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Computerized tomography and radionuclide scanning in hepatic disease: a retrospective study.

This was a retrospective study of 117 patients, who had both computerized tomography (CT) and nuclear scans of the liver. In the evaluation of hepatic masses, the nuclear and CT scans, demonstrated 83% and 77% of the masses, respectively, in combination they demonstrated 97%. The nuclear scan proved to be a more sensitive procedure for demonstrating the presence of intrahepatic pathology. The CT scans were better able to demonstrate specific disease entities, such as biliary obstruction and fatty infiltration of the liver. CT was also able to evaluate adjacent organs. When used in combination, CT and nuclear scans tended to complement each other and in many cases were helpful in arriving at a more specific diagnosis.

Humans

Spectinomycin in the treatment of anal gonorrhea: a retrospective study.

The authors conducted a retrospective study of 125 male patients treated for anal gonorrhea with 4 g of spectinomycin in a social hygiene clinic. Of those treated, nine (7.2%) still had cultures positive for Neisseria gonorrhoeae when tested again five to 14 days after treatment.

Adult

Intensive care unit in the University Teaching Hospital, Lusaka. A retrospective study for the year 1975.

A retrospective study was made of cases admitted to intensive care unit at U.T.H. at Lusaka in 1975. Injury accounted for the majority of admissions and deaths. Head injury alone or in combination with other injuries was the commonest cause of admission and death. This study is hoped to help those who will work in the new intensive care unit and also to help those hoping to open similar units in Zambia.

Humans

Enteroliths in horses--a retrospective study of 30 cases.

In a retrospective study of selected cases, abdominal colic in 30 horses was attributed to enterolith obstructions of the large intestine. Obstructions caused by "true" enteroliths were confined to horses more than four years old. Prominent clinical features were recurrent mild abdominal pain, inappetance, gaseous distension and minimal intestinal motility. The various aspects of the clinical syndrome, including diagnostic problems and clinical management, are discussed. Most obstructing enteroliths were found near the beginning of the small colon and most horses contained only a single major concretion. Enteroliths were formed by mineral deposition in concentric layers about a central nidus of ingested material and were spherical or tetrahedral in shape. Intestinal concretions were found to consist primarily of ammonium magnesium phosphate.

Animals

[Histopathologic classification of malignant melanoma of the skin. Retrospective study of 149 cases].

In a retrospective study, the histological slides of 149 cutaneous melanomas are classified according to CLARK et al. (1969) into four levels of dermal invasion and three types of melanoma. Simultaneously, the depth measured in millimeters is added in a slightly modified version of BESLOW's method. This demonstrates the practicability of CLARK'S classification with only a few routine sections. The presumptions are (1) The tumor must be cut through its largest extension. (2) The bordering parts of the lesion in the epidermis must be examinable. (3) The specimen must be excised down to the subcutaneous fat. (4) Beside the Hämalaun-Eosin stains, a Van Gieson Elastica stain should be available to determine the level of invasion. Although it is easy to recognize level V, it is difficult to distinguish level II from III or III from IV in some cases. Our material, as compared to the literature, contained more nodular melanomas and lesions of levels IV and V. The reasons for this are discussed. The prognosis of nodular melanomas is worse than that of superficial spreading melanomas even when they are classified into the same level of invasion. A good correlation between the survival rate and the level of invasion is shown. In addition, the prognostic value of the histological staging can probably be optimized by measuring the vertical extent of the lesions in millimeters.

Humans

[The difficulty of choosing a good control group in a retrospective study (author's transl)].

The choice of either hospital or population controls in retrospective studies is guided by rules implying underlying hypotheses. In a study on aesophageal cancer in relation to alcohol and tobacco consumption, two such control groups were available and were compared. It was found that some of the currently accepted assumptions relating to representativeness of cases or controls were verified but many others were not, particularly in hospital controls. These were found to give less correct estimates of drinking and smoking habits than those obtained from population controls. The limitations in the use of either type of controls is discussed, in relation to the purpose of the study concerned.

Adult

[Retrospective study of 149 cases of hepatitis B virus infections. Study of markers and of evolution].

