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Articles 7651 - 7680 of 9413

Full-Text Articles in Medical Specialties

Small Cell Carcinoma Of The Lung In The Intensive Care Unit, Paul Harkaway, Cynthia Glines, Michael Eichenhorn, Paul Kvale, Robert Chapman, John Popovich Jr. Dec 1986

Small Cell Carcinoma Of The Lung In The Intensive Care Unit, Paul Harkaway, Cynthia Glines, Michael Eichenhorn, Paul Kvale, Robert Chapman, John Popovich Jr.

Henry Ford Hospital Medical Journal

The outcome of 29 patients with a diagnosis of small cell carcinoma of the lung admitted to the medical intensive care unit (MICU) from 1980 through 1984 was reviewed retrospectively. Respiratory failure was the most common admitting diagnosis (23 patients [80%]). followed by cardiopulmonary arrest (three patients [10%]), and hypotension (three patients [10%] ). Only five patients survived to leave the MICU, and only two of these patients lived longer than two months after MICU discharge. Of the features examined, the absence of sepsis was the only statistically significant predictor of MICU survival. Treatment of the malignancy did not appear …

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Robert K. Nixon, Md, Robert J. Priest Dec 1986

Robert K. Nixon, Md, Robert J. Priest

Henry Ford Hospital Medical Journal

No abstract provided.

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Back Matter Dec 1986

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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Barium Granuloma Mimicking Rectal Carcinoma, Freda L. Arlow, Diane M. D'Angelo Sep 1986

Barium Granuloma Mimicking Rectal Carcinoma, Freda L. Arlow, Diane M. D'Angelo

Henry Ford Hospital Medical Journal

No abstract provided.

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Front Matter Sep 1986

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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Restrictive Cardiomyopathy, Remigio Garcia, Mohsin Alam Sep 1986

Restrictive Cardiomyopathy, Remigio Garcia, Mohsin Alam

Henry Ford Hospital Medical Journal

Restrictive obliterative cardiomyopathy, with emphasis on amyloid infiltration of the heart, is discussed. The presence of right-sided failure associated with low-voltage electrocardiographic complexes may simulate constrictive pericarditis. Intractable congestive heart failure is the most frequent presentation of amyloid heart disease, and the average survival from diagnosis is 14 months. Digitalis sensitivity and fatal arrhythmias are notoriously common. Other important, although less common, restrictive cardiomyopathies include 1) hemochromatosis, which is the only reversible cause of heart failure in this group: and 2) endomyocardial fibrosis, which is rarely seen in temperate zones but which is amenable to surgical palliation. Many questions regarding …

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Potassium And Heart Failure, Howard S. Rosman, Mihai Gheorghiade, Sidney Goldstein Sep 1986

Potassium And Heart Failure, Howard S. Rosman, Mihai Gheorghiade, Sidney Goldstein

Henry Ford Hospital Medical Journal

No abstract provided.

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Beta-Adrenergic Blocking Agents In Congestive Heart Failure, Sidney Goldstein Sep 1986

Beta-Adrenergic Blocking Agents In Congestive Heart Failure, Sidney Goldstein

Henry Ford Hospital Medical Journal

Although recent physiologic studies suggest that increased catecholamine release in humans may in the long run represent an adverse homeostatic mechanism, this catecholamine release is acutely important in permitting human response to stress. Clinical interventions with beta-adrenergic blocking agents have showed a salutary effect on cardiac function in patients with severe heart failure: in patients with heart failure associated with myocardial infarction, these agents may help improve mortality rates. These studies indicate that the drugs are well tolerated when used carefully in these high-risk patients.

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New Positive Inotropic Agents, Syed M. Jafri, James A. Bristol Sep 1986

New Positive Inotropic Agents, Syed M. Jafri, James A. Bristol

Henry Ford Hospital Medical Journal

Current therapy for heart failure remains inadequate. New positive inotropic agents that augment myocardial contractility have been introduced. The positive inotropic effects of these nonglycoside, nonsympathomimetic agents are due, at least in part, to inhibition of cardiac phosphodiesterase activity and hence to an increase in myocardial cyclic AMP levels. These agents also have vasodilator properties through their effects on the enzyme phosphodiesterase in the vascular smooth muscle. Recent developments in the preclinical pharmacology, mechanism of action, and clinical experience with these new inotrope vasodilators are presented in this review. The role these drugs will play in revising our therapeutic strategy …

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Azathioprine-Lnduced Reversible Severe Dyserythropoiesis As A Cause Of Anemia, Sundara B. K. Raman, Joseph P. Abraham, Sheikh M. Saeed, Maria Sawdyk Sep 1986

Azathioprine-Lnduced Reversible Severe Dyserythropoiesis As A Cause Of Anemia, Sundara B. K. Raman, Joseph P. Abraham, Sheikh M. Saeed, Maria Sawdyk

