ABSTRACT Background.A retrospective study was conducted at a university hospital to determine the efficacy of conjugated estrogen in reducing blood product transfusion during orthotopic liver transplantation. Methods.The charts of patients who had orthotopic liver transplantation were retrospectively reviewed. Only those having a reaction time > 30 mm or 15 minutes…
ABSTRACT Background.Frailty prevention and remedial programs based on exercise, hormone replacement, and vitamin supplementation are becoming available for use with older patients, but success of these programs depends largely on seniors' willingness to participate. Methods.We evaluated preferences for specific aspects of these programs using a sample of 359 older persons…
ABSTRACT Background.Homeless people with mental illness have relatively high rates of human immunodeficiency virus, comorbid antisocial personality disorder, and may be homeless more frequently and for greater lengths of time. All of these factors may increase the risk of tuberculosis. Methods.Our study was done to ascertain if homeless men with…
ABSTRACT Background.Physicians often treat patients with physical illnesses that have a functional component. Investigators have discovered that many of these patients have unresolved emotional problems associated with histories of trauma and abuse. Methods.Abused and traumatized patients with medical complaints often seek medical help. Empathic nonpsychiatrist physicians play an important role…
ABSTRACT Background.Reactive airways dysfunction syndrome (RADS) is characterized by persistent bronchial hyperreactivity and asthmatic symptoms in a previously healthy individual after a single intense exposure to an irritant fume, vapor, or gas. On October 23,1995, a cloud of dinitrogen tetroxide (N2O4) escaped from a railroad tanker car in Bogalusa, Louisiana,…
ABSTRACT Background.Screens for anemia are among the most commonly done laboratory tests in children. The red cell distribution width (RDW) has been proposed as a diagnostic aid in the evaluation of pediatric anemias, but no prospective studies have been published describing its use. Methods.A screening hematocrit determination done at the…
ABSTRACT Background.Superficial fungal infections of the skin are among the most common infections encountered in medicine. The diagnosis is easily confirmed with simple officebased procedures. In certain clinical situations, the diagnosis can be elusive. Methods.We analyzed clinical data on five patients who came in referral for treatment of a recalcitrant…
ABSTRACT Background.The abdominal compartment syndrome (ACS) is a newly appreciated and potentially fatal consequence of increased intra-abdominal pressure. It can be due to either trauma or surgery, as well as numerous medical conditions. Prolonged, unrelieved elevation of intra-abdominal pressure can produce pulmonary compromise, renal impairment, cardiac failure, shock, and death….
ABSTRACT Background.The number of methicillin-resistant Staphylococcus aureus (MRSA) infections in the hospital setting is increasing but little is known of its prevalence in the community. In a 1986-1987 study, the prevalence in dermatology outpatient clinics was < 0.9%. This study reports changes in the same facilities from 1988 through 1996….
ABSTRACT Background.The objectives of this study were to survey compliance and identify factors that influence continued participation with periodic colon cancer screening guidelines once patients are seen for their first screening. Methods.The study group consisted of 95 patients who had initial fecal occult blood tests (FOBT) and flexible sigmoidoscopy (FS)…
ABSTRACT Background.We have previously reported a significant increase beginning in the late 1980s in the incidence of invasive disease due to group A β-hemolytic streptococci (GABS) in children admitted to our hospital. To determine subsequent trends in epidemiology, we have continued to monitor cases. Methods.We prospectively monitored cases of invasive…
ABSTRACT Background.We surveyed emergency medicine, practice systems in Louisiana. Methods.We surveyed 105 emergency department (ED) directors in Louisiana requesting annual ED volume, hospital type, physician coverage scheduled, type of documentation used, use of physician extenders, use of minor care or observation areas, and employment status of emergency physicians. Results.Directors of…
ABSTRACT Background.While most chronic medications can be safely continued in the perioperative period, decisions regarding certain medications remain controversial. Methods.We mailed a questionnaire to all 150 anesthesiology program directors in the United States, with 113 (75%) responding. Opinions regarding preoperative discontinuance or modification of selected medications were assessed. Results.Antiplatelet agents…
ABSTRACT: A case of recurrent hemorrhagic catamenial hemopneumothorax resulting from diffuse pleural endometriosis is presented. The pathogenesis of this rare entity is discussed, and the immediate and long-term surgical and medical options for therapy are reviewed.
ABSTRACT: Bilateral pulmonary nodules in an immunocompromised host may offer a diagnostic dilemma. We present a case of a human immunodeficiency virus positive patient with history of intravenous drug abuse (IVDA) who was incidentally found to have bilateral multiple pulmonary nodules. She was diagnosed as having nodular pulmonary amyloidosis, presumably…
ABSTRACT: Endogenous or metastatic bacterial endophthalmitis is a severe, sight-threatening infection of the vitreous humor that is only rarely due to Serratia marcescens. We report the case of a hemodialysis-dependent diabetic patient who had endogenous endophthalmitis of the right eye due to S marcescens, presumably from an infected dialysis catheter….
ABSTRACT: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for many conditions including arthritis. A rare complication of their use is diaphragm-like strictures of the small and large intestines. A 65-year-old woman with a 12-year history of arthritis came to us with a 35-pound weight loss and anorexia. She had been…
ABSTRACT: The patient described had generalized tetanus and required anesthetic care during debridement of a lower extremity wound. Despite widespread vaccination, which limits the incidence of the disease in the United States, tetanus remains a major health problem in developing countries. The pathophysiology of tetanus, its clinical manifestations, and current…
ABSTRACT: Ventilation-perfusion lung scans are commonly done in the diagnosis of pulmonary thromboembolic disease. We describe a patient in whom absent perfusion involving an entire lung was due to bronchogenic carcinoma. Echocardiography and chest computed tomography were essential tests in evaluating a nonembolic etiology.
ABSTRACT: Wegener's granulomatosis is a serious systemic vasculitis that needs to be diagnosed promptly to limit morbidity and mortality. Atypical presentations of this disease are not uncommon. This case illustrates a rare manifestation of Wegener's granulomatosis (ie, perirectal abscess) and the value of the antineutrophil cytoplasmic antibody in conjunction with…
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