Biomedical subjects

J F Kiraly

Publications and source records attributed to J F Kiraly.

4 recordsLinked to original sources

PubMed1977

The management of gonorrhea in an emergency room.

This study reviews the experience with gonorrhea and "pelvic inflammatory disease" in an emergency room of a university hospital. In spite of the large volume of critically ill patients seen in the emergency room, proper diagnostic methods and appropriate treatment for gonococcal disease were used by these physicians in over 90% of the cases. However, performance of serologic tests for detection of latent syphilis and the reporting of the disease to the Health Department were often overlooked. Two other problems in the management of these diseases were identified. One was the discovery of a low yield of organisms by culture, and the other was the failure of most patients to return for followup. This study indicates that periodic retrospective analysis is a useful method of ascertaining the effectiveness of diagnosis and management of gonococcal infections in a setting not specifically oriented to venereal disease. This analysis indicates that better mechanisms can be instituted in treating these infections to assure high quality care.

Adolescent↗

PubMed1976

Hazards of phlebotomy in polycythemic patients with cardiovascular disease.

Three patients with polycythemia and previous evidence of cardiovascular disease underwent routine phlebotomies. Systolic hypotension followed by ineffective volume replacement with electrolyte solutions developed in all patients after phlebotomy. In two patients acute myocardial infarction and in a third cardiovascular collapse and death were temporally related to the procedure. This experience suggests that phlebotomy in patients with cardiovascular disease should be performed by the slow removal of small volumes of blood under continuous blood pressure monitoring. Effective restoration of the plasma volume with plasma or colloid is essential unless volume overload is present.

Acute Disease↗

PubMed1976

Bone marrow necrosis.

The clinical findings of bone marrow necrosis in 13 patients undergoing bone marrow examination to investigate a peripheral blood cytopenia or leukoerythroblastic blood smear were reviewed and compared to those in the literature. Excluding sickle cell disease, all cases of bone marrow necrosis diagnosed during life were associated with a neoplastic process involving the marrow. A myeloproliferative disorder was found in five patients, metastatic carcinoma in five patients, a lymphoma in two patients, and both a myeloproliferative disorder and metastatic carcinoma in one patient. Marrow necrosis was found to involve the marrow at multiple sites in a piecemeal fashion with areas of necrotic marrow and structurally intact marrow adjacent to each other. Severe bone pain without roentgenographic abnormality was the major symptom in 85% of the patients. Marrow and fat emboli, hypercalcemia and peripheral blood cytopenias were identified as direct complications of marrow necrosis. The prognosis of patients with marrow necrosis secondary to neoplastic disease was found to be extremely poor with a median survival of less than one month. However, one patient responded to antineoplastic chemotherapy and showed healing of the bone marrow.

Adenocarcinoma↗

PubMed1970

Diabetic ketoacidosis. A review of cases at a university medical center.

Twenty-five cases of diabetic ketoacidosis were studied retrospectively with respect to clinical characteristics and results of therapy. In this series (as with all 88 patients admitted in the last five years with a diagnosis of diabetic ketoacidosis) there were no deaths. Infection was found to be the most common precipitating event, documented by physical findings and cultures in one-third of these cases. In about two-thirds of the cases, electrocardiograms which were read as abnormal on admission reverted to normal after therapy. In all patients serum potassium levels decreased from admission values; one patient became symptomatically hypokalemic. Low serum potassium levels on admission and early vigorous bicarbonate therapy are emphasized as major predisposing factors of symptomatic hypokalemia. None of the patients had overt hyperosmolar coma, lactic acidosis or cerebral edema during therapy.

Adolescent↗