Henry Ford Hospital Medical Journal

A 43-year-old woman with a 20-year history of systemic lupus erythematosus was treated with azathioprine for progressive complications of the disease. She developed pancytopenia within four weeks after starting azathioprine therapy. Bone marrow examination showed marked dyserythropoiesis and varying degrees of marrow hypoplasia. Changes seen in normoblasts consisted of nuclear buds, multinucleation, Howell-Jolly bodies, and abnormal mitoses. Azathioprine was discontinued. Peripheral blood counts improved in the next four weeks. A progress bone marrow examination six weeks later showed marked improvement in red blood cell abnormalities. An additional bone marrow examination performed four months after discontinuation of azathioprine showed complete disappearance …

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Bilateral Dislocation Of The Crystalline Lens In A Patient With Presumed Syphilitic Uveitis, Jeffrey S. Rapkin, David D. Bogorad Sep 1986

Bilateral Dislocation Of The Crystalline Lens In A Patient With Presumed Syphilitic Uveitis, Jeffrey S. Rapkin, David D. Bogorad

Henry Ford Hospital Medical Journal

Dislocation of the crystalline lens has been described in association with numerous systemic disorders and as a complication of ocular trauma. We present a case of bilateral lens dislocation in a patient with presumed syphilitic uveitis. The mechanism of lens dislocation is related to humoral and cellular effects of inflammation, although the role of trauma cannot be ignored. Persistent uveitis should be considered as a sign of active infection.

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Back Matter Sep 1986

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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Heart Failure: New Questions And Insights About An Old Foe, Jeffrey B. Lakier Sep 1986

Heart Failure: New Questions And Insights About An Old Foe, Jeffrey B. Lakier

Henry Ford Hospital Medical Journal

No abstract provided.

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Indications For Acute And Chronic Digitalis Administration In Heart Failure, Mihai Gheorghiade Sep 1986

Indications For Acute And Chronic Digitalis Administration In Heart Failure, Mihai Gheorghiade

Henry Ford Hospital Medical Journal

No abstract provided.

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Pathophysiology Of Heart Failure, Mihai Gheorghiade, Jeffrey B. Lakier Sep 1986

Pathophysiology Of Heart Failure, Mihai Gheorghiade, Jeffrey B. Lakier

Henry Ford Hospital Medical Journal

Heart failure occurs when the heart is unable to maintain a cardiac output sufficient to satisfy the oxygen requirements of the body despite adequate blood volume and hemoglobin content. Regardless of the initial cause of heart failure and in spite of compensatory mechanisms, patients often follow a course of worsening heart failure that is characterized by a low cardiac output, high filling pressures, and increased peripheral vascular resistance. In addition to persistence of the initiating event, cardiac deterioration may be caused or aggravated by a variety of factors including depletion of cardiac norepinephrine stores, down-regulation of myocardial beta-adrenergic receptors, microvascular …

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Altered Platelet Function In Patients With Severe Congestive Heart Failure, Syed M. Jafri, Jeanne M. Riddle, Sundara B. K. Raman, Sidney Goldstein Sep 1986

Altered Platelet Function In Patients With Severe Congestive Heart Failure, Syed M. Jafri, Jeanne M. Riddle, Sundara B. K. Raman, Sidney Goldstein

Henry Ford Hospital Medical Journal

Platelet function was assessed in 15 patients with severe congestive heart failure (CHF) and in 26 control subjects of similar ages. The platelet count (mm3), surface reactivity, aggregometry studies, release factors, and circulating aggregates were investigated. The mean number of circulating platelets was normal, but a hyperactive platelet response was found in 53% of the CHF patients. CHF patients had a 42% mean for the spread type platelet, and the average number of aggregates was 64: control subjects had a 12% mean for the spread type platelet, and the average number of aggregates was 40 (p < 0.05). Aggregation with all of the inducers was normal, although 27% of CHF patients showed spontaneous aggregation. The mean plasma levels of both platelet factor 4 and betathromboglobulin were abnormally elevated. No circulating platelet aggregates were detected. Our studies indicate that platelet function is abnormal in patients with CHF. The abnormal platelet reactivity found might contribute to the increased incidence of thromboembolic events observed in CHF patients.

