Ultrasound and arthrography in the detection of ruptured Baker's cysts.
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Biomedical subjects
Publications and source records attributed to P Hayes.
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Child abuse is defined as physical, emotional, verbal, or sexual injury inflicted upon children. It is a complex problem requiring a systematic approach to intervention and treatment. All family members are victims of child abuse. Because child abuse tends to be a cyclic problem, rooted in several generations of parenting, long-term treatment in the community must be available for abusing families, both adults and children. At the core of all successful treatment are the significant relationships which must be established between parents and the case worker and the abused child and the case worker. These relationships must be based on mutual trust, respect, and support-characteristics that are lacking in the relationships of most victims of child abuse. The nurse who works with abusing families in the community brings empathy, a knowledge and understanding of child development, and a holistic approach to health, growth, and change to the relationship. Nurses have a significant role on the child abuse treatment team as primary workers with the family, case managers, and liaisons in a multi-agency interventional effort.
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Blunt injury to the neck can cause hemorrhage and pseudoaneurysm formation. A 76-year-old patient with severe blunt injury to the anterior neck was found to have entrapment of the left vertebral artery at C2-C3. Arch aortography 3 weeks postinjury revealed a large aneurysm at the injury site. The mass was surgically reduced, followed by ligation of the artery 9 days later, which resulted in prompt elimination of the mass and its accompanying bruit. Rapid recognition of this injury depends on early carotid and vertebral artery angiography.
Twenty-eight women participating in a screening program had a breast cancer diagnosed subsequent to the report of a negative mammogram which was read by only one of a group of radiologists. Fourteen occurred prior to a scheduled routine screening visit (interval cancers) and 14 were detected during such an examination. The negative mammograms from the 28 cancer patients, together with those from 120 women without cancer (controls) were independently reviewed by each member of a panel of three radiologists. Forty-six percent of the cancer cases and 5.8% of the controls were interpreted as positive by two or more of the radiologists. These findings suggest that agreement among several independent reviewers enchances the value and accuracy of mamography by reducing the number of false negative interpretations.
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Following a picnic, nearly half of the persons who attended became ill. Sixty-three of 139 throat cultures were positive for group A beta-hemolytic streptococci. Forty-seven of the positive cultures were available for typing, 34 of which harbored the epidemic strain, group A beta-hemolytic Streptococcus type T-3/13/B3264. This contrasted with two of 204 controls who had not attended, but harbored the epidemic strain. Food preferences and illness rates implicated the potato salad, and from it the epidemic strain was isolated. The attack rate and case-to-infection ratio among those who attended the picnic was significantly greater for persons over 10 years of age. Prompt institution of chemoprophylaxis could possibly have prevented at least 50% of the cases.
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Hrom February 1974 through May 1975, 58 isolates of ampicillin-resistant Hemophilus influenzae from patients were submitted to the Center for Disease Control from 23 states and the District of Columbia. The epidemiologic characteristics of these widely scattered cases were strikingly similar to those of cases previously reported from individual communities or institutions. Because of the nationwide distribution of resistant isolates and the adverse consequences of ineffective therapy, the use of chloramphenicol is recommended for the initial management of systemic illness definitely or probably due to H. influenzae type b.
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Experiments in goats showed that the application of bone wax to the divided sternum retarded healing. An autologous red cell compound was an efficient haemostatic and lacked the obstructive effect of wax. A human autologous red cell compound has been applied to the sterna of 15 patients following median sternotomy with good effect.
Melioidosis, the clinical manifestation of infection with Pseudomonas pseudomallei, has occurred infrequently in American citizens; almost all reported cases have been in Vietnam veterans, usually associated with respiratory disease. A Vietnam veteran from Mississippi developed chronic prostatitis, with no other clinical manifestations, during service in Vietnam, and P. pseudomallei was isolated from prostatic secretions 2 years after his return to the United States. The patient had had sexual contact with four women including his wife since his return from Vietnam. Vaginal and cervical cultures and serum samples were obtained from the four women, and serum samples and cultures of semen were obtained from the patient. Vaginal swabs and semen cultures were negative for P. pseudomallei. The patient and his wife had hemagglutination titers (greater than 640) diagnostic of P. pseudominallei infection. This occurrence of venereal transmission is the first report of person-to-person spread of P. pseudomallei infection.
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