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Articles 451 - 480 of 2152
Full-Text Articles in Medical Specialties
The Clinical Usefulness Of Measuring Apolipoproteins In Diabetic Patients: A Preliminary Report, J. David Fachnie, Janet Mcgill, Craig Foreback, Dorothy M. Kahkonen
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 …
Management Of Alcohol Withdrawal In The Critically Ill Patient: A Selected Review, Rebecca B. Kantz, H. Mathilda Horst
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.
Trauma In Pregnancy, Victor J. Sorensen, Brack A. Bivins, Farouck N. Obeid, H. Mathilda Horst
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 …
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
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 …
Pulmonary Microembolism In The Canine Model: Report Of A Pilot Study, Brack A. Bivins, Robert P. Rapp, Richard M. Bell
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 …
Mortality From Postoperative Myocardial Infarction In Nonthoracic Surgical Patients At A Community Hospital, Martha L. Gray, Randall S. Reimer, Michael D. Thompson
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 …
Nineteen-Year Radiographic Follow-Up Of Untreated Paget's Disease Of Bone, Christopher K. Shier, Burton I. Ellis, Gregory Tennyson, Michael Kleerekoper
Nineteen-Year Radiographic Follow-Up Of Untreated Paget's Disease Of Bone, Christopher K. Shier, Burton I. Ellis, Gregory Tennyson, Michael Kleerekoper
Henry Ford Hospital Medical Journal
Radiographic and histologic findings in Paget's disease of bone have been previously well described, and characteristic features of each stage have been determined. Long-term radiographic follow-up of untreated patients is rarely reported. We had the opportunity to observe the radiographic evolution of untreated Paget's disease of the tibia. Sequential radiographic studies spanning a 19-year period have allowed us the opportunity to study the natural course of this disease.
Endodermal Sinus Tumor In A 14-Year-Old Girl, Lorenzo C. Boyce, Kiran Balchandani, Roshinder Padda
Endodermal Sinus Tumor In A 14-Year-Old Girl, Lorenzo C. Boyce, Kiran Balchandani, Roshinder Padda
Henry Ford Hospital Medical Journal
A case report on a 14-year-old girl with a large pelvic and abdominal mass is presented. Initial evaluation suggested the mass to be of ovarian origin, and the diagnosis of endodermal sinus tumor was confirmed by the pathological specimen. Alpha fetoprotein (AFP) levels on admission were 12,700 mg/dL. but AFP decreased immediately in the postoperative period and has continued to decline toward normal levels over the past four months of combination chemotherapy. After completion of chemotherapy, AFP levels will continue to be monitored and a second-look procedure may be in order.
Injection Sclerotherapy Of Bleeding Esophageal Varices: The Henry Ford Hospital Experience, Stephen R. Verbeck, Martin C. Zonca, Dominic K. H. Wong
Injection Sclerotherapy Of Bleeding Esophageal Varices: The Henry Ford Hospital Experience, Stephen R. Verbeck, Martin C. Zonca, Dominic K. H. Wong
Henry Ford Hospital Medical Journal
An update is provided of our ongoing sclerotherapy experience at Henry Ford Hospital, based on 47 patients who have undergone this procedure. One-month mortality rates for Child's classes C, B, and A were 50%, 22%, and 0%, respectively. Follow-up after one month revealed ten additional mortalities, but none were secondary to esophageal variceal hemorrhage. Strictures secondary to sclerotherapy were amenable to dilation. We advocate sclerotherapy as the treatment of choice for esophageal variceal hemorrhage.
Chest Radiographs In Surgical Intensive Care Patients: A Valuable "Routine", H. Mathilda Horst, Brian Fagan, Gordon H. Beute
Chest Radiographs In Surgical Intensive Care Patients: A Valuable "Routine", H. Mathilda Horst, Brian Fagan, Gordon H. Beute
Henry Ford Hospital Medical Journal
A total of 411 "routine" chest films were evaluated to determine their clinical value for surgical intensive care unit patients. There were 138 unexpected findings on 112 chest radiographs. These unexpected findings were equally divided between pulmonary problems (72) and device malposition (66). Of the unexpected findings, 30% were considered potentially life-threatening. On the basis of this study, we recommend "routine" chest films for monitoring in critically ill surgical intensive care patients.