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"Congestion": An Infrequent Feature In Patients With Chronic Heart Failure On Therapy, Syed M. Jafri, Jeffrey B. Lakier, Howard S. Rosman, Sidney Goldstein Sep 1986

"Congestion": An Infrequent Feature In Patients With Chronic Heart Failure On Therapy, Syed M. Jafri, Jeffrey B. Lakier, Howard S. Rosman, Sidney Goldstein

Henry Ford Hospital Medical Journal

The clinical presentation of chronic heart failure has changed with advances in therapy, and the physical findings of congestion are now inconsistently present. To determine the clinical signs of congestion, we studied the clinical findings of 44 patients who had chronic heart failure and abnormal left ventricular ejection fractions (23 ± 10%). Signs of pulmonary edema manifested as rales were absent in all patients in New York Heart Association (NYHA) classes I and II, in 66% of patients in NYHA class III, and in 14% of patients in NYHA class IV. Signs of right heart failure manifested as elevated jugular …

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Echocardiographic Evaluation Of Patients With Congestive Heart Failure, Mohsin Alam Sep 1986

Echocardiographic Evaluation Of Patients With Congestive Heart Failure, Mohsin Alam

Henry Ford Hospital Medical Journal

Echocardiography is a useful noninvasive test for evaluating patients with suspected heart failure and enlarged cardiac silhouette. This test can obtain the dimensions and wall thickness of all four cardiac chambers and can evaluate left ventricular function. The test results are reproducible, and in many instances the etiology of heart failure can be determined.

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The Effect Of Aortic Valve Replacement On Left Ventricular Function In Patients With Aortic Valvular Disease, Tennyson Lee, Cathy L. Glick, Jeffrey B. Lakier, Sidney Goldstein Sep 1986

The Effect Of Aortic Valve Replacement On Left Ventricular Function In Patients With Aortic Valvular Disease, Tennyson Lee, Cathy L. Glick, Jeffrey B. Lakier, Sidney Goldstein

Henry Ford Hospital Medical Journal

Despite improved surgical techniques and survival in patients following aortic valve replacement for aortic stenosis and aortic insufficiency, the proper timing for surgery remains controversial. The incomplete reversibility of left ventricular dysfunction remains a concern, and postoperative improvement of left ventricular function is not consistently demonstrated. We studied 11 patients with aortic stenosis and nine patients with aortic insufficiency using angiographic and radioisotope assessment of left ventricular function preoperatively. Postoperative left ventricular function was assessed over nine to 13 months by radioisotope multiple-gated acquisition (MUGA) scan. All patients with impaired left ventricular function preoperatively showed slow but significant recovery toward …

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Status Of Cardiac Transplantation With A Report Of The First Year's Experience At Henry Ford Hospital, Fraser M. Keith, Donald J. Magilligan Jr., Jeffrey B. Lakier, Conrad Drost Sep 1986

Status Of Cardiac Transplantation With A Report Of The First Year's Experience At Henry Ford Hospital, Fraser M. Keith, Donald J. Magilligan Jr., Jeffrey B. Lakier, Conrad Drost

Henry Ford Hospital Medical Journal

Cardiac transplantation is now widely accepted as effective treatment for selected patients with end-stage heart disease. Improvements in immunosuppressive treatment and monitoring in the past 15 years have resulted in impressive one-year and five-year survival rates of 80% and 60%. In general, survivors have enjoyed a considerably improved quality of life. A cardiac transplantation program was initiated at Henry Ford Hospital in 1985, and a total of 15 patients received heart transplants in the first 12 months. Fourteen patients are currently alive and well at various stages posttransplant. This early clinical success has prompted the consideration of both combined heart-lung …

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A Tribute To Dr. Szilagyi, Roger F. Smith Sep 1986

A Tribute To Dr. Szilagyi, Roger F. Smith

Henry Ford Hospital Medical Journal

No abstract provided.

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Gravid Uterine Rupture Following Cesarean Section And Intervening Vaginal Delivery, Anthony Udo-Inyang, Chang Lee, Elizabeth Evans Sep 1986

Gravid Uterine Rupture Following Cesarean Section And Intervening Vaginal Delivery, Anthony Udo-Inyang, Chang Lee, Elizabeth Evans

Henry Ford Hospital Medical Journal

No abstract provided.

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Critical Surgical Services And The Fragmented Patient, Brack A. Bivins Jun 1986

Critical Surgical Services And The Fragmented Patient, Brack A. Bivins

Henry Ford Hospital Medical Journal

No abstract provided.

