ABSTRACTAlthough the incidence of AIDS-related Kaposi's sarcoma (KS) has been declining in recent years, the uncommon and unfortunate progression to symptomatic pulmonary KS still represents a significant therapeutic challenge. Pulmonary KS generally occurs in the late stages of the disease. Review of the literature and of the experience of the…
ABSTRACTAt 2 months of age, 145 infants were randomized to receive either a two-component acellular pertussis vaccine [lymphocytosis-promoting factor (LPF)/filamentous hemagglutinin (FHA)] or standard whole-cell pertussis vaccine, each combined with diphtheria-tetanus toxoids, as their primary immunization series. Of the 132 subjects (91%) who completed the study, those receiving the acellular…
ABSTRACTAugmentation mammoplasty has been said to reduce the risk for subsequent development of mammary gland carcinoma, but it may confer a worse prognosis should breast cancer develop. Nine patients who had breast cancer after augmentation mammoplasty were treated at the Ochsner Foundation Hospital and Clinic. The mean interval between augmentation…
ABSTRACTDuring a time when gastric cancer in the United States appears to be decreasing in incidence and occurring primarily in older individuals, a 12-year review of our experience (1977 to 1989) has identified a disproportionate number of gastric cancers in the young black population. In this series of 97 patients…
ABSTRACTHealing wounds and preventing amputations in diabetic patients is a challenge. Baptist Hospital in Nashville, Tennessee, developed an outpatient Wound Care Center program to treat patients with chronic wounds. This comprehensive program includes wound assessment, vascular studies, revascularization, antibiotic therapy, wound debridement, a topical growth factor solution of platelet-derived wound…
ABSTRACTI report a new, extremely rapid, noninvasive technique for the diagnosis of coronary artery occlusion. An ultrafast x-ray cine-computed tomographic scanner (cine-CT) allows visualization of the coronary arteries without injection of contrast material. The arteries can be seen because of the CT contrast between blood in the arteries and the…
ABSTRACTIn our large single-specialty cardiology practice, we implemented a lipid management program based on the recommendations of the Expert Panel of the National Cholesterol Education Program and the Helsinki Heart Study. This program used allied health professionals and customized computer software to deliver efficient, comprehensive care to the 1214 patients…
ABSTRACTOne of the more difficult psychopharmacologic aspects of current clinical psychiatry is finding a neuroleptic drug that adequately treats delusional states. Furthermore, many chronic schizophrenics remain resistant to standard antipsychotic medication, and clozapine is effective in only 30% to 50% of refractory cases. In addition, clozapine has several serious side…
ABSTRACTPublic opinion, the federal government, and financial constraints are demanding that the cost of medical care be controlled. Physicians are keenly aware of this problem. We believe that the contribution of fine needle aspiration to cost containment has not yet been fully recognized. We advocate fine needle aspiration as the…
ABSTRACTRecent data suggest that the homeless and those with chronic mental illness may be at increased risk for HIV infection. A review of the recent literature reveals insufficient rigorously collected data to identify with confidence any particular subgroup of chronically mentally ill patients at increased risk. Nonetheless, it seems reasonable…
ABSTRACTRecombinant human granulocyte colony-stimulating factor (G-CSF) is a nonglycosylated protein produced in Escherichia coli using recombinant DNA technology. G-CSF was first defined in vitro as a relatively selective stimulator of pure granulocyte colonies from normal marrow and as a factor that induces differentiation of leukemic cell lines. Additional studies have…
ABSTRACTSince 1974 the United States Air Force has treated more than 300 cases of carbon monoxide poisoning with hyperbaric oxygen (HBO). Fourteen of the patients treated were younger than 2 years of age. In all but one case, poisoning resulted from a faulty home heating unit; in all but two…
ABSTRACTSix patients with Marfan's syndrome were included in a study to determine the effect of β-blockers on progressive aortic dilatation. Patients' histories and results of physical examination, chest radiogram, electrocardiogram, and echocardiogram are reported. Patients ranged in age from 5 years 8 months to 14 years; one was black, five…
ABSTRACTSyringe and needle exchange (SANE) programs appear to be a pragmatic approach to reducing the rising incidence of human immunodeficiency virus (HIV) infection among intravenous drug users (IVDUs). One purported indication of the effectiveness of SANE programs is lower prevalence rates of cases of AIDS or of HIV seropositivity in…
ABSTRACTThe benefits and problems of comprehensive screening mammography are well recognized. Using, the advantages inherent in a unified medical community, we designed a low-cost screening program with emphasis on prompt work-up, continuity, and conservative management of lesions with low probability of being malignant. Its goals were to duplicate the good…
ABSTRACTThe efficacy and safety of cefixime, the first oral third-generation cephalosporin, were evaluated in a multicenter clinical trial involving 118 adult patients with acute sinusitis or acute exacerbations of chronic sinusitis. Patients received a single daily dose of 400 mg of cefixime for a mean duration of 10 days; 106…
ABSTRACTThe first large-scale syringe and needle exchange (SANE) programs were established in The Netherlands and in the United Kingdom (UK) about 8 years ago. Since then, SANE programs have been established in Australia, Sweden, Canada, and the United States. To date, the most useful data concerning the impact of these…
ABSTRACTTo determine the prevalence of vulvar ulcerations in girls with myelocytic leukemia receiving chemotherapy, we reviewed the records of 108 patients. At the time of diagnosis, 69 patients were prepubertal, and the remaining 39 patients were postpubertal. Genital ulcerations were seen in 11 girls (10%), all of whom were white…
ABSTRACTWe analyzed 51 proven cases of endometrioma and characterized the sonographic patterns as purely cystic, cystic with few septations or minimal debris, complex combinations of cystic and solid elements, and largely solid. In this series 30% were purely cystic, 62% showed various degrees of complexity with septation or debris, and…
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