ABSTRACT: A hypereosinophilic syndrome associated with dermatitis has been observed rarely in association with HIV infection. We describe the case of a young man with AIDS who came to us with a diffuse cutaneous eruption, fever, angioedema, eosinophilia, and a mildly elevated serum IgE level. No allergic or infectious cause…
ABSTRACT: Between 1986 and 1990, rates of primary and secondary syphilis increased 134% in rural counties in the South. Reasons for the increases are speculative. During the. 14 months ending in October 1992, outbreaks in four eastern Texas counties provided an opportunity to characterize syphilis in rural Texas. We reviewed…
ABSTRACT: Birth defects in live-born infants were documented for 2 years in Jefferson County, Alabama (USA)—1986 and 1987—and in Uppsala County, Sweden—1985 and 1986. A total of 27,561 live births (9,179 white male, 8,728 white female, 4,883 black male, and 4,771 black female infants) occurred in Jefferson County; 6,896 live…
ABSTRACT: Endometriosis of abdominal wall scars is rare, especially in the postmenopausal woman. However, it must be considered as a possible cause of any abdominal wall mass in a woman who has had previous pelvic surgery and who is of reproductive age or taking exogenous hormones.
ABSTRACT: Formerly, for gastrostomy, we passed a No. 18 French red rubber catheter through the antrum of the stomach with the tip directed toward the fundus. We used this method with great success, both for decompression and feeding. Recently, a tube made of silicone rubber and thus resistant to gastric…
ABSTRACT: Gefotaxime is a third-generation cephalosporin with excellent in vitro antimicrobial activity against Neisseria gonorrhoeae, including ß-lactamase-producing strains. A single 1-g intramuscular dose is suitable for the treatment of uncomplicated gonorrhea. We conducted an open, randomized study to evaluate the efficacy, safety, and cost impact of a lower dose (500…
ABSTRACT: Heal disease in the United States is usually caused by Crohn's disease. Accumulating reports, however, show that nonsteroidal anti-inflammatory drugs (NSAIDs) may cause ileal and colonic inflammation and strictures that may mimic inflammatory bowel disease and other conditions. A patient is described with weight loss, loose stools, and terminal…
ABSTRACT: Invasive disease due to Moraxella catarrhalis is rare and has been associated mostly with immune deficiency conditions. We describe the first case of M catarrhalis bacteremia and preseptal cellulitis in an immunocompetent infant. This organism may be evolving from one with low pathogenicity to one with increased pathogenicity.
ABSTRACT: Mirizzi's syndrome is a partial obstruction of the biliary tree caused by a stone impacted in the cystic duct, with or without development of a cholecystobiliary fistula. We report our experience with five cases and review current methods of diagnosis and management. Preoperative diagnosis greatly facilitates management. Diagnosis may…
ABSTRACT: Our prospective, standardized cohort study was designed to assess the presence of alpha wave intrusions during non-rapid eye movement sleep (alpha-delta sleep) and its relationship to fibromyalgia, major depression, and chronic fatigue syndrome (CFS) in patients with a chief complaint of chronic fatigue. The study group comprised 30 consecutive…
ABSTRACT: Pneumocystis carinii pneumonia has been the most common life-threatening opportunistic infection in patients with acquired immunodeficiency syndrome. With a better understanding of the natural history of HIV infection, however, we have come to realize that prophylaxis against P carinii can prevent the majority of such pneumonias. In this article,…
ABSTRACT: Postoperative pain is commonly treated with significant doses of narcotics, occasionally resulting in side effects including nausea, pruritus, and respiratory depression. One potential advantage of regional anesthesia is profound postoperative analgesia that reduces exposure to potent narcotics. To evaluate the efficacy of two longacting local anesthetics, bupivacaine and etidocaine,…
ABSTRACT: Recent studies have suggested that steroid therapy may reduce the morbidity and mortality of HIV-associated Pneumocystis carinii pneumonia (PCP) in a select population of patients. However, the risks of steroid therapy for this group have not been well defined. We describe the case of a patient admitted with severe…
