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PubMed2004

[Osmotic demyelination syndrome--can we avoid it?].

Osmotic demyelination syndrome is an iatrogenic disease related to inappropriately rapid correction of plasma osmolar disorders. The precise mechanism of injury is still unknown. Focal demyelination may appear in pontine (central pontine myelinosis, CPM) and extrapontine locations (extrapontine myelinosis, EPM), determining clinical manifestations of the disease. Modern techniques of radiological imaging like MRI play important role in demyelination syndrome diagnosis. The knowledge of conditions associated with an increased risk of osmotic demyelination syndrome and careful management of osmotic disturbances according to current standards may contribute to improved prognosis in this disease.

Demyelinating Diseases↗
PubMed2005

Androgenic-anabolic steroids abuse in males.

Androgenic-anabolic steroids (AAS) is an official definition for all male sex steroid hormones, their synthetic derivatives and their active metabolites. AAS are drugs with specific therapeutic indications, yet they are popularly known because of their worldwide non-therapeutic use in a large number of healthy individuals. Doping with AAS has become so widespread in athletics that it affects the outcome of sports contests. Furthermore, AAS non-therapeutic use is increasing particularly among adolescents and females, becoming one of the main causes of iatrogenic diseases due to drug abuse. All physicians must be aware about the large diffusion and side effects related to AAS non-therapeutic use, in order to discover clinical signs of AAS abuse and/or to start adequate preventive and/or therapeutic actions.

Adolescent↗
PubMed1989

[The effects of neuroleptics and social research in psychopharmacology.].

The use of neuroleptic drugs in psychiatry brought with it a wave of iatrogenic diseases and their socio-legal implications. These phenomena remain incompletely examined by the mental health professions. Social practitioners reflect in their professional literature a large ignorance of these problems. The author summarizes recent evidence on therapeutic and toxic effects of neuroleptics. Therapeutic effects are emphasized in the literature, so that toxic effects are still not well known. Ex-trapyramidal syndromes, in particular, remain poorly recognized and are often confused with psychiatric symptoms. The inability or refusal to perceive drug-induced problems from the perspective of the patient prolongs unecessary suffering. The author discusses some professional and political issues in the use of neuroleptics, and the need for a rational reexamination of the justifications for this use. Avenues for intervention as well as applied and fundamental research in social psychopharmacolo-ty are suggested.

English Abstract↗
PubMed2006

[The association between the medical arts of Japan, Korea, and Ming Dynasty China during Toyotomi Hideyoshi's War].

Traditional Korean medicine's pronounced impact on Japan came about as a result of Toyotomi Hideyoshi's war on Korea in the late 16th century. The influences of Korean medicine on Japan were caused by the introduction not only of a large number of medical books printed in the Yi dynasty and the techniques of publication but also those of the people of talent. We researched one doctor who came to Japan during the war of the Bunroku periods. The name of the doctor was Kintokuho. He learned medicine from a Chinese, Unkai(YunHai). He caused the iatrogenic diseases in the first year and so he changed his medical prescription to fit Japanese. After this, his treatment produced a curative effect. After his death, his art of medicine was passed on to his pupils.

China↗
PubMed1991

Sterilization and disinfection in the physician's office.

OBJECTIVE: To review the principles and practice of sterilization and disinfection of medical instruments in the office setting. DATA SOURCES: Searches of MEDLINE for articles published from 1980 to 1990 on disinfection, sterilization, cross infection, surgical instruments and iatrogenic disease, bibliographies, standard texts and reference material located in a central processing department. STUDY SELECTION: We reviewed surveys of decontamination practices in physicians' offices, reviews of current recommendations for office decontamination procedures, case reports of cross infection in offices and much of the standard reference material on decontamination theory and practice. DATA SYNTHESIS: There have been few surveys of physicians' decontamination practices and few case reports of cross infection. Office practitioners have little access to practical information on sterilization and disinfection. CONCLUSION: The increasing threat of cross infection from medical instruments calls for greater knowledge about decontamination. We have adapted material from various sources and offer a primer on the subject.

Cross Infection↗
PubMedDate not supplied

[Review of 15 cases of hypervitaminosis D].

In our experience, hypervitaminosis D, which at present should only be a historic remembrance in pediatrics, is still a frequent cause of hipercalcemia in childhood. It is easy understand that its appearance should turn out to be a complication in the treatment of hypoparathyroidisms or in vitamin D resistant rickets, but its persistance as a purely iatrogenic diseases is at present inexplicable. The frequency with which we have seen it has led us to review 15 cases where erroneous administration of high doses of vitamin D has resulted in serious clinical, biological and anatomical problems.

Child, Preschool↗
PubMed1990

A case of osteoporosis associated with adenosine deaminase deficiency.

The authors report a case of early and marked osteoporotic syndrome in a patient affected with adenosine-deaminase deficiency (ADA) of the heterozygotic type. The negative results obtained in all the tests carried out to ascertain any dysmetabolic, nutritional or iatrogenic disease, and the literature reporting homozygotic patients with osteometabolic and skeletal changes similar to those observed in this particular patient, led the authors to suggest a possible pathogenetic role in ADA deficiency. They conclude by describing the mechanisms by which this enzymatic defect could determine the clinical picture, and by presenting a possible type of treatment.

Adenosine Deaminase↗
PubMed1990

[One stage surgical treatment of complex urethral strictures with a pedicled skin graft. Report of 104 cases].

