[Clinical picture, diagnosis and therapy of large liver hemangiomas].
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Biomedical subjects
Publications and source records attributed to W Schweizer.
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The use of ultrasound in detecting urinary tract alterations by Schistosoma haematobium such as hydronephrosis and bladder calcifications was studied in 125 patients of the out-patients department of a district hospital in SE Tanzania, in an area highly endemic for this disease. Ultrasound was compared with plain abdominal X-ray (in 33 patients), intravenous pyelography (29), cystoscopy (31) and simple urine examination (125). Except for bladder calcifications which could not be demonstrated other than by X-ray, sonography compared favorably with IVP and cystoscopy and proved therefore to be a valuable tool in assessing S.h. related morbidity. In children moderate and advanced hydronephrosis were always associated with an irregular bladder wall and correlated strongly with the prevalence and intensity of S.h. infections as well as with haematuria and proteinuria. Important congestive pathology was observed in 1 out of 10 infected children and in 1 out of 20 examined adults.
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In an area where urinary schistosomiasis was endemic 349 patients were examined by ultrasonography. To evaluate the sensitivity and specificity of this technique, intravenous pyelography and cystoscopies were also done on 29 and 31 patients, respectively. Ultrasonography compared favourably with pyelography and cystoscopy except in demonstrating bladder calcifications. It was a valuable tool for rapid mass detection of Schistosoma haematobium related morbidity. Major renal congestion and irregularity of the bladder wall as seen on ultrasonography correlated strongly with the prevalence and the intensity of S haematobium infection as well as with microhaematuria and proteinuria, thus indicating the usefulness of urine dip sticks for S haematobium case-finding, especially during attempts at morbidity control in endemic areas.
1. Symptoms which may afflict us include a characteristic chest pain, a typical palpitation, a special kind of breathlessness and a peculiar loss of consciousness. These symptoms differ from the symptoms produced by heart diseases. They are psychic in origin and the manifestation of a special state of mind. The misleading term "functional symptoms" should be abandoned. 2. The psychogenic symptoms are very frequent. 170 out of a non-selected group of 310 patients in a cardiological private practice complained of one or the other of these symptoms. In 107 of these patients the complaints were exclusively psychic in origin. More than half of all chest pains, 30% of all palpitations, a fourth of the breathlessness and 65% of all loss of consciousness belonged to this category. 3. Awareness that these symptoms are harmless, and that complete well-being is a rather rare and mostly shortlived gift, would appear to be helpful and is often followed by a considerable improvement in health. In other patients, however, more extensive psychotherapy appears to be needed.
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Despite the advances in therapy, the high incidence, high mortality, and prematurity of coronary heart disease demonstrate the need for prevention. Measurement of a series of easily determined risk factors permits the early recognition of subjects at risk with remarkable reliability. However, reduction of risk factors affords protection against the illness only if they are causally connected with the disease mechanisms. The major evidence for linking atherosclerosis and its consequences with risk factors is reviewed. Particular attention is focused on serum lipids and the "lipid theory", smoking, elevated blood pressure, and physical inactivity, which are, on the basis of current knowledge, not only the most important factors but those most readily influenced by changes in daily living habits. Among the multiple risk factors mention is also made of obesity, diabetes, psychosocial stress, and hereditary predisposition. The probability of a causal relationship between risk factors and disease mechanisms justifies every effort to prevent the development of these precursors, or to treat them prophylactically if already present.
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The evidence suggest that its possible on the fourth day after myocardial infarction to identify a group of patients with near-zero mortality during the next 14 days. These patients can leave hospital on the fifth day if adequate home care is available. Since 66 of our series of 255 patients belonged to this fortunate group, a notable cost reduction was achieved.
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