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The Clinical Usefulness Of Measuring Apolipoproteins In Diabetic Patients: A Preliminary Report, J. David Fachnie, Janet Mcgill, Craig Foreback, Dorothy M. Kahkonen Jun 1986

The Clinical Usefulness Of Measuring Apolipoproteins In Diabetic Patients: A Preliminary Report, J. David Fachnie, Janet Mcgill, Craig Foreback, Dorothy M. Kahkonen

Henry Ford Hospital Medical Journal

A commercial assay for apolipoproteins A-1 and B as well as total cholesterol, triglyceride, and high-density lipoprotein (HDL) cholesterol was applied to 12-hour fasted serum from 24 insulin-dependent and 19 noninsulin-dependent diabetic persons. Women with noninsulin-dependent diabetes mellitus (NIDDM) had the highest levels of total cholesterol and apolipoprotein B. Apolipoprotein B values fell within the normal range in all patients except the NIDDM females, where four of the ten (40%) samples were elevated. When apolipoprotein B was elevated, total cholesterol was also elevated, over 220 mg/dL. Apolipoprotein A-1 values fell within or above the normal range in all subjects, and …

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Front Matter Jun 1986

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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Management Of Alcohol Withdrawal In The Critically Ill Patient: A Selected Review, Rebecca B. Kantz, H. Mathilda Horst Jun 1986

Management Of Alcohol Withdrawal In The Critically Ill Patient: A Selected Review, Rebecca B. Kantz, H. Mathilda Horst

Henry Ford Hospital Medical Journal

No abstract provided.

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Trauma In Pregnancy, Victor J. Sorensen, Brack A. Bivins, Farouck N. Obeid, H. Mathilda Horst Jun 1986

Trauma In Pregnancy, Victor J. Sorensen, Brack A. Bivins, Farouck N. Obeid, H. Mathilda Horst

Henry Ford Hospital Medical Journal

Management of 12 pregnant trauma patients is reviewed. These patients had injuries to the neck, chest, abdomen, and extremities. Six patients had penetrating wounds, and six others had blunt injuries. Eight of the 12 women required surgical intervention during their hospitalization. Liberal use of diagnostic procedures such as roentgenograms, diagnostic peritoneal lavage, and angiography aided in the evaluation of these patients. None of the 12 patients died, and only two developed major complications. One fetus died as a result of shock in the mother and only one major neonatal complication occurred. Rapid resuscitation combined with thorough diagnostic evaluation and early …

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The Safety And Efficacy Of A New Patient-Controlled Analgesia Device In Hospitalized Trauma And Surgery Patients, Terry J. Baumann, Luz Maria Gutschi, Brack A. Bivins Jun 1986

The Safety And Efficacy Of A New Patient-Controlled Analgesia Device In Hospitalized Trauma And Surgery Patients, Terry J. Baumann, Luz Maria Gutschi, Brack A. Bivins

Henry Ford Hospital Medical Journal

The objective of this investigation was to evaluate a new patient-controlled analgesia (PCA) device. Eighteen trauma and surgical patients were allowed to use a self-activated, intravenous infusion device for two to seven days for postoperative pain relief. Initial PCA dosage/interval settings were adjusted to provide a 0.5 to 1 mg dosage of morphine per injection with a six-minute lockout interval. Adjustments were made to these initial settings based on the individual patient's response. Pain and sedation scores and respiratory rates were recorded. Subjective evaluations of PCA indicated that 17 of the 18 patients (94.4%) participating in the study "preferred this …

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Pulmonary Microembolism In The Canine Model: Report Of A Pilot Study, Brack A. Bivins, Robert P. Rapp, Richard M. Bell Jun 1986

Pulmonary Microembolism In The Canine Model: Report Of A Pilot Study, Brack A. Bivins, Robert P. Rapp, Richard M. Bell

Henry Ford Hospital Medical Journal

Use of in-line final filters to prevent the infusion of foreign particulates has lowered the rates of postinfusion phlebitis in several controlled studies. The systemic effect of particulate infusion, however, has not been thoroughly studied. In this study, 12 mongrel dogs recovering from a right pneumonectomy were studied following infusion of various-sized particulates. Ten of the dogs were infused with either 10 or 40 million, 9 or 25 μm, latex particles. The remaining two dogs were control animals. Hemodynamic parameters were monitored in each animal. At death or 72 hours following particle injection, the left lung was examined grossly and …

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Mortality From Postoperative Myocardial Infarction In Nonthoracic Surgical Patients At A Community Hospital, Martha L. Gray, Randall S. Reimer, Michael D. Thompson Jun 1986

Mortality From Postoperative Myocardial Infarction In Nonthoracic Surgical Patients At A Community Hospital, Martha L. Gray, Randall S. Reimer, Michael D. Thompson

Henry Ford Hospital Medical Journal

In a 20-month prospective study, 35 patients with postoperative myocardial infarction were identified. All patients referred to cardiologists by nonthoracic surgeons were evaluated for evidence of postoperative myocardial infarction as defined by symptoms, electrocardiographic changes, and cardiac enzyme elevation. Ten of the 35 patients (29%) subsequently died, seven (20%) from the myocardial infarction. Twenty-five of the 35 patients (71%) had preexisting coronary artery disease. Reported experience with patient mortality following postoperative myocardial infarction varies from 28% to 69%. Our patient mortality rate at 29%, though still substantial, is lower than many current reports. Despite close perioperative surveillance of patients with …

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