Hemodynamic Response To Fluid Challenge: A Means Of Assessing Volume Status In The Critically Ill, H. Mathilda Horst, Farouck N. Obeid
Hemodynamic Response To Fluid Challenge: A Means Of Assessing Volume Status In The Critically Ill, H. Mathilda Horst, Farouck N. Obeid
Henry Ford Hospital Medical Journal
Cardiovascular and oxygen transport variables were studied during fluid challenges in 50 critically ill patients. The results show three distinct patterns of response: hypovolemic, normovolemic, and hypervolemic. Colloid fluid challenge is a rapid, effective diagnostic modality for determination of cardiovascular function in the surgical critical care patient.
The Failure Of Anthropometry As A Nutritional Assessment Tool, Judith J. Bencich, Diana L. Twyman, Ann Fierke
The Failure Of Anthropometry As A Nutritional Assessment Tool, Judith J. Bencich, Diana L. Twyman, Ann Fierke
Henry Ford Hospital Medical Journal
Anthropometric measurements are commonly used to assess body composition changes and adequacy of nutritional support in the hospitalized patient. To test their utility as nutritional assessment tools in the intensive care unit (ICU) patient, body weight, triceps skinfold (TSF), mid-arm muscle circumference (MAMC). and fluid balance and intake were collected on 21 critically ill patients during their ICU stay. Correlations were sought between adequacy of nutritional support and changes over time in weight. MAMC, fluid balance, and TSF. A significant change over time in mean body weight (p < 0.0001) was seen, reflecting a mean weight loss despite a positive cumulative fluid balance of almost 20 L by day 14 for all patients (p < 0.0001). There was a significant change over time in the mean fractional intake of required calories ranging from 41.7% on observation day 1 to a peak of 84.0% on day 22 (p < 0.001). TSF and MAMC could not be obtained on a large percentage of ICU patients due to severe edema including the mid-upper arm. Obtained measurements showed no change over the study period in TSF (p = 0.24) and MAMC (p = 0.71) despite significant changes in weight (p < 0.0001). caloric intake (p = 0.0001). and cumulative fluid balance (p = 0.0001). From these data it appears that anthropometric indices of TSF and MAMC are unrelated to nutritional intake and weight in ICU patients and are therefore not of use in the nutritional assessment of this population.
Evaluation Of The Economic Impact Of Pharmacist Involvement In Hyperalimentation Therapy, Larry Crots, Larry Shoup
Evaluation Of The Economic Impact Of Pharmacist Involvement In Hyperalimentation Therapy, Larry Crots, Larry Shoup
Henry Ford Hospital Medical Journal
A prospective parallel study of patients receiving total parenteral nutrition (TPN) was undertaken to identify characteristics of TPN solution use and waste. Thirty consecutive patients receiving TPN by order of the primary clinical service (control group) were compared with 25 consecutive patients receiving TPN under the supervision and monitoring of the Nutritional Support Service (study group). The patients were evenly divided between medical and surgical problems, with 53% of the control group being surgical patients compared to 56% of the study group. There were 136 L of TPN or 4.5 L/patient discarded in the control group compared to 65 L …
D-Penicillamine-Induced Polymyositis Occurring In Patients With Rheumatoid Arthritis: A Report Of Two Cases And Demonstration Of A Positive Lymphocyte Stimulation Test To D-Penicillamine, Takayuki Matsumura, Takamichi Yuhara, Kazuhide Yamane, Ichiro Kono, Teizo Kabashima, Heihachiro Kashiwagi
D-Penicillamine-Induced Polymyositis Occurring In Patients With Rheumatoid Arthritis: A Report Of Two Cases And Demonstration Of A Positive Lymphocyte Stimulation Test To D-Penicillamine, Takayuki Matsumura, Takamichi Yuhara, Kazuhide Yamane, Ichiro Kono, Teizo Kabashima, Heihachiro Kashiwagi
Henry Ford Hospital Medical Journal
Two patients with erosive, seropositive rheumatoid arthritis developed polymyositis during treatment with D-penicillamine. In both patients the HLA tissue typing revealed the presence of DR4. The myopathy improved promptly after withdrawal of D-penicillamine and institution of prednisolone therapy. In one patient, hypersensitivity to D-penicillamine was demonstrated by a lymphocyte stimulation test. This is the first case of D-penicillamine-induced polymyositis in which T-cell proliferative response to D-penicillamine was demonstrated in vitro.
