ABSTRACT
Skin infections are common and may be caused by bacteria, fungi or viruses. Breaks in the skin integrity, particularly those that inoculate pathogens into the dermis, frequently cause or exacerbate skin infections. Bacterial skin infections caused by corynebacteria include erythrasma, trichomycosis axillaris and pitted keratolysis. Staphylococci may cause impetigo, ecthyma and folliculitis. Streptococcal skin infections include impetigo and erysipelas. Human papillomavirus skin infections present as several different types of warts, depending on the surface infected and its relative moisture, and the patterns of pressure. The many dermatomycoses (skin infections caused by fungi or yeasts) include tinea capitis, tinea barbae, tinea cruris, tinea manus, tinea pedis and tinea unguium (onychomycosis). Candidal infections occur in moist areas, such as the vulva, mouth, penis, skinfolds and diaper area. Wounds caused by wood splinters or thorns may result in sporotrichosis. Animal bites may result in complex, serious infections, requiring tetanus and, possibly, rabies prophylaxis in addition to appropriate antibiotic therapy.
Subject(s)
Skin Diseases, Infectious , Wound Infection , Humans , Skin Diseases, Infectious/drug therapy , Skin Diseases, Infectious/microbiology , Wound Infection/drug therapy , Wound Infection/microbiologyABSTRACT
Cystic neoplasms of the pancreas are uncommon. The two major types of cystic pancreatic neoplasms are microcystic (serous) cystadenoma and mucinous cystic lesions (mucinous cystadenoma and mucinous cystadenocarcinoma). The two types differ substantially in the long-term mortality. Symptoms and signs do not distinguish between the two types, and small lesions are often asymptomatic. The neoplasms may be discovered during imaging procedures for unrelated complaints. Computerized tomography may suggest the diagnosis of microcystic adenoma or mucinous cystic neoplasm when the features are typical, but the final diagnosis must be established by surgical biopsy. Characteristic gross findings, light microscopic findings, and immunohistochemical staining patterns distinguish between the two types. When preliminary open biopsy confirms microcystic adenoma, extensive unnecessary surgery can be avoided.
Subject(s)
Cystadenoma/diagnostic imaging , Pancreatic Neoplasms/diagnostic imaging , Aged , Cystadenoma/pathology , Cystadenoma/surgery , Diagnosis, Differential , Female , Humans , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
When a relative needs a kidney to survive, family members often impulsively offer to donate one without stopping to consider the physical, emotional, and financial ramifications, which can be considerable. The family's primary care physician can be very helpful in guiding and educating potential donors and, by arranging for screening to be done in the community, can ease the financial strain. The authors discuss the things a potential kidney donor should consider.
Subject(s)
Family/psychology , Kidney Failure, Chronic/surgery , Kidney Transplantation/psychology , Physician's Role , Physicians, Family , Tissue Donors/psychology , Adolescent , Algorithms , Altruism , Counseling , Humans , Kidney Transplantation/adverse effects , Kidney Transplantation/economics , Middle Aged , Risk FactorsSubject(s)
Family Practice/education , Internship and Residency , Motivation , Obstetrics , Humans , Insurance, Liability , KansasABSTRACT
Data reported from this survey of the members of the Kansas Academy of Family Physicians indicate that members performing obstetrics are paying significantly higher professional liability premiums than members not providing such services. This difference, as well as the overall escalating costs of professional liability insurance, can be expected to result in loss of family physician-provided obstetrical services. As family physicians are providing the only readily available obstetrical services in a substantial number of rural areas, it seems likely that rural areas will experience a significant loss of access to obstetrical care. Although delivery fees have risen, they have not risen at the same rate as premiums. A net loss of family physicians providing obstetrical services has been noted during the period of 1985-88, and such losses appear to be an accelerating future trend.
Subject(s)
Obstetrics/trends , Physicians, Family , Academies and Institutes , Female , Humans , Insurance, Liability/economics , Kansas , Obstetrics/economics , Practice Patterns, Physicians'/economics , Practice Patterns, Physicians'/trendsSubject(s)
Heart Failure/physiopathology , Puerperal Disorders/physiopathology , Respiratory Distress Syndrome/physiopathology , Adult , Blood Pressure , Family , Female , Heart/diagnostic imaging , Humans , Pneumonia/physiopathology , Pregnancy , Pregnancy Complications, Infectious/physiopathology , Pulmonary Artery , Pulmonary Edema/physiopathology , Pulmonary Wedge Pressure , Radionuclide Imaging , Social SupportABSTRACT
This common fracture most frequently affects young males. In most cases, the fracture is found on initial examination. Occasionally, it is missed on the initial radiographic evaluation but becomes apparent on follow-up films. Although most scaphoid fractures respond to conservative therapy, some fail to heal. Nonunion of the scaphoid may respond to various nonoperative and operative techniques. In such cases, consultation with a hand surgeon is useful.
