiration Syndrome
ABSTRACT:Meconium aspiration syndrome (MAS) is a common cause of morbidity and mortality in neonates. Chemical pneumonitis can lead to persistent pulmonary hypertension of the newborn (PPHN) with irreversible hypoxia and death. Extracorporeal membrane oxygenation (ECMO) for the treatment of severe PPHN became available at the Ochsner Foundation Hospital in September…
Primary Article
Nosocomial Sepsis in the Neonatal Intensive Care Unit
ABSTRACT:During a 12-month study of the causes of and risk factors for nosocomial sepsis in a neonatal intensive care unit (NICU), we detected 23 episodes of nosocomial sepsis in 20 of the 155 infants at risk who were hospitalized in the NICU for at least one week. The associated mortality…
Primary Article
Clinical Significance of Bacillus Species Isolated From Blood Cultures
ABSTRACT:To determine the clinical significance of blood isolates of Bacillus, we reviewed all blood cultures obtained at North Carolina Memorial Hospital between 1981 and 1985. Over the five-year study period the number of patients (incidence per 10,000 hospital admissions) from whom Bacillus was isolated increased from 4.97 in 1981 to…
Primary Article
High-Dose Corticosteroid Therapy for Pneumocystis carinii Pneumonia in Patients With Acquired Immunodeficiency Syndrome
ABSTRACT:Overwhelming Pneumocystis carinii pneumonia (PCP) in patients with acquired immunodeficiency syndrome (AIDS) carries a poor prognosis. Patients who require mechanical ventilation have up to a 90% mortality rate despite vigorous treatment. Although there are theoretic contraindications to steroid use in severely immunocompromised individuals, case reports of AIDS patients with PCP…
Primary Article
Netilmicin Sulfate as Single-Agent Therapy for Pseudomonas Infections
ABSTRACT:In a prospective multicenter clinical trial, 69 patients with Pseudomonas infections were treated with netilmicin sulfate as the only antipseudomonal antibiotic. Clinical resolution or improvement was observed for 81% of the infections, whereas 19% were considered treatment failures. The bacteriologic response, based on follow-up culture results, showed elimination of Pseudomonas…
Primary Article
Osteomyelitis of the Skull Base
ABSTRACT:Osteomyelitis of the temporal bone often begins with minor trauma and results in a persistent external otitis. I report my experience with ten patients managed with combined medical and surgical therapy, and discuss the progression of the disease process and how it affects the duration of antibiotic therapy and the…
Primary Article
Helping Family and Patients Decide Between Home Care and Nursing Home Care
ABSTRACT:Good home health and institutional care alternatives are important for the care of aging patients. The physicians assistance is crucial in helping family and patients decide on the optimal level of care. Knowledge of the patients medical status, family and patient resources and preferences, cost factors, and the patients functional…
Primary Article
Rigid Facial Skeletal Fixation Advances in Treatment
ABSTRACT:Rigid facial skeletal fixation with miniplates, combined with craniofacial reconstruction techniques, has dramatically changed the treatment of facial fractures. Our use of these newer techniques in 142 facial fractures treated during the past 14 months has resulted in improved aesthetics and function, with a low complication rate. Advances over other…
Review Article
Proximal Gastric Vagotomy for Duodenal Ulcer Disease
ABSTRACT:Proximal gastric vagotomy is a useful operation for duodenal ulcer disease that is intractable to medical management. It is also useful in selected patients with acute duodenal ulcer perforation. We present an overview of the indications for proximal gastric vagotomy, along with its results. The major benefits of proximal gastric…
Current Concepts
Surgical Management of Epilepsy
ABSTRACT:About 300,000 people in the United States suffer from medically uncontrolled focal epilepsy. It is estimated that about 40,000 of these patients are candidates for surgery. Underuse of surgical treatment of epilepsy is reflected by the fact that only about 1% of these candidates are operated on. Candidates for ablative…
