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At least 163 records · Page 9Linked to original sources
PubMed1986

Horrible Harry.

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Adult↗
PubMed1982

The effects of a nonsurgical treatment for obstructive sleep apnea. The tongue-retaining device.

The tongue-retaining device (TRD) was designed to increase the unobstructed dimension of the nasal breathing passage during sleep. Twenty male patients with diagnoses of sleep apnea syndrome, primarily of the obstructive type, confirmed by clinical polysomnography, were fitted with the device. The TRD holds the tongue in a forward position by negative pressure. Fourteen patients have been tested before and after this treatment, and ten of these have also completed two follow-up recordings four to six months after being trained in the use of this device. There was significantly improved sleep and significantly fewer and shorter apneic events on all nights when the device was worn. On the first night of wearing the TRD for a half night only, there was a significant reduction in the number of obstructive and central apneic episodes. The mean apnea plus hypopnea index while wearing the TRD is comparable with the rate reported for patients who have been treated surgically by either tracheostomy or by uvulopalatopharyngoplasty, although the tracheostomy group contained more severe cases.

Adult↗
PubMed1994

Dangerous brew.

Polypharmacy, the use of multiple medications concurrently, is common among the elderly. Beers and Ouslander report that older North Americans consume 4.5 medications on average at any one time. In Canada, seniors take 25 per cent of all prescriptions but comprise only 12 per cent of the population. And according to Cartwright, 50 per cent of Britain's seniors take two or more medications on a regular basis.

Aged↗
PubMed1994

Fine-needle aspiration biopsy of pituitary carcinoma with cervical lymph node metastases: a report of two cases and review of the literature.

Metastases from pituitary carcinomas are rare lesions that can mimic other tumors on fine-needle aspiration biopsies. Two patients with primary pituitary neoplasms developed cervical lymph node metastases, which were sampled and diagnosed correctly using the fine-needle aspiration biopsy technique. These two cases demonstrate the varied cytologic patterns of pituitary neoplasms, ranging from uniform bland cells to cells with striking anaplastic features. The time period between the onset of symptoms and subsequent metastases is unpredictable as well, underscoring the need for an accurate clinical history before a meaningful cytologic interpretation is made.

Adult↗
PubMed1993

Traumatic rupture of an aortic ulcerative atherosclerotic plaque producing aortic dissection: a complication of interscapular back blows used to dislodge objects from the esophagus.

Penetrating atherosclerotic ulcer of the aorta is a rare entity which usually occurs in the descending thoracic aorta. Herein, we report an unusual case of penetrating aortic ulcer which ruptured into the mediastinum. Interscapular back blows were performed on our patient in an attempt to dislodge an aspirin which she thought was lodged in her esophagus. Unlike previously reported cases of this entity, the penetrating aortic ulcer in our patient was located in the distal thoracic ascending aorta. Diagnosis of penetrating aortic ulcer can be made by utilizing aortography, contiguous dynamic contrast-enhanced computed tomography or magnetic resonance imaging. Treatment consists of adjunctive medical therapy until surgery can be performed.

Aged↗
PubMed1993

Histiocytic necrotizing lymphadenitis (Kikuchi's disease): cytologic diagnosis by fine-needle biopsy.

A cytologic diagnosis of histiocytic necrotizing lymphadenitis (Kikuchi's lymphadenitis) was made in a 14-yr-old female with cervical lymphadenopathy, fever, neutropenia, and hepatosplenomegaly. A predominance of reticulum cells, foamy macrophages, and karyorrhectic debris are clues to the diagnosis in the fine-needle biopsy smears. Subsequent histology confirmed the diagnosis of Kikuchi's lymphadenitis. The differential diagnoses are discussed including malignant lymphoma, which was excluded by morphology as well as flow cytometry and polymerase chain reaction (PCR) studies.

Adolescent↗
PubMed1988

Pseudoparasitic Liesegang structures in perirenal hemorrhagic cysts.

Periodic structures with equally spaced radial striations identified as Liesegang-like rings were seen in two male patients' hemorrhagic perirenal cysts. The patients, one 48 and the other 60 years old, had acute right-flank pain and anemia; both had nephrectomy. The rings, initially believed to represent parasites (Dioctophyma renale), were from 8 to 500 micron in diameter and had uniform, pink-tan, radially striated double walls. Multiple small rings within a larger ring predominated in one case. Morphologically, the rings differed from D. renale when compared with specimens from animals infected naturally or experimentally with the giant kidney worm. Histochemical and immunoperoxidase tests for iron, calcium, mucopolysaccharides, amyloid, keratin, and hemoglobin had negative results. Energy-dispersive x-ray elemental analysis demonstrated no detectable elements; ultrastructurally, however, the rings displayed a fine fibrillary composition with a concentric and radial pattern. These rings are believed to be an end product of a phenomenon resembling or are, in fact, the Liesegang phenomenon. Because these Liesegang-like structures may be mistaken for parasites on fine-needle aspiration or surgical specimens of hemorrhagic areas, pathologists should be aware of them.

