ABSTRACTA recent (and continuing) epidemic of chancroid in Houston has included morphologic variation in the disease, including so-called dwarf, classic, giant, transient, follicular, phagedenic, and pseudogranuloma inguinale types. Most cases were clearly acquired by unprotected sexual encounters with local prostitutes. The strain of Haemophilus ducreyi responsible for this outbreak was…
ABSTRACTA resurgence of acute rheumatic fever (ARF) has been reported in many areas of the United States in recent years. We retrospectively reviewed the medical records of inpatients with a new diagnosis of ARF from 1982 through 1988 at a children's hospital that serves a six-state referral area in the…
ABSTRACTA review of the literature and our experience suggest that attention deficit hyperactivity disorder does not necessarily disappear in adolescence but may persist into adult life. Detection of the disorder later in life may be made more difficult when it is masked by other diagnostic labels. Once the disorder has…
ABSTRACTA total of 11 head and neck paragangliomas were the subject of pathologic study, including histologic, immunohistochemical, and DNA flow cytometric analyses. We cannot absolutely predict aggressive clinical behavior using histologic parameters alone, but we can use such parameters to segregate patients into low-risk and high-risk groups. Several trends were…
ABSTRACTDeep femoral to anterior tibial artery bypass is a reconstructive technique occasionally applicable when more conventional attempts at revascularization of the distal portion of the leg have failed. Three such patients, in whom the anterior tibial was the only distal patent branch of the popliteal artery, had severe symptoms of…
ABSTRACTFifty-five pregnant patients referred to my colposcopy service from 1985 to 1990 for biopsy-proven mild dysplasia were entered into a program of serial evaluations, including Pap test, colposcopy, and directed biopsy if indicated. The evaluations were done every 12 weeks during pregnancy and at 6 weeks postpartum to rule out…
ABSTRACTGastrointestinal bleeding accounts for 2% of all adult hospital admissions each year. Angiodysplasia is one of the most frequently reported causes of lower gastrointestinal bleeding. In 80% of patients with bleeding angiodysplasia, the bleeding will stop spontaneously, but will often recur. Although angiography may detect bleeding in 86% of actively…
ABSTRACTHysterosalpingography (HSG) has assumed a diagnostic and possibly therapeutic role in the evaluation of the infertile couple. The procedure is done using either an oil-based (OBCM) or a water-based (WBCM) contrast medium. Data from several retrospective studies suggest that higher pregnancy rates may be achieved when OBCM is used. Interpretation…
ABSTRACTMorbidly obese patients' perceptions of obesity-related prejudice arid discrimination were assessed before and 14 months after operation for obesity. Preoperatively, the 57 consecutive patients perceived overwhelming prejudice and discrimination at work, within the family, and in public places. After a weight loss of more than 45.5 kg (100 lb), these…
ABSTRACTSlight albuminuria predicts clinically significant nephropathy in patients with insulin-dependent diabetes mellitus (IDDM) and early death in patients with non-insulin-dependent diabetes mellitus (NIDDM). This study compares four commercially available methods for measuring low concentrations of urinary albumin. We tested random spot urine specimens from 50 nondiabetic volunteers and 100 diabetic…
ABSTRACTTo assess morbidity, mortality, and benefit associated with percutaneous endoscopic gastronomy (PEG), we retrospectively studied 42 patients who had had PEG. Mortality was exceptionally high during the first 60 days after PEG (43%), and then stabilized. In nearly half of the cases (20/42) the PEG tube was removed during the…
ABSTRACTWe asked 39 physicians providing primary care for a mostly minority patient population to respond to a questionnaire concerning their attitudes and behavior toward AIDS risk assessment and preventive counseling and to indicate their beliefs concerning patients' knowledge and behavior. Most of the 36 physicians who responded (92%) agreed that…
ABSTRACTWe assessed two interventions designed to improve the care of patients with diabetes mellitus by documenting the complications of their disease. These were a flow sheet, included with outpatient medical records, and a weekly patient education clinic, in which a nurse educator provided individualized instruction to patients with diabetes. Physician…
ABSTRACTWe have reviewed our experience with 71 patients who had a femorofemoral bypass for unilateral iliac artery occlusion or stenosis. We analyzed morbidity, mortality, initial relief of symptoms, early patency, and long-term primary and secondary patency; and we attempted to identify the cause of graft failure. The overall hospital mortality…
ABSTRACTWe reviewed the experience with breast cancer at Wilford Hall USAF Medical Center for the years 1978 through 1988. A total of 868 cases were identified in the Wilford Hall Tumor Registry; overall 5-year and 10-year survivals were 63% and 39%, respectively. Infiltrating ductal carcinoma represented the principal histologic category….
ABSTRACTWould the money spent on treating hypercholesterolemia save more lives if spent elsewhere? How many dollars must be spent on a treatment to make one person live 1 year longer? This cost-effectiveness analysis uses the cost per year of life gained to compare a wide variety of health care interventions…
But if the objection here is that [the Old Myth] was all wrong, and that the race labored under a pointless bondage for centuries, and that the fields of joy ahead in which we will frolic free of our fears about abstinence and continence and scruple in sexuality promise more…
If once a man indulges himself in murder, very soon he comes to think little of robbing; and from robbing he next comes to drinking and Sabbath-breaking, and from that to incivility and Procrastination
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