Idiopathic Bilateral Chylothorax Presenting As A Left-Sided Neck Swelling, Larry B. Tankanow, Carlos Petrozzi, Joseph C. Ward, George C. Bower
Idiopathic Bilateral Chylothorax Presenting As A Left-Sided Neck Swelling, Larry B. Tankanow, Carlos Petrozzi, Joseph C. Ward, George C. Bower
Henry Ford Hospital Medical Journal
No abstract provided.
Joseph A. Johnston, Md: An Appreciation, Gordon Manson
Joseph A. Johnston, Md: An Appreciation, Gordon Manson
Henry Ford Hospital Medical Journal
EDITOR'S NOTE: Over the years many fine and distinguished physicians have helped make Henry Ford Hospital one of the leading medical institutions in Michigan and throughout the United States. With this issue we begin our tribute to those "pioneers" who have played an integral part in the history of Henry Ford Hospital. At the first meeting of the Henry Ford Hospital Joseph A. Johnston Pediatric Society, October 11. 1985. Dr Gordon Manson honored the late Dr Johnston. The following is Dr Manson's personal presentation and tribute to his long-time friend and colleague, Johnny Johnston.
Medical Challenges In Space, Boy Frame
Medical Challenges In Space, Boy Frame
Henry Ford Hospital Medical Journal
No abstract provided.
Imaging, Screening, Artificial Intelligence, And The Diagnostic Dilemma: An Epidemiologist's Response, John C. Lane
Imaging, Screening, Artificial Intelligence, And The Diagnostic Dilemma: An Epidemiologist's Response, John C. Lane
Henry Ford Hospital Medical Journal
Issues in imaging, screening, and information processing discussed in a special issue of this Journal (Henry Ford Hosp Med J 1985;33:65-148) have implications for the decision-making algorithms of all clinicians who use those imaging and screening techniques. Epidemiologic and psychological research show that clinicians, like other professionals, do not obey the laws of conditional probability in their judgments of risk or outcomes under uncertainty. Although physicians cannot be expected to make complex probabilistic calculations every time they receive the result of a screening test, teachers of medicine should present algorithms that would allow the physician-in-training to make efficient use of …
Interventional Neuroradiology: Henry Ford Hospital Experience With Nonembolization Procedures, Clifford R. Jack, Bharat A. Mehta, Roushdy S. Boulos, Suresh C. Patel, James I. Ausman, Ghaus M. Malik
Interventional Neuroradiology: Henry Ford Hospital Experience With Nonembolization Procedures, Clifford R. Jack, Bharat A. Mehta, Roushdy S. Boulos, Suresh C. Patel, James I. Ausman, Ghaus M. Malik
Henry Ford Hospital Medical Journal
Innovative technical developments over the past two decades have resulted in the development of a variety of useful interventional procedures for minimally invasive treatment of a variety of head and neck lesions. We have had experience with four different types of nonembolization interventional neuroradiologic procedures at Henry Ford Hospital from 1981 through 1985. Percutaneous transluminal angioplasty of six external carotid artery stenoses has been performed in five patients. Five were successful, and the artery became occluded in one patient. Intracarotid BCNU infusion was performed successfully in five patients with recurrent astrocytoma. Intraarterial streptokinase infusion was performed in one patient with …
Dnr — A God-Like Decision, Dwain