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1.
A review of the complications of urethral instrumentation performed at our institution during the last 15 years revealed 2 cases of urethrorectal perforation. These patients were managed with loop colostomy and suprapubic cystostomy diversion with excellent healing and no evidence of fistula formation at 24-month followup. This rare complication is described and the principles of diagnosis, prevention and prompt aggressive management are emphasized. 相似文献
2.
E Grunfeld R Glossop I McDowell C Danbrook 《Canadian Medical Association journal》1997,157(8):1101-1105
The emphasis on home-based care is one important aspect of health services restructuring initiatives in Canada. Fundamental to the preference for home-based care over institutional care is the expectation that family caregivers will be available in the home to support patients who would otherwise be in an institution. The authors explore the potential impact of this devolution of services from institutions to the home in 2 vulnerable patient populations--elderly patients with dementia and elderly patients with terminal illnesses. Community-based surveillance strategies are needed to determine the true health, quality-of-life and economic outcomes of these restructuring initiatives. 相似文献
3.
Preliminary evidence for a role of apolipoprotein E alleles in identifying haemodialysis patients at high vascular risk 总被引:1,自引:0,他引:1
Olmer M; Renucci JE; Planells R; Bouchouareb D; Purgus R 《Nephrology, dialysis, transplantation》1997,12(4):691-693
Conventional risk factors have very low predictive power in identifying
haemodialysis patients at high risk of vascular accidents. A role for
apolipoprotein E isotypes was looked for in a small, but rigorously
defined, cohort of longterm haemodialysis patients. In individuals with
high vascular risk, as identified by higher common carotid intima/media
thickness, we found an excess of apolipoprotein E4 alleles. This
preliminary result requires confirmation in large patient cohorts.
相似文献
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I McDowell 《American journal of preventive medicine》1988,4(3):172-177
Most approaches to preventing chronic disease involve changing personal behavior. Appeals to change are often made on the grounds that certain behavior incurs a risk to health, but evaluative studies of health education suggest that this may not be a persuasive argument. Humans have always lived with risks and do not necessarily equate risk with personal danger. Many forces, both social and psychological, underlie the willingness to tolerate risks, and altering familiar behaviors may seem to the individual to be more of a loss than a benefit. If we seek to change health behavior, we must acknowledge this and recognize that factual information on risks will not encourage change unless the change forms part of a broader reappraisal of the person's values. Individual appeals for change will have little impact as long as broader social forces continue to encourage health risk behavior. 相似文献
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B. M. McClements I. F. W. McDowell D. R. McCluskey 《Irish journal of medical science》1988,157(5):157-157
We report a case of malignant melanoma in which the presenting feature was melanuria. Melanuria should be considered in the differential diagnosis of any patient presenting with dark urine. 相似文献
10.
Hodgkin disease: CT of the thymus 总被引:2,自引:0,他引:2
The computed tomography (CT) scans in two groups of patients with Hodgkin disease were reviewed to determine the frequency of thymic enlargement. In 50 CT scans from 50 patients with evidence of thoracic disease on CT scans who were examined for primary staging, the thymus was enlarged in 15 of 50 (30%). Fifty CT scans were obtained from 44 patients at the time of 50 separate episodes of known or suspected relapse. Relapse occurred in the mediastinum in 12 episodes, lung parenchyma in five, and both sites in one. Thymic enlargement thought to be due to involvement by disease was present in seven of 18 (38%). Mediastinal disease was associated with thymic enlargement in all but one patient in whom a thymic cyst developed after radiation therapy. Differentiation of thymic enlargement from enlarged superior mediastinal lymph nodes was easily made in all but two patients. Thymic enlargement in the absence of lymph node enlargement may indicate a different disease, since isolated Hodgkin disease of the thymus is uncommon. Primary thymic tumor should be considered initially, whereas after treatment, rebound hyperplasia of the thymus may be the cause of enlargement. 相似文献