Anecdote and objectivity.
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Periodicals as Topic↗
Biomedical subjects
J Herman
Publications and source records attributed to J Herman.
In praise of audit.
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Drug Prescriptions↗
[Surgical treatment of patients with paraesophageal and mixed hiatal hernias].
In 1948-1990 the authors operated 112 patients with paraoesophageal and mixed hiatus hernias. 100 patients operated in 1988 were followed up on a long-term basis. Gastroesophageal reflux was recorded before operation in 52%, haemorrhage in 18%, an ulcer in the neck in 7% an incarceration and obstruction in 9%. Before the onset of the seventies hiatorrhaphy and gastropexy were performed. During check-up examinations in these patients relapses were recorded in 47%, reflux in 43%, subjective complaints in 26%. This made the authors change the surgical procedure and in subsequent years they performed hiatorrhaphy, fundoplication, fundophrenopexy and anterior gastropexy. The incidence of relapses of hernia during check-up examinations declined to 21%, of gastroesophageal reflux to 9% and subjective complaints to 10%. The follow-up period varied between 1 and 19 years. The surgical lethality was 2%.
Adult↗
[Surgical treatment of patients with paraesophageal and mixed hiatal hernias].
During the years from 1948-90, we operated on 112 patients with paraesophageal and mixed hiatal hernias. One hundred patients who had been operated on up to the year 1988 were followed up over a long period. Preoperatively gastroesophageal reflux occurred in 52%, hemorrhage in 18%, riding ulcer in 7%, and incarceration and obstruction in 9%. Up to the beginning of the seventies, hiatoraphy and gastropexy were carried out. In these patients, the checking showed the occurrence of the relapse of hernias in 47%, reflux in 43% and subjective complaints in 26%. This finding induced us to change the surgical procedure and, in the following years, we performed hiatoraphy, fundoplicatio, fundophrenopexy and anterior gastropexy. The checking showed a decrease in the occurrence of the relapse of hernias to 21%, gastroesophageal reflux to 9% and subjective complaints to 10%. The period of the follow-up ranged from 1 to 19 years. The operative letality was 3%.
Adolescent↗
[Long-term follow-up of patients surgically treated for para-esophageal and mixed hiatal hernias. Experiences with more than 100 surgical patients].
During the years from 1948-1990, we operated on 112 patients with paraesophageal and mixed hiatal hernias. One hundred patients who had been operated up to the year 1988 were followed up over a long period. Preoperatively, gastroesophageal reflux occurred in 52%, hemorrhage in 18%, riding ulcer in 7%, and incarceration and obstruction in 9%. Up to the beginning of the seventies, hiatoraphy and gastropexy were carried out. In these patients, the checking showed the occurrence of the relapse of hernias in 47%, reflux in 43% and subjective complaints in 26%. This finding induced us to change the surgical procedure and, in the following years, we performed hiatorhaphy, fundoplicato, fundophrenopexy and anterior gastropexy. The checking showed a decrease in the occurrence of the relapse of hernias to 21%, gastroesophageal reflux to 9% and subjective complaints to 10%. The period of the follow-up ranged from 1 to 19 years. The operative letality was 3%.
Adolescent↗
Outbreak of pertussis in a closed population with a high vaccination rate.
An outbreak of pertussis encompassing 78 cases in a population of 964 persons living on kibbutz is described. The attack rate was 36.1% among children aged 4 to 11 years, although all had been fully vaccinated. Female predominance and seasonal incidence conformed with what has been reported in the literature. The age distribution, however, was markedly different from that usually observed, indicating that local factors may influence the epidemiology of whooping cough. Despite the seeming paradox of the disease breaking out in a population with a high immunization rate, our results suggest that the vaccine had a protective effect in all age-groups. The incidence of pertussis in Israel in 1987 was considerably higher than that in the United States for the same year, and raises the question of changing the recommendations for vaccination here.
Adolescent↗
Eating strategies used by persons with head and neck cancer during and after radiotherapy.
