ABSTRACT: Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff principle) is an excellent means of managing many patients with altered bladder function, especially those with good bladder volume and low pressure. Motivated patients unable to perform urethral catheterization because of paresis or other reasons now have a…
ABSTRACT: Diabetic nephropathy is the most common cause of end-stage renal disease in the United States. This review focuses on (1) the problem of diabetic nephropathy, (2) hypertension in patients with diabetes mellitus, (3) the pathophysiology of diabetic nephropathy, and (4) therapeutic methods designed to provide renal protection to patients…
ABSTRACT: During the past decade, the annual incidence of patients entering long-term dialysis for end-stage renal disease (ESRD) has been increasing, while mortality from stroke and coronary artery heart disease has been decreasing. In the Southeast, hypertension is the most common cause of ESRD, followed closely by diabetes mellitus occurring…
ABSTRACT: Eleven patients, aged 36 to 55 years, with silicone breast implants had episodes of severe chest pain similar to heart attacks 6 weeks to 7 years after breast implantation; one patient had a severe attack 1 month after explantation. The chest pain, which was not related to physical exertion,…
ABSTRACT: End-stage renal disease has become a major and costly public health problem owing primarily to an accelerating incidence of renal failure from hypertension and diabetes. In both disease groups the primary problem appears to be persistent elevation of blood pressure, and there is evidence that, early and effective blood…
ABSTRACT: In this study of 503 consecutive cases of amebic liver abscess documented during a 21-year period, 110 (22%) were complicated by perforation. Perforation sites included pleuropulmonary structures (79 cases, 72%) subphrenic space (15 cases, 14%); and peritoneal cavity (11 cases, 10%). The less common sites were the thoracic and…
ABSTRACT: Interleukin-1β (IL-1β) a proinflammatory cytokine associated with adult lung diseases, may play a role in the development of bronchopulmonary dysplasia (BPD). Concentrations of IL-1β were measured in bronchoalveolar lavage fluid from 17 infants on day 1 of life and in 18 infants intubated until day 14. IL-1β was detected…
ABSTRACT: Intrathoracic desmoid tumors are extremely rare, only 12 cases having been reported in the literature. In the 14-year-old girl we describe, a desmoid tumor manifested as an intrathoracic mass. Computed tomography of the chest after administration of intravenous contrast medium showed a large intrathoracic heterogeneous mass and lysis of…
ABSTRACT: Isolated central nervous system (CNS) mucormycosis is a rare but life-threatening infection. We report a case of bilateral frontal lobe mucormycosis in a previously healthy woman. Intravenous drug use was the most likely route of infection. After treatment with surgical drainage and amphotericin B, she survived but suffered permanent…
ABSTRACT: Parenteral iron therapy is infrequently required but generally well tolerated. We present a case in which intravenous iron dextran was successfully given to a patient who had an anaphylactoid reaction to the test dose. After pretreatment with methylprednisolone, diphenhydramine, ephedrine, and dextran 1, 2 g of iron dextran were…
ABSTRACT: Progressive renal failure is conditioned by a number of factors, including type of renal disease, sex, level of arterial pressure, insulin deficiency and/or hyperglycemia in diabetes mellitus, and dietary protein intake. Elevated arterial pressure may cause a progressive renal disease, hypertensive nephrosclerosis, and accelerate the rate of progression of…
ABSTRACT: The hypothesis that dietary protein restriction slows the rate of progression of chronic renal disease has been tested in four large clinical trials, the largest and most elegant of which was the Modification of Diet in Renal Disease (MDRD) study conducted recently in the United States. During these trials…
ABSTRACT: The Patient Self-Determination Act became effective in December 1991 and mandates that patients be given information about legal rights regarding living wills and durable powers of attorney for health care. We investigated the impact this law has had on hospitals, medical personnel, and patients. We conducted a survey of…
ABSTRACT: This review will address five selected conditions associated with variable degrees of renal insufficiency or renal failure. Early diagnosis, usually possible in the office setting, should encourage early treatment and/or referral that will be rewarded by substantial improvement or return of normal renal function. Hypertensive nephrosclerosis, particularly among black…
ABSTRACT: Uterine rupture occurs in less than 1% of pregnancies. The literature over the past several years confirms the safety of the low transverse uterine scar. We report a case of spontaneous rupture of a low transverse cesarean scar at 36 weeks' gestation, resulting in fetal death.
ABSTRACT: We designed a study to assess the personal gun ownership and safety practices of trauma center workers in Birmingham, Alabama. Survey questionnaires administered to nurses, physicians, and other workers in pediatric and adult trauma centers showed that two thirds (65%) owned a gun and 56% owned a handgun. Gun…
ABSTRACT: Zenker's diverticulum is an unusual site of origin for clinically significant upper gastrointestinal hemorrhage. Only three such cases have been previously documented. We report a case of massive upper gastrointestinal bleeding from a Zenker's diverticulum seen as hemoptysis and associated with chronic ingestion of one aspirin tablet every other…
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