Mucoid presentation of acute enterocolitis in children: a hospital-based case-control study

A hospital-based case-control study was carried out to clarify the characteristics of mucoid presentation of acute enterocolitis in children. One hundred sixty-eight cases of acute mucoid enterocolitis (study population) were compared with 200 cases of watery diarrhoea and 118 cases of blood dysentery (control groups) on the basis of clinical characteristics and findings on stool examination. Study and control groups were comparable with respect to age, body weight and nutritional status. There was no significant difference in clinical characteristics (duration of diarrhoea, stool frequency, presence of vomiting, fever and dehydration) between patients suffering from mucoid enterocolitis and blood dysentery. However, watery diarrhoea patients had significantly high frequencies of vomiting (p = 0.00001) and dehydration (p     

Utilization of screening mammography: comparison of different physician specialties

Data obtained on 426 consecutive patients referred to a breast center by 122 physicians, including family practitioners, general surgeons, and other specialists, showed that the obstetricians-gynecologists referred the greatest average number of patients per physician, with more than 50% of these referrals for screening mammography. Internists referred fewer patients by nearly a factor of ten, with only one-third of these patients referred for screening mammography. Internists may be the weakest link in the utilization of screening mammography.     

Lead poisoning from retained missiles. An experimental study.

The problem of lead poisoning from bullets has been investigated by surgically implanting discs of lead, each enriched in a different natural isotope, into the tissue of two mongrel dogs and monitoring by mass spectrometry the release of the lead into each animal's blood over the course of 3 years. Lead placed in the knee underwent vigorous attack by the synovial fluid, far in excess of what would be expected from corrosion theory, and reached a maximum concentration in blood 4-6 months after operation. Thereafter, lead concentration exponentially declined as the remaining fragments became encapsulated. The disc placed in muscle was sparingly soluble immediately following implantation. It is concluded that the greatest danger of lead poisoning from an injury involving many fragments having collectively a large surface area will occur within a month, and that the cases of lead poisoning resulting from bullets in joints that occur 5 or more years after injury are caused by continual wear of metal on a joint surface, storage of lead so released in the skeleton, and its subsequent resorption during a change in osteocyte activity.     

Familial amyloidotic patients' experience of the disease and of liver transplantation

Liver transplantation is a new treatment for familial amyloidotic polyneuropathy (FAP). No qualitative study examining these patients' experiences of the disease and the treatment has been published. The purpose of this study was to explore and describe the experience of the disease and the liver transplantation from the FAP patient's perspective. In-depth interviews with 11 liver transplant FAP patients were performed. The process of the FAP disease and a liver transplantation was found to involve the following categories: going downhill, defence and denial, a chance of surviving, the decision — no choice, waiting powerless and uncertain, the first few steps after surgery, freed from the death sentence, still disabled, mastering up strength to recover, and the need for support and help.     

肝移植患者术后白蛋白的应用

目的:低白蛋白血症是肝移植患者的常见并发症,也是患者预后的重要影响因素。肝移植术后选择合理的白蛋白应用方案将有益于提高肝移植患者术后近远期疗效。方法:选择2000-10/2005-06于北京大学第三医院行肝移植并且随访时间大于6个月的患者80例,对治疗方案均知情同意。医院自2003年8月开始改变了肝移植术后白蛋白的输入方案:①方案改变之前患者即白蛋白输入方案未改变组(n=50),术后早期常规输入白蛋白剂量大于60g/d。②方案改变之后患者即白蛋白输入方案改变组(n=30),适当减少术后早期白蛋白输入的常规剂量至0￣20g/d。统计分析两组患者的一般情况、术后白蛋白使用情况、预后情况及住院费用。另外,对于两组中术后存在低白蛋白相关严重并发症的患者进行进一步的比较分析。结果:80例患者全部进入结果分析。①两组患者术前及术中一般情况差异无显著性意义(P>0.05)。②白蛋白输入方案改变组术后早期白蛋白的使用量及其费用/总住院费用比例显著低于白蛋白输入方案未改变组(P<0.01)。但两组患者术后第3天肝功能情况、白蛋白水平、早期并发症发生率、早期死亡率、半年生存率及呼吸机时间等情况差异均无显著性意义(P>0.05)。③两组中术后出现低白蛋白相关严重并发症患者术后第3天肝功能情况、白蛋白水平、早期死亡率、半年生存率及呼吸机应用时间等情况差异均无显著性意义(P>0.05)。结论:肝移植术后过多输入白蛋白不能改善患者预后;适当减少术后白蛋白的常规输入剂量,同时根据血白蛋白水平及并发症情况随时调整白蛋白的输入量能够减少白蛋白的用量,对患者预后因素亦无明显影响。     

Plasmid-associated hemolysin and aggregation substance production contribute to virulence in experimental enterococcal endocarditis.

A rabbit endocarditis model was utilized to evaluate the virulence conferred by the conjugative plasmid pAD1 with the following strains: Enterococcus faecalis plasmid-free FA2-2 and FA2-2 containing plasmids pAD1 (hemolysin and aggregation substance positive), pAM9058 (insertional inactivation of hemolysin), and pAM944 or pAM947 (insertional inactivation of aggregation substance). All isolates were similar in ability to produce endocarditis. Mean vegetation weight was greater in animals inoculated with strains that produced aggregation substance (P < 0.01). Mortality was significantly increased in animals given FA2-2 containing pAD1 compared with those given all other strains (P < 0.01). These results suggest that the combination of hemolysin and aggregation substance is associated with increased mortality and that vegetation weight is associated with production of aggregation substance in experimental E. faecalis endocarditis.