Simplified Scaling for Life Change Events

Abstract

A relatively simple interval scaling method for adjustment to life change events was compared to the original, more difficult, proportionate scaling method. Ranking of life events by both methods was extremely similar. Evidence also was found that today Americans scale several minor life change events as requiring greater adjustment than that estimated for these events a decade earlier.     

The Double-Line Sign: A False Positive Finding on the Focused Assessment with Sonography for Trauma (FAST) Examination

Background: Emergency physicians commonly perform Focused Assessment with Sonography for Trauma (FAST) examinations to evaluate for free intraperitoneal fluid. Many ultrasound findings can be misinterpreted as free fluid, resulting in false-positive FAST examinations. Objectives: To describe a previously unreported ultrasound finding that can be misinterpreted as free intraperitoneal fluid. Case Report: A 32-year-old man was stabbed in the left upper abdomen. A FAST examination was performed and a right perinephric fat pad was interpreted as showing free fluid in Morison's pouch. After transfer to a trauma center, a repeat FAST examination revealed no signs of intraperitoneal free fluid. Wound exploration showed no signs of penetration into the peritoneal cavity. Conclusions: When performing a FAST examination, a wedge-shaped hypoechoic area in Morison's pouch that is bounded on both sides by echogenic lines (the “FAST Double-Line Sign”) is likely to represent perinephric fat and may result in a false-positive FAST examination.     

Nonoperative management of delayed splenic rupture in an adult

Due to the evidence that a splenectomized patient is at increased risk for serious infection, nonoperative management of splenic injury, as well as operations designed to preserve functioning splenic tissue, have been recently reported. Most experience in nonoperative management has been in the pediatric and young-adult age groups. We report a case of delayed rupture of the spleen in a middle-aged patient who was successfully managed nonoperatively and was followed with ultrasonography to resolution.Supported in part by the Bureau of Medicine and Surgery Clinical Investigation Program.     

Common sense in the treatment of pilonidal disease

Summary The management of pilonidal cyst disease in a large military hospital is described. Of special interest to the military practice is the “buddy” system, in which patients help one another to keep their wounds clean and dry. The specific objectives of our technic are: 1) obtaining excellent hemostasis by the use of zinc peroxide paste; 2) avoiding recurrences by an open-wound method of treatment; 3) preservation of a pad of subcutaneous tissue over the postsacral fascia, thus reducing long-term morbidity by insuring a mobile scar; 4) decreasing the duration of hospitalization, achieved by frequently drying the wounds with warm air. Read at the meeting of the American Proctologic Society, Hollywood, Florida, April 12 to 16, 1970. The opinions or assertions contained herein are those of the authors and are not to be construed as official or as reflecting the views of the Navy Department.     

Ileocecal Tuberculosis

Three cases of ileocecal tuberculosis are presented with a review of pathogenesis, diagnosis and therapy.
Emphasis is placed upon preoperative suspicion and the indications for resectional surgery in combination with antituberculous drugs in the management of the patients.