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61.
Y. Tal L. Even A. Kugelman D. Hardoff I. Srugo M. Jaffe 《European journal of pediatrics》1997,156(6):457-459
The objective of the study was to evaluate the significance of rigor as a predictor of bacterial infection in hospitalized
febrile infants and children. One hundred febrile children with rigor were studied and compared to 334 febrile matched controls
without rigor. All underwent clinical evaluation and appropriate laboratory investigations. The patients were then divided
into “bacterial” and “non bacterial” infection groups, as defined in the text. It was demonstrated that 66% of the patients
with rigor belonged to the bacterial infection group versus 50% in the non-rigor group (P< 0.005). There was a significantly greater yield of positive blood cultures in the patients with rigor (P < 0.04), especially those over the age of 1 year (P < 0.015). The only laboratory examination of potential value as a predictor of bacterial infection in children with rigor was the
band count. An absolute band count of more than 1500/mm was significantly more frequent in the rigor group (P < 0.003), and the combination of a rigor and band count of more than 1500 increased the relative risk for a bacterial infection by
a factor of 1.35. These data demonstrate that rigor in hospitalized febrile infants or children significantly increase the
likelihood of bacterial infection.
Conclusion Although the absence of rigors in febrile children does not exclude bacterial aetiology, their presence significantly increases
the probability of an infection requiring appropriate workup and a readier institution of antibiotic therapy.
Received: 7 June 1996 / Accepted: 15 November 1996 相似文献
62.
63.
Maruyama M Capello WN D'Antonio JA Jaffe WL Bierbaum BE 《Clinical orthopaedics and related research》2000,(370):183-191
Polyethylene wear is a major contributor to osteolysis and subsequent aseptic loosening of prosthetic components in total hip arthroplasty. Use of ion implantation as a surface modification to the metallic bearing component of orthopaedic implants may be an effective means of reducing wear debris at the bearing interface. In July 1991, low friction ion treated femoral heads were introduced. This study evaluates the effect of the low friction ion treated femoral head on polyethylene wear. Fifty-five total hip arthroplasties (53 patients) with low friction ion treated femoral heads followed up a minimum of 3 years were matched with 55 total hip arthroplasties (47 patients) without low friction ion treated femoral heads for the same postoperative period. Socket wear was evaluated radiographically. Case matching and strict inclusion criteria were used to control for known factors influencing polyethylene wear. These criteria included: (1) cases matched for gender and age within 2 years; (2) diagnosis limited to osteoarthritis or avascular necrosis of the femoral head only; (3) femoral head diameter limited to 26 or 28 mm only; (4) hydroxyapatite coated femoral stem of the same design and a metal backed socket of the one of two designs with the same polyethylene insert; and (5) minimum followup of 3 years. The linear wear rate of polyethylene was 0.161 +/- 0.095 mm per year in the group without the low friction ion treated heads and 0.116 +/- 0.101 mm per year in the low friction ion treated group. The volumetric wear rates were 74.5 +/- 44.3 mm3 per year for the group without the low friction ion treated heads and 57.8 +/- 51.1 mm3 per year for the low friction ion treated group. Assuming the sensitivity of these measurements can detect these small differences in wear accurately, these results suggest low friction ion treated prosthetic heads are useful in reducing polyethylene wear at 3-year minimum followup. 相似文献
64.
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66.
William T. Johnson Parth Patel Amanda Hernandez Lisa M. Grandinetti Arthur C. Huen Stanley Marks Jonhan Ho Sara E. Monaco Ronald Jaffe Jennifer Picarsic 《Journal of cutaneous pathology》2016,43(3):270-275
Langerhans cell histocytosis (LCH) and Erdheim‐Chester disease are two rare histiocytic disorders. Their occurrence in the same patient is more infrequent, but has been described. We report a case of a 38‐year‐old woman who presented with a diagnosis of single system cutaneous LCH. Subsequently, she developed multiple papules on her extremities consistent with a non‐LCH xanthogranuloma type lesion. BRAFV600E mutation immunostain, VE1 was positive in the skin lesion, which was confirmed by molecular polymerase chain reaction (PCR) studies, initiating a complete systemic workup for Erdheim‐Chester disease. Systemic involvement was confirmed with bilateral sclerotic bone lesions and retroperitoneal and pelvic fibrosing disease. She was also found to have a BRAFV600E mutation positive papillary thyroid carcinoma. New suspicious cutaneous lesions presenting in patients with a history of LCH need to be biopsied. A BRAFV600E mutation in a non‐LCH histiocytic lesion with a xanthogranuloma phenotype (CD163/CD68/CD14/fascin/Factor 13a) should prompt an Erdheim‐Chester disease workup. This is a unique case of a woman with BRAFV600E mutation positive Erdheim‐Chester disease and cutaneous LCH, while also being, to our knowledge, the first reported case in the English literature of it occurring in a patient with a BRAFV600E mutation positive papillary thyroid carcinoma. 相似文献
67.
68.
The regimen for treating refractory angina is similar to that for impending infarction. Specific approaches to treatment include drugs and other medical methods. Operative intervention is reserved for those patients who do not respond to medical measures. 相似文献
69.
Laura G. Stansell Ariana L. Smith William I. Jaffe 《Current Bladder Dysfunction Reports》2011,6(1):37-44
The neurophysiology of volitional voiding is a poorly understood and constantly evolving field. Some of the most difficult
clinical problems in urology arise from structural or neural deviations from this process. These may occur as a result of
traumatic injury, congenital defect, or neurological disease. Neurogenic voiding dysfunction is a frequently encountered disorder
with multiple etiologies and nonstandardized care. A pervasive complaint in neurogenic voiding dysfunction is detrusor overactivity
and resultant urinary incontinence. However, the results of “ideal” initial therapy—catheterization with or without anticholinergics—have
been far from satisfactory. This review attempts to go beyond perfunctory measures to explore recent data on anticholinergic
therapies, long-term data on botulinum A toxin injections, and applications of neuromodulation. 相似文献
70.
Skin lesions are rare in visceral leishmaniasis, especially in Mediterranean countries. We describe an unusual case of visceral leishmaniasis in a 41-year-old man that began with a skin lesion. The parasites isolated from both the skin lesion and the bone marrow were typed as Leishmania donovani sensu stricto. This pathogen is not endemic in Israel or neighboring countries; its contribution to adult visceral leishmaniasis in Israel is summarized. 相似文献