ABSTRACTEnterococci frequently cause endocarditis and are the most common gram-positive isolates in polymicrobial bacteremia. We report three cases of polymicrobial endovascular infections at a single institution during a 12-month period; the enterococcal isolates were highly resistant to penicillins. These cases comprised 18% of all enterococcal endovascular isolates during the same…
ABSTRACTFine needle aspiration specimens from 29 patients with bone and soft tissue neoplasms were analyzed by flow cytometry for DNA index and cell cycle analysis to determine whether such studies were helpful in cytologic diagnosis. Of 15 cases initially cytologically diagnosed as benign, 14 had a DNA index of 1.0,…
ABSTRACTI believe that the circumstances in which one learns of being infected with human immunodeficiency virus (HIV) can form a pattern that may either hasten or postpone the physical and psychologic progress of HIV to full-blown AIDS. The experience of learning about one's seropositivity from one's physician sets the stage…
ABSTRACTIn this era of occurrence screening, increased documentation of surgical resident supervision, and overall efforts to alter quality of patient care through increased documentation, an in-house quality assurance data base can greatly facilitate these activities. To establish a data base, 6241 operative procedures over a 15-month interval were logged into…
ABSTRACTIntrinsic age-related structural and functional changes in the skin, independent of sun-induced damage, directly affect wound healing in the elderly. These alterations, as well as concomitant medical illness, pharmaceutical intake, and dietary changes, result in delayed wound healing, decreased ultimate tensile strength, and increased rates of wound dehiscence, ecchymosis, tape-strip…
ABSTRACTNeurologic manifestations of vitamin B12 deficiency are protean, including neuropathy, depression, and dementia. We present evidence to dispel confounding myths about vitamin B12 deficiency. Hematologic indices are normal in up to 30% of patients with vitamin B12 deficiency, and results of the Schilling test may be normal in patients with…
ABSTRACTReviewed herein are the long-term weight loss outcomes of three fairly recent major modifications of standard dietary therapy for obesity. Appraised separately and in combination, these therapeutic approaches are very low calorie diets (VLCD), behavior modification, and exercise. The weight loss results from VLCD are impressive for only the first…
ABSTRACTThe cohort for this study included 39 patients, between the ages of 8 and 20 years, who had had thoracotomy. Postoperative analgesia was provided by one of three techniques: intravenous narcotics (20 patients), thoracic epidural catheter (10 patients), or interpleural analgesia (IPA) (nine patients). Both IPA and epidural analgesia were…
ABSTRACTThe hospital chaplain is a relatively new member of the health care team, and there is little objective information on the chaplaincy's role in the hospital. To evaluate the chaplain's role, I collected information from the chaplain's daily logs and from a medical staff/parent questionnaire on the use of the…
ABSTRACTWe evaluated the medical history, physical examination, and laboratory tests done on 245 patients with laparoscopically proven ectopic pregnancies. The absence of abdominal pain was the only clinically useful negative predictive value (91%) regarding tubal rupture. Although mean levels of serum human chorionic gonadotropin (hCG-β subunit) were significantly higher in…
ABSTRACTWe report three cases of emphysematous pyelonephritis, all of them associated with perinephric emphysema, and one case of emphysematous pyelitis to demonstrate the value of computerized tomography (CT) in both diagnosis and patient management. The differentiation between air in the collecting system (emphysematous pyelitis), air within the parenchyma (emphysematous pyelonephritis),…
ABSTRACTWe retrospectively reviewed 443 patients who had cardiopulmonary resuscitation (CPR). The focus of the study was to discover what preexisting factors should be assessed to determine the probability of survival. There were 88 successes out of 340 cases (25.9%). The absence of a previous myocardial infarction (MI), shock, partial pressure…
ABSTRACTWe surveyed 178 orthopedic physicians in the Washington, DC, area to ascertain the effect on patient care of previous education in the area of drug and alcohol issues. The return rate was 75%. Of the respondents, 99% were male, average age was 46.7 years (± 9.3), and average number of…
SUMMARYWe have presented a study of 125 patients treated for incisional hernia. This complication occurred more frequently in women (81 %), and gynecologic and obstetric procedures were responsible for 58%. The method of surgical repair in all cases was peritoneal-aponcurotic transposition. The 5-year recurrence rate was less than 3%.
SUMMARYWe have reported the case of a patient with neuroleptic-induced akathisia who had rapid amelioration of his symptoms after treatment with the highly lipophilic β-blocker propranolol. His symptoms had previously failed to respond to traditional pharmacologic treatment. There is clearly a need for more double-blind studies to assess the efficacy…
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