A retrospective study has been performed in 149 subjects with present or past HBs antigenemia. The group consisted of 8 asymptomatic carriers, 90 with acute hepatitis, 7 with fulminating hepatitis, 27 with chronic hepatitis, 16 with cirrhosis and 1 with hepatoma. The changes from one clinical condition to another, the sources of infection, the percentage of acute hepatitis in the history of chronic hepatitis cases and the working capacity an average of two years after the infection were studied. HBe antigen and the corresponding antibody were detected by immunodiffusion and the results compared with the clinical course.

Acute Disease

Non-suppurative otitis media in children. (A retrospective study of 100 cases).

This is a retrospective study of 100 cases of non-suppurative otitis media among children who presented to the E.N.T. Department at Poole General Hospital between 1975 and 1978. Their histories, investigations and management are reported, with special emphasis on the significance of surgical treatment, and its value in the prognosis of such cases.

Child

[Hormonal contraception and lipid metabolism. Prospective and retrospective studies of lipid metabolic parameters during the use of contraceptives].

Remarkable changes of several parameters of lipid metabolism were observed in a retrospective study of women, who had used different oral contraceptives for a longer time, in comparison with women without any hormonal contraception. In contrast, under the conditions of a prospective double-blind study no statistically significant alterations of the same parameters were seen under the use of two oral contraceptives different in dosage. Nevertheless, oral contraceptives should not be prescribed to patients with hyperlipidaemia.

Adult

[Farmer's lung disease in the Aveyron department (a retrospective study of 82 cases)].

The authors present a retrospective study of 82 cases of farmer's lung disease in the Aveyron department. Observations were selected on precise diagnostic criteria classified on acute (8 cases), progressive (69 cases) and chronic alveolitis (5 cases). They observe an almost exclusive repartition in the bovine breeding areas, which are regions of large hay culture and of high humidity. They show the annual repartition of cases is strongly linked to the pluviometry of the previous hay-making. They underline the fact that the modernising of agricultural work reduces some factors favourable to the disease but can promote new ones.

Acute Disease

Leber's congenital amaurosis. A retrospective study of 33 cases and a histopathological study of one case.

This report is a retrospective study of 33 patients seen over a 16-year period in whom a diagnosis of Leber's congenital amaurosis was made. The findings of an autosomal recessive heredity in 33%, connatal blindness (visual acuity less than 20/200) in 95%m nystagmus in 75%, and a markedly abnormal electroretinogram in 100% is in agreement with the findings of previously published large series. The difficulty in making the correct diagnosis initially was related to the wide variety of fundus findings and a high association (30%) of central nervous system disease. In the differential diagnosis of connatal blindness, only Leber's congenital amaurosis exhibits an absent or markedly diminished response on electroretinogram. The histopathologic findings in a 6-month-old infant with this disorder are compared with those of previously published reports.

Atrophy

[Reno-vascular hypertension: prognosis variations according to the method; surgery, or medical treatment. Retrospective study of 114 cases (author's transl)].

A retrospective study made of 114 cases of renovascular hypertension was undertaken to compare the effectiveness of different types of treatment. In this series, with a follow-up of 18 months to 9 years, a favourable result with regard to blood pressure was obtained in 45% of cases with surgery, in 63% of cases with medical treatment and in 88% of cases if treatment included beta-blockers. Medical treatment represents a valid alternative to surgery in hypertension of this type, regardless of the amount of renin secretion and whatever the criteria of ischaemia. The choice of surgery as a method of treatment thus depends above all upon the age of patient, the type of stenosis and the anatomical risk represented by the vascular malformation. Despite the very spectacular results of medical treatment, it remains essential to seek a renal cause for hypertension, since many renal conditions which require specific treatment present with hypertension alone.

Adrenergic beta-Antagonists

[Encephalitis and acute amnesic encephalopathies. Retrospective study of 16 cases (author's transl)].