ABSTRACT: Regular physical activity increases a person's ability to perform daily activities more efficiently, reduces the risk of specific chronic diseases, including coronary artery disease, and lowers death rates in general. The Healthy People 2000 Physical Activity and Fitness Objectives underscored the importance of monitoring and tracking the prevalence of…
ABSTRACT: The medical literature is replete with reports on traumatic aortic transection. These reports have delineated many factors regarding the morbidity and high mortality of this ominous injury. Most reports are reviews of the collective experience of a single institution over a period of years. It is likely that many…
ABSTRACT: The purpose of this study was to evaluate the value of preoperative electrocardiography in predicting postoperative cardiac complications. Four hundred eighty-one patients having elective surgery were eligible. The patients' ages and specific ECG findings were recorded preoperatively. The patients had prospective follow-up from admission to discharge for the development…
ABSTRACT: The use of an episiotomy for vaginal delivery is a controversial topic in modern obstetrics. If one is done, however, correct technique and appropriate suture material are important. On the LSU Obstetrics Service, the usual midline episiotomy has traditionally been closed with 2-0 chromic suture. Theoretically, the use of…
ABSTRACT: This report of disseminated pneumocystosis in an HIV-infected patient describes an unusual presentation consisting of splenic disease mimicking lymphoma, absence of typical roentgenographic signs of pulmonary or disseminated pneumocystis, and absence of use of aerosolized pentamidine. Because of these factors, a diagnosis of disseminated pneumocystosis was not considered. Our…
ABSTRACT: This study is a 2-year follow-up to a 1987-1988 survey of North Carolina hospitals regarding hospital utilization by patients with acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection. Almost 99% of the state's hospitals participated in the resurvey for the fiscal year 1989-1990. The number of general…
ABSTRACT: Three patients with atypical manifestations of cat-scratch disease (CSD) had the diagnosis supported by a newly available serologic assay for antibodies to Rochalimaea henselae. Previously, CSD has been a diagnosis of exclusion because no confirmatory test was readily available. Atypical or severe cases of CSD have often required detailed…
ABSTRACT: To define the clinical presentation of histoplasmosis among hospitalized children, we reviewed the charts of patients treated for histoplasmosis at Vanderbilt University Children's Hospital during the years 1968 through 1988. Thirty-five patients with histoplasmosis diagnosed by culture, pathologic examination, or serologic testing were identified, including 29 patients (83%) with…
ABSTRACT: To determine the accuracy of four pulse oximeters during mild and moderate arterial hypoxemia, we produced stepwise arterial blood desaturation in 25 healthy, nonsmoking volunteers by adjusting the inhaled oxygen concentration. At plateaus of <80%, 85%to 90%, 90% to 95%, and 95% to 100%, pulse oximetry saturation (SpO2) was…
ABSTRACT: To determine the epidemiologic characteristics of hospital-acquired infections (HAI) in pediatric burn patients, we retrospectively reviewed hospital charts of pediatric burn patients from two similar burn units. All patients less than 18 years of age admitted to the burn unit from January 1, 1980 to July 10, 1988, were…
ABSTRACT: To make informed career decisions, physicians must acquire a basic knowledge in medical management and health care economics as they evaluate the potential survival and growth of a primary care practice. Health care providers considering a specific community and local leaders and hospital administrators attempting to recruit internal medicine…
ABSTRACT: Using a randomized, double-blind, placebo-controlled, parallel, single-dose, single-center, 6-hour study, we compared the analgesic response and tolerability of oral ketorolac tromethamine and intramuscular morphine sulfate and placebo. The study group comprised 176 patients with moderate, severe, or very severe pain after hip or knee surgery at a teaching hospital….
ABSTRACT:Bone marrow transplantation has become a beneficial and curative technique used in treatment of patients with different hematologic conditions. It has become widely used at our institution for hematologic malignancies and certain resistant solid tumors; However, this treatment can result in immunosuppression, with an increased chance of infection. The purpose…
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