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At least 91 records · Page 5Linked to original sources

[The fate of patients with stenosis of the trunk of the left coronary artery].

We have studied the fate of 49 patients with stenosis of the trunk of the left coronary artery of more than 50%. The follow-up period extends from 1,5 years to 5 years (with a mean of 33.83 +/- 13.55 months). The clinical picture was not characteristic. Unstable angina was found in 59% of cases. The exercice test (29 patients) was positive in 100%, with a mean depression of 3.3 mm. Stenosis of the trunk, which is rarely an isolated condition (8% of cases), is usually associated with disorders of the other main coronary vessels. Twenty six patients underwent surgery. Thirteen patients who were operable were treated medically. The performance of the left ventricle and the degree of involvement of the coronary arteries were comparable in these two groups. Seven inoperable patients were treated medically. Actuarial survival curves show a significant difference (p less than 0.01) in survival after two years between the operated cases (88%), the operable cases treated medically (60%), and the inoperable cases (57%). The decreased mortality of the operated cases corresponds also with a greater functional capacity in the survivors compared with that of the cases treated medically.

Adult↗

[Electrocardiographic abnormalities during meningeal hemorrhage].

The electrocardiogram (E.C.G.) was recorded in 100 cases of meningeal hemorrhages. The most frequent abnormalies encountered were bradycardia (32%) and inversion of the T wave (34%). Rhythm and conduction problems were less frequently found. Bradycardia was frequently and T wave inversion rarely found in cases without disturbances of consciousness and those with favourable prognosis. The contrary was found in comatous patients and cases with lethal outcome. The existance of an aneurysm and the location of it did not influence the type of electrocardiographic abnormalies. The influence of the parasympathetic and especially the sympathetic nervous systems is emphasized.

Arrhythmias, Cardiac↗

Outpatient management of intercostal tube drainage in spontaneous pneumothorax.

In a series of 226 patients with spontaneous pneumothorax, 167 (74%) were managed successfully on an outpatient basis by observation (20%) or by intercostal tube drainage and a flutter valve (54%). Only 59 patients (26%) were hospitalized, and 42 of these were treated surgically (18.6%). Outpatient management with a flutter valve has proved to be safe, efficient, and economical.

Adolescent↗

Premature opening of aortic valve in severe aortic regurgitation.

Premature opening of the aortic valve in late diastole has been demonstrated by echocardiography in a patient with severe aortic regurgitation. Valve opening coincided with the end of the diastolic murmur and equalization of aortic and left ventricular diastolic pressures. Echocardiography of the aortic valve in severe aortic reflux may, therefore, provide valuable information about the underlying haemodynamic disturbance.

Adult↗

Laparoscopic vs. open intraoperative ultrasound examination of the liver: A controlled study.

A prospective study was undertaken to determine whether the use of laparoscopy plus laparoscopic ultrasound examination can avoid unnecessary laparotomy, without missing potentially curable disease, in patients scheduled for curative liver surgery. Thirty-one consecutive patients who underwent surgery for planned curative liver surgery were prospectively evaluated by means of both laparoscopy plus laparoscopic ultrasound and laparotomy with intraoperative ultrasound. Laparoscopic ultrasound examination of the liver could not be performed in two patients, and in two other patients only partial examinations were possible because of dense adhesions. All patients underwent laparotomy with intraoperative ultrasound. A total of 50 malignant lesions were identified by laparoscopic ultrasound. All of these lesions were confirmed to be malignant at laparotomy with intraoperative ultrasound, that is, there were no false positive results. An additional four malignant lesions in four patients were not seen at laparoscopic ultrasound examination but were identified at laparotomy with intraoperative ultrasound (sensitivity 93%, specificity 100%, positive predictive value 100%, negative predictive value 85%). Based on the laparoscopic ultrasound findings, nontherapeutic laparotomy could have been avoided in 10% of our patients. Laparoscopy with laparoscopic ultrasound is a promising technology that may allow some patients to avoid a nontherapeutic laparotomy without significant risk of missing potentially curable disease.

Humans↗

Tympanometric screening in elementary school children.

The revised ASHA (American Speech Language Hearing Association, 1990) hearing screening guidelines were developed to decrease over-referrals for middle ear disorders through amended tympanometric measurements. These guidelines also recommended a large-scale normative study be done with tympanometric measures to further reduce the over-referral rate. Seven hundred and fifty ears from 392 kindergarten through third-grade children were tested. Normative values of Peak Ytm and tympanometric width were calculated by grade. For increasing grade level, there was an orderly increase in the mean Peak Ytm and a decrease in the mean tympanometric width. Sensitivity and specificity were calculated at 65 and 80% respectively, with a prevalence of 11%. Suggestions for improving sensitivity and specificity are discussed.

Acoustic Impedance Tests↗

HIV/AIDS and childbirth: a feminist midwife's view.

This paper explores the impact that the presence of the Human Immunodeficiency Virus has had on the care of pregnant and childbearing women in Victoria and on my professional life as a midwife in private practice and a midwife educator. It provides an overview of my personal experience and discusses how the issues associated with HIV/AIDS have gradually infiltrated the area of midwifery care in our hospital system. The prejudices and practices of the dominant patriarchal medical system have resulted in women being oppressed and controlled in pregnancy and labour in institutions that are supposed to be there to serve their needs.

Attitude to Health↗