A retrospective study was conducted on sixteen cases of encephalitis or acute amnesic encephalopathies, only one of which was confirmed by pathological examination, seen over the last fifteen years. The amnesic syndrome was always associated with a very marked anterograde deficiency and the absence of severe disturbances of other higher functions. Its onset was always acute, was secondary to disturbances of consciousness or associated with epilepsy, and in half of the cases presented as a severe infections disorder with high fever. The mood and behavioural disorders, and the temporal epilepsy, were evidenced clinically as a pure or predominant hippocampic lesion. The diversity of the progressive nature of the disorders, and the etiological environmental factors, enable divison into three groups : a group of six cases of postencephalitic Korsakoff's syndrome, probably of herpetic origin, and associated with a stable amnesic syndrome which remained as a sequela ; a group of 5 patients with non-herpetic but probable viral "curable amnesic encephalitis" ; another group of 5 patients with "acute amnesic encephalopathy" with various etiologies and with obvious encephalitic lesions.

Acute Disease

[Oral contraceptives and trisomy 21. A retrospective study of 730 cases (author's transl)].

A retrospective study of 730 cases of trisomy 21 and of 1 035 cases of abnormal children without a detectable chromosomal aberration, allows the study of the frequency of use of oral contraceptives by their mothers. The statistical analysis shows no notable differences for mothers 30 years old and younger. Among the mothers 30 to 38 years old, these is an excess of pill-taking by mothers of trisomy 21 children. For this second category of mothers (30 to 38 years) this excess is significant (a) when the delay between the cessation of pill-taking and the conception of the child is six months of less; (b) when the duration of pill-taking has been longer than one year; and (c), when those two factors are present simultaneously. Moreover, the frequency of males is significantly reduced in trisomy 21 children when their mothers have taken the pill. As a whole, for the subsample of mothers 30 and older, a correlation is observed between the three factors analysed, pill-taking, sex ratio, and trisomy 21. In view of the fact that decrease of the sex ratio and the increase of the frequency of trisomy 21 both are correlated with maternal aging in the general population, it seems remarkable that a correlation between these two variables and the use of oral contraceptives is observed only when the women had already passed the first of their reproduction period.

Adolescent

[Oral contraceptive and trisomy 21. A retrospective study of 730 cases (author's transl)].

A retrospective study of 730 cases of trisomy 21 and of 1 035 cases of abnormal children without a detectable chromosomal aberration, allows the study of the frequency of use of oral contraceptives by their mothers. The statistical analysis shows no notable differences for mothers 30 years old and younger. Among the mothers 30 to 38 years old, there is an excess of pill-taking by mothers of trisomy 21 children. For this second category of mothers (30 to 38 years) this excess is significant (a) when the delay between the cessation of pill-taking and the conception of the child is six months or less ; (b) when the duration of pill-taking has been longer than one year ; and (c), when those two factors are present simultaneously. Moreover, the frequency of males is significantly reduced in trisomy 21 children when their mother have taken the pill. As a whole, for the subsample of mothers 30 and older, a correlation is observed between the three factors analysed, pill-taking, sex ratio, and trisomy 21. In view of the fact that decrease of the sex ratio and the increase of the frequency of trisomy 21 both are correlated with maternal aging in the general population, it seems remarkable that a correlation between these two variables and the use of oral contraceptives is observed only when the women had already passed the first half of their reproduction period.

Abnormalities, Drug-Induced

Measles as a cause of fetal defects. A retrospective study of tem measles epidemics in Greenland.

In a retrospective study of ten epidemics of measles in virgin-soil populations in Greenland, 368 women were found to be pregnant at the time of their infection with measles. Information on the course of the pregnancies was obtained in 327 of these women and a clinical examination was made of 252 of their children. The risk of fetal death among women infected in the first trimester was found to be high. About half of 20 women infected during their first two months of pregnancy and a fifth of 31 women infected in the third month had abortions. 9% of 64 women infected in the first trimester and going to term had stillbirths. 28 women infected in the first two months of pregnancy had live children, but four of these had congenital malformations, three of extreme rarity and severity, leading to death. The rate of perinatal mortality and prematurity was equal among infants exposed to measles in the first, second and third trimester of fetal life.

Congenital Abnormalities