The technique of one stage operations using pedicled skin grafts represent an undeniable progress in the treatment of urethral strictures. The same operator in 1984-1990 performed 104 urethroplasties by using this technique. The proposed technique, originally inspired by Orandi and Blandy was performed as surgical treatment to all of the urethral strictures encountered most often, to broaden a stenosed urethra by the use of the pedicled skin graft as a patch, for other cases, by making a tubular graft meant to replace a segment of the urethra and for 2 extreme cases to replace pratically the entire damaged urethra. The urethral strictures were of different localisations: 19 were penien, 55 were bulbar perineal, 30 were bulbar membranous. The majority of the cases were qualified as "difficult and complex urethral strictures" due to: accompanying infections and iatrogenic diseases, 31 of them were fistular stenosis, 37 were multi-operated, half of the total number of the cases suffered upstream repercussions of the stenosis, and 17 cases had an associated pathology. The author used the pedicled skin graft as a patch to broaden the stenosed urethra on 91 patients, made a tubular graft to replace a segment of the urethra for 11 patients and for 2 extreme cases, to replace practically the entire urethra. Follow-up for half of the cases operated extended up to 2 years, the longest being up to 5 years, showed that 96% of the patients were satisfied. The criteria used for judging the quality of the results were clinical, radiographic and endoscopic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Vitamin E in neonatology.

It is difficult to maintain an objective attitude toward the use of vitamin E in neonatology. On the one hand, the desire to ameliorate iatrogenic diseases, such as BPD and ROP, makes one grasp hopefully at any theory or clinical trial that suggests a role for vitamin E in decreasing the handicaps that patients take with them from the intensive care nursery. On the other hand, when the question of toxicity arises, one tends to be negative, remembering the unfortunate experiences with oxygen, chloramphenicol, sulfisoxazole, and now, E-Ferol Aqueous Solution. We like to think that if this review had been written 2 years ago, our conclusions, based on the analysis of the data, would have been the same. But, probably, in the absence of data on the severe toxicity of one vitamin E preparation, we would have been more liberal in our recommendations for the use of vitamin E in neonatology. At this time, however, any use of supplemental vitamin E beyond the guidelines of the American Academy of Pediatrics cannot be recommended. Nor can the monitoring of blood Vitamin E levels be recommended as an assurance of nontoxic tissue concentrations in sick, premature infants. All physicians caring for premature infants are urged to review their nursery policies to make sure that excessive doses of vitamin E are not being administered. It is hoped that additional clinical trials will provide more definite answers to the questions about the efficacy of vitamin E in ROP and IVH.

Humans↗
PubMed1985

The surgical treatment of well-differentiated carcinoma of the thyroid.

Ninety-five surgically treated patients with well-differentiated carcinoma of the thyroid with an average of 11.2 years of follow-up were reviewed. Overall complications included 13% recurrence, 3% deaths due to thyroid cancer, 3% recurrent laryngeal nerve damage, and 2% hypoparathyroidism. Statistically significant prognostic findings included lower rates of recurrence and/or death among patients who were female, without lymph node involvement, or younger than 45. In comparison with total thyroidectomy, subtotal thyroidectomy was associated with markedly higher rates of recurrence and death among Stage II+ patients. No such difference appeared among Stage I patients. No statistically significant differences or meaningful trends could be found in the recurrence or death rates for age, sex, and lymph node status-matched patients treated with total versus subtotal thyroidectomy. These findings suggest the use of age, sex, and staging criteria to decide between subtotal and total thyroidectomy in patients with localized, well-differentiated thyroid cancer. More specifically, females younger than 45 with small tumors and no clinical evidence of nodal involvement or metastases can be treated using subtotal thyroidectomy with some confidence that undue recurrence or death due to cancer will not result. This selective use of subtotal thyroidectomy would avoid the complications of total thyroidectomy, namely, bilateral recurrent laryngeal nerve trauma and hypoparathyroidism, the latter being a particularly troublesome iatrogenic disease.

Adenocarcinoma↗
PubMedDate not supplied

Orthopedic problems in hemophilia.

Orthopedic management of the various complications resulting from musculo-skeletal bleeds in the hemophiliac, has now become standard and routine. However, the orthopedist should never minimize the threat of iatrogenic disease resulting from his surgery, or from the hemostatic control necessary for all operations. Operations should be properly indicated with standard and established techniques always being used. The development of antibodies, the risk of wound breakdown and secondary infection, and the need for further operative intervention, all create serious hazards to the hemophiliac patient. The orthopedist must be fully supported by a hematologist and laboratory back-up. Finally he should understand coagulation control and the necessity for its monitoring.

Adult↗
PubMed1974

Anesthesia mortality.

Since the first report in 1846 on the use of anesthesia for a surgical procedure, deaths have occurred with practically every agent and technique used. Those mishaps of which we are aware are probably just a small segment of those that have actually occurred, since presently there is no widely used method for identifying anesthesia-associated deaths. Several sources of information are available, including the United States National Center for Health Statistics and articles in the medical literature. Neither of these encompasses more than a fraction of the total experience; in addition, the population upon which most reports are based and the number of anesthesias involved are usually not available as a denominator in determining the incidence of mishaps and the magnitude of the problem. Extrapolating from data from community anesthesia study committees and from population and operative figures, we can estimate that there are over 5,000 deaths associated with anesthesia in this country each year. This is 3 times as many as are caused by muscular dystrophy and multiple sclerosis, 15 times as many as with sickle cell anemia, 20 times as many as with myasthenia gravis and 40 times as many with poliomyelitis. We thus must recognize that anesthesia is an iatrogenic disease that deserves serious attention as a public health problem.

Anesthesia↗