[Lumbar hernia nuclei pulposi; should not always initially treated conservatively].
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Acute Disease↗
Biomedical subjects
R H Bartels
Publications and source records attributed to R H Bartels.
Acute pancreatitis due to sulfamethoxazole-trimethoprim.
We have reported a case of sulfonamide-induced acute pancreatitis. A review of the literature showed only eight previously reported cases. Adverse reactions to sulfonamides are well known, but acute pancreatitis is a very serious complication. If evidence of pancreatic involvement occurs during sulfonamide therapy, the medication should be discontinued immediately and, if necessary, be replaced by an alternative. Other causes of pancreatitis must be excluded.
Acute Disease↗
Spinal subdural abscess. Case report.
Only 44 cases of spinal subdural abscess have been reported to date. The authors present another case and review the relevant literature. The findings of intraspinal gassification on computerized tomography scans and Escherichia coli as the causative organism have not previously been described in relation to spinal subdural abscess. Most frequently, Staphylococcus aureus is the responsible organism. Hematogenous spread of infection from a distant source often takes place. In a surprising number of incidences, iatrogenic causes are the primary foci of spinal subdural abscess. Spinal subdural abscess is an unpredictable disease, with an unfavorable outcome if left untreated. If there is suspicion of a spinal subdural abscess, urgent radiological examination followed by immediate surgical drainage and appropriate antibiotic therapy is warranted.
Empyema, Subdural↗
Selection of regression models for health care data.
We discuss several linear and nonlinear regression models and their appropriateness in modeling a set of data from a cohort study of the use of medical services in a prepaid medical plan. Although computational considerations once forced researchers to use linear models almost exclusively, modern computer hardware and efficient algorithms have made it possible to use nonlinear models almost as easily as linear ones. Thus, in choosing a regression model, a researcher should give strong consideration to how well the model reflects (presumed) intrinsic properties of the phenomena under study, even if the consideration leads to the choice of a nonlinear model. Modern computer programs for nonlinear minimization should be employed to fit the model. The model should be judged on how well it describes the data and how reasonably it predicts the future.
Health Maintenance Organizations↗
Symptomatic vertebral hemangiomas.
Symptomatic vertebral hemangiomas are rare. Several therapeutic modalities for vertebral hemangiomas with neurologic deficit have been described. Personal experience with laminectomy followed by radiation therapy in four patients and radiation therapy in one patient is reported. Considering our results, literature and theoretical aspects a proposal for treatment of symptomatic vertebral hemangiomas is made.
Adult↗