Seborrheic dermatitis and daylight.

Patients with mood depression have been found to have a higher prevalence of seborrheic dermatitis (SD), possibly related to their tendency to live indoors. The prevalence of outpatients with SD has now been found to be directly related to the number of gloomy days in the area. Since UV light might not be the only reason for the well-known improvement in SD in summer, an explanation possibly related to melatonin is envisaged.     

Use of prolonged sympathetic blockade as an adjunct to surgery in the patient with sympathetic maintained pain

Twenty patients with sympathetic maintained pain (SMP) underwent surgery to treat an associated nerve injury. In each patient, an axillary catheter technique was used to maintain anesthesia and sympatholysis for up to 4 days following surgery. In no instance was the SMP exacerbated by the operation. The use of prolonged sympathetic blockade as an adjunct increases the margin of safety in surgery for these patients when nonoperative measures cannot relieve the pain or restore function.     

Respiratory tract infections due to Branhamella catarrhalis: epidemiological data from Western Australia

During a 3-year period Branhamella catarrhalis was isolated in significant numbers from 239 (1.3%) of 19,488 specimens of sputum sent for routine microbiological examination at a 700-bed general hospital. The majority of patients (83%) were over 60 years of age and 65% were male. There was a distinct seasonal variation in isolations with a peak incidence during the winter and early spring, a pattern not found with other pathogens. Susceptibility to amoxycillin decreased by approximately 50% over the 3 years, corresponding to an increased incidence of beta-lactamase-producing strains. There were minimal changes in susceptibility to other antimicrobial agents. Underlying pulmonary disease was the major factor predisposing to B. catarrhalis infection, and 71% of patients were smokers or ex-smokers.     

Malignancies following long-term azathioprine treatment in chronic liver disease

ABSTRACT— One hundred and fifty-four patients with histologically verified nonalcoholic chronic liver disease were randomized to azathioprine or prednisone treatment. After a median of 91 months observation time, the cause of death was assessed retrospectively. Autopsy was performed in 82% of 71 deaths. In the azathioprine group 33% (13/39) died from malignant neoplasia, and in the prednisone group (13%) (4/32) (p = 0.08). Considering a possible fatal outcome as a consequence of treatment, this finding urges caution in the long-term application of azathioprine at the usual dose level.     

The relationship of scoring systems and mortality in the surgical intensive care unit

To determine the relationship between severity of illness and mortality, therapeutic intervention score (TISS) and acute physiology score (APS) were determined on admission to the Surgical Intensive Care Unit (SICU). Patients were divided into survivors and nonsurvivors and differences were compared by chi-square analysis. The 1524 patients admitted to the SICU during a 12-month period had a mean TISS of 3.03 and a mean APS of 13. The average length of stay (LOS) was 3.75 days. Of the 1524 patients, 97 (6.4%) died. The number of nonsurvivors increased with higher TISS and APS scores (P less than 0.001). There were no deaths in the TISS Category 1 patients or in the APS 0-5 group. Mortality rates dramatically increased with APS greater than 20 (P less than 0.001). There were 1286 patients with APS less than 20, and 24 (2%) of these patients died, whereas 73 (31%) of 238 patients with APS greater than 20 died. Nonsurvivors had a mean TISS of 3.6, mean APS of 27, and LOS of 4.88 days, all of which totals were higher than the survivors' totals. In this study population, risk of death was one in three if the APS was greater than 20. These data indicate that TISS and APS scores are effective means of assessing mortality risk in SICU patients.