This descriptive study identified the patient's perspective on eating problems during and after radiotherapy for head and neck cancer and pinpointed strategies used by patients to improve food intake during treatment. Eleven subjects were interviewed during a follow-up clinic appointment within 6 months of completion of radiotherapy and were asked to describe treatment problems and eating strategies. Open-ended interviews were tape-recorded and analyzed for recurring themes. A review of the medical records of each subject distinguished parameters of nutritional status during treatment. Eating strategies were clustered into three categories: food choice and preparation, attitude adoption, and acceptance of assistance. Subjects responded to treatment problems with specific eating strategies, implying relationships among treatment side effects, symptom management, and eating strategies.
Adaptation, Psychological↗
A platelet membrane glycoprotein (GP) deficiency in healthy blood donors: Naka- platelets lack detectable GPIV (CD36).
It has recently been shown that the Naka antigen, which is absent in 3% to 11% of Japanese blood donors, is expressed on platelet glycoprotein IV (GPIV; CD36) (Tomiyama et al, BLOOD, 75:684, 1990). In the present studies, flow cytometry was used to distinguish differences in the reactivity of Naka+ and Naka- platelets with both OKM5, a monoclonal antibody that recognizes an epitope on GPIV, and with polyclonal anti-GPIV antibody. OKM5 was also used to screen 871 platelet concentrates prepared from healthy US blood donors. Three of these showed markedly deficient binding of 125I-OKM5 or an incidence of 0.34%. Two of these donors were re-accessed and showed less than 1% binding of 125I-OKM5 as compared with 10,300 +/- 1,500 binding sites per platelet in controls (n = 4). Platelets from these two US donors were radiolabeled (125I, 3H) and compared with control platelets and with platelets from Japanese Naka+ and Naka- donors by crossed immunoelectrophoresis, protein blots, immunoprecipitation, and two-dimensional gel electrophoresis. GPIV could not be detected by any of these techniques in the Naka- platelets nor in the donors whose platelets showed deficient binding of OKM5. These results suggest that GPIV functions as an isoantigen rather than an alloantigen in immunizing Naka- platelet recipients. This is the first report of the absence of a major platelet membrane GP in healthy blood donors.
Antibodies, Monoclonal↗
Amebic liver abscess. An unusual presentation.
Amebic liver abscess responds readily to appropriate therapy, but diagnosis may be difficult. In the case described, the patient's signs and symptoms were atypical, suggesting a hematologic malignancy. The correct diagnosis was made only after ultrasound revealed a mass in the liver.
Adult↗
Adolescents' AIDS risk taking: a rational choice perspective.
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Acquired Immunodeficiency Syndrome↗
Intimations of uncertainty in the practice of medicine.
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Diagnosis↗
Influence of feeding on the bioavailability of ronidazole prolonged-release formulations in pigeons.
The influence of feeding on the bioavailability of ronidazole (5 mg per animal) formulated as a hydrophilic-matrix tablet or as lipophilic pellets, was evaluated in pigeons. Administered to fed pigeons, prolonged drug absorption was obtained for both formulations. In non-fed pigeons an immediate grinding of the formulations in the gizzard resulted in rapid drug absorption. This indicates that prolonged residence of the prolonged-release formulations in the crop obtained in the fed condition seemed the only possible means of obtaining prolonged drug release in pigeons.
Absorption↗
Collaboration to enhance research productivity: the Adjunct Nurse Researcher program.
The Adjunct Nurse Researcher program is a collaborative initiative that facilitates design, funding, implementation, and application of clinical nursing research. A mutually beneficial effort between a veterans administration hospital and a college of nursing, the program was developed in response to clinicians' desire for research consultation and academicians' commitment to conduct clinical studies. The collaborative research program supports nursing research and fosters its research utilization in clinical decision making. The Adjunct Nurse Researcher program has led to mutual respect between clinicians and academicians, modification in delivery of nursing services, and enriched patient care, education, and research environments.
Clinical Nursing Research↗
Elective mutism in family practice.
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Child↗
Slipping rib syndrome.
Slipping rib syndrome is a rare and underdiagnosed condition. Since approximately one third of the cases reported to date have involved patients considered to be psychoneurotic and/or who have undergone psychiatric evaluation, a conservative treatment approach is recommended. Many patients respond to simple reassurance, and in others, a single intercostal nerve block provides lasting relief. In the case reported here, radicular pain, a history of injury to the affected side, noncontributory findings on ancillary investigations, a positive response to the hooking maneuver, and relief of pain after intercostal nerve block led to the diagnosis.
Female↗