Cysts↗
PubMed2006

Autistic defenses in agoraphobic syndrome: "flat" objects and the retardation of projective identification.

The function of autistic defenses in the generation of agoraphobic symptoms is explored in the case of a patient treated in psychoanalytic psychotherapy. The therapist's growing awareness of autistic modes of relating in the case facilitated various changes in the transference relationship. Although oedipal concerns are seen as important, a formulation is presented whereby autistic modes of generating experience are viewed as fundamental to an understanding of agoraphobic experience. Clinical findings in the transference-countertransference relationship led to the additional observation that the retardation of defensive forms of projective identification further contributed to the patient's agoraphobic difficulties. This formulation is tied theoretically to the idea that agoraphobic experience occurs when the dialectic between paranoid-schizoid and autistic-contiguous modes of generating experience collapses. The treatment implications of these observations are briefly explored.

Adult↗
PubMed1994

Elimination of methicillin-resistant Staphylococcus aureus from a neonatal intensive care unit after hand washing with triclosan.

Evaluating hand wash products in terms of user acceptability and effectiveness against methicillin-resistant Staphylococcus aureus (MRSA) has been part of a long-term strategy to eliminate endemic MRSA from the neonatal intensive care unit at the Royal Women's Hospital (Brisbane). Following the introduction of a new hand wash disinfectant (triclosan 1% wt/vol), new cases of MRSA colonization were monitored for 12 months. In addition, the use of antibiotics, the incidence of multi-resistant Gram-negative cultures and neonatal infections were noted. No changes were made to any procedures or protocols during the trial. All babies colonized with MRSA had been discharged from the nursery within 7 months of the introduction of triclosan and in the subsequent 9 months no new MRSA isolates had been reported. Reduction in the use of vancomycin has resulted in a cost saving of approximately $A17,000. The total number of Gram-negative isolates has not increased, although Pseudomonas aeruginosa is now reported more often. Compared with the previous 12 months, fewer antibiotics were prescribed and fewer nosocomial infections recorded (P < 0.05).

Colony Count, Microbial↗
PubMed2006

Are gadolinium-based contrast media nephrotoxic? A renal biopsy study.

Gadolinium-based contrast media were originally introduced as alternatives to iodinated media for magnetic resonance imaging. Although originally thought to be nonnephrotoxic, gadolinium-based contrast media have recently been reported to be associated with acute renal failure; the mechanism and the underlying renal injury are not completely understood. We report what is, to our knowledge, the first renal biopsy in this context. A 56-year-old patient underwent 2 consecutive vascular imaging procedures in conjunction with gadolinium-based contrast medium administration. A few days later, the patient developed acute renal failure. A renal biopsy showed acute tubular cell injury including patchy tubular cell necrosis, tubular cell degeneration, and marked proliferation of tubular cells, together with mild interstitial edema and interstitial inflammation, but without significant glomerular or vascular changes. During supportive therapy, renal function was partially regained. This case emphasizes the potential nephrotoxicity of gadolinium-based contrast media and suggests that the nephrotoxicity is related to potentially reversible acute tubular cell injury.

Biopsy↗
PubMed1988

A cluster of three cases of aplastic anaemia in children.

During a 2-week period three unrelated children presented with severe aplastic anaemia at a general hospital serving a population of 25,000 children aged 0-15 years. The probability of this occurring by chance alone was 0.00009 (exact probability cluster analysis). Serology for common viral infections including hepatitis A & B and infectious mononucleosis was negative. It was not possible to demonstrate IgM antibodies to human parvovirus (HPV) by radioimmunoprecipitation or HPV virions by DNA hybridization in the patients or any members of their families. Epidemiological investigation failed to demonstrate a common environmental toxin. It did reveal, however, that all three patients had spent time, within the preceding 3 months in a swimming pool and its surrounding area in a region of Cardiff where none of them resided. Pool maintenance was satisfactory and water analysis showed no abnormality. The possibility must remain that the cluster was caused by an undisclosed environmental toxin.

Anemia, Aplastic↗
PubMed1993

Sporothrix schenckii endophthalmitis presenting as granulomatous uveitis.

Sporothrix schenckii occurs worldwide as a chronic subcutaneous mycotic infection, but can result in intraocular infection of cryptogenic origin without evident systemic infection. A case of S schenckii endophthalmitis is presented without a history of trauma or systemic infection originally diagnosed as granulomatous uveitis that resulted in scleral perforation.

Adult↗