Fracture of the corpora cavernosa and urethral rupture during sexual intercourse.
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Biomedical subjects
Publications and source records attributed to J Cumming.
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A review of 86 patients referred to a urological clinic with impotence showed that in 58% the causation was predominantly psychogenic. These patients were managed with psychosexual counselling. The various treatment options were discussed with those patients with organic impotence and 14 underwent the implantation of a penile prosthesis. A review of 130 patients who received penile prostheses in the period 1983 to 1987 was carried out to compare the complications and results obtained with the various types of prosthesis. The overall satisfaction rate was 81%; dissatisfaction usually arose as a result of complications of surgery. These were highest in patients with diabetes and priapism. The complications were also related to the type of prosthesis used.
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Fifty-five prostate cancer and 55 breast cancer patients with positive bone scintigrams were studied. The pattern of spread in the axial skeleton and pelvis showed differences between the 2 groups. This difference was not related primarily to bone volume at the site of metastasis. The difference in distribution of bony metastases between breast and prostate is explained by our knowledge of Batson's vertebral venous plexus.
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About one in every six voluntary mental patients discharges himself against medical advice. But despite the high rate of AMA discharges, the authors found the literature on the subject to be sparse and of little help in explaining why patients leave the hospital against medical advice. They examine the approaches that have been used thus far to study the phenomenon. They also report the findings of their own study, which showed that patients discharged against medical advice had a poorer response to treatment than those discharged in the traditional manner. The study identified factors that contributed to the poor response and were related to the discharge.
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In 1971, budget restrictions in New York State provided the impetus for the transfer of 2,174 patients among state hospitals in the mental hygiene system. The discharge rate was greatly increased over what would have been expected, but varied greatly among the receiving hospitals. The major factor relating to this difference appears to be the values and beliefs of the receiving hospitals as to the proper placement of patients. The patient's return to the hospital after discharge did not relate to a liberal discharge policy, but seemed to depend on whether or not the patient was physically healthy and could meet minimal social role expectations. Factor usually associated with probability of discharge are analyzed, but while some, such as age, affect chances of discharge, none are as potent predictors as the type of hospital.
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