Immunofluorescence and radioimmunoassay for Australia antigen.
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Biomedical subjects
Publications and source records attributed to J A Coller.
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The records of 650 patients were analyzed to determine factors predisposing the patients to wound infections. Statistically significant increases in infections were found in association with Crohn's disease, stomas present preoperatively, serum albumin levels of less than 2.9 g/dl, operative blood losses greater than 1,200 ml or operative times longer than two hours, preoperative irradiation, and bowel preparations other than mechanical preparation and nonabsorbable antibiotics. Wound infection did not occur in patients who were prepared for the operation with the neomycin-erythromycin antibiotic regimen.
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Seventy-four patients having primary Crohn's disease of the small intestine have had follow-up studies for at least 10 years after initial resection, and the results of treatment are presented. The commonest indication for operative treatment was obstruction, followed by fistula formation, intractability, abscess formation, and free perforation. Disease recurred in 69 per cent of patients in this series, and 55 per cent of this group required fruther operative treatment. It is necessary to have a lengthy follow-up period if we are to appreciate fully the serious nature of the recurrence problems of Crohn's disease of the small intestine.
Anal fissures, fistulas, and abscesses occurred as complications in 22 per cent of our population of 1,098 patients with Crohn's disease. Crohn's colitis was much more frequently associated with an anal lesion than Crohn's disease of the small bowel (52 per cent vs. 14 per cent). When an anal lesion is the manifesting sign, Crohn's disease will soon develop elsewhere in the intestine. Since these lesions frequently herald the onset of intestinal Crohn's disease, the physician must always be aware of the possibility of inflammatory bowel disease when dealing with suspicious anal lesions.
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