Subject(s)
Pregnancy Complications , Pregnancy , Superior Mesenteric Artery Syndrome , Adult , Aorta/diagnostic imaging , Duodenum/diagnostic imaging , Female , Humans , Intestine, Small/diagnostic imaging , Malnutrition/etiology , Malnutrition/therapy , Mesenteric Artery, Superior/diagnostic imaging , Nutrition Therapy/methods , Remission, Spontaneous , Superior Mesenteric Artery Syndrome/diagnostic imaging , Superior Mesenteric Artery Syndrome/therapy , Tomography, X-Ray ComputedABSTRACT
The senior authors have performed 141 proximal femoral whole-bone allografts in failed total hip reconstruction. The results of the first 50 have been previously reported. This study reviews 70 additional cases performed since 1987 and reflects improved technique and several different junctional constructs. Modest improvements in the rate of union (64% v 80%) and of dislocation (28% v 16%) have been achieved. The infection rate (6% v 4%) and demographics of the groups have remained constant. The frequency of complications (67% v 53%) has decreased, but unfortunately remains high. A step-out allograft junction with a long lateral sleeve has been the most reliable construct.
Subject(s)
Femur/transplantation , Hip Prosthesis/methods , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Fractures, Ununited/etiology , Hip Prosthesis/adverse effects , Humans , Male , Middle Aged , Postoperative Complications , Prosthesis Failure , Reoperation , Transplantation, Homologous , Treatment OutcomeABSTRACT
Forty patients undergoing needle biopsy of the prostate via the perineal route were studied bacteriologically. Four had positive blood cultures 5 min after the biopsy but none developed septicaemia, although no prophylactic antibiotics were used. Three of the four patients developing bacteraemia were found to have an unsuspected urinary tract infection and the same organisms were cultured from blood and urine, suggesting that this was the source of the bacteraemia.
Subject(s)
Biopsy, Needle/adverse effects , Prostate/pathology , Sepsis/etiology , Humans , Male , Perineum , Prostatic Neoplasms/pathologyABSTRACT
Up to fifteen plasma proteins were measured before treatment in 249 women presenting with lumps in the breast. Concentrations showed considerable overlap between the various clinical stages, and were often normal even in metastatic disease. A discriminant function is proposed, based on measurement of C-reactive protein, beta 2-microglobulin, carcinoembryonic antigen and ferritin and calculation of a score for each subject. High-risk scores resulted for all 18 patients with Stage 4 (i.e., metastatic) disease, and the number of Stage 1 patients attaining high scores was consistent with the reported incidence of development of metastases in such a group. Follow-up studies are in progress.
Subject(s)
Blood Proteins/analysis , Breast Neoplasms/blood , Neoplasm Staging/methods , C-Reactive Protein/analysis , Carcinoembryonic Antigen/analysis , Female , Humans , Pregnancy Proteins/analysis , Transferrin/analysis , beta 2-Microglobulin/analysisABSTRACT
With many asthmatic children for whom emotional factors are significant, joint pediatric and psychiatric management is essential. A three-level model of collaboration is presented, including (1) pediatric care, (2) psychiatric consultation, and (3) inpatient psychosomatic treatment. The organization, professional roles, and treatment protocol of the psychosomatic inpatient service are described. A review of the first 16 asthmatic children who received inpatient care in the program suggests that such a model may present a viable alternative to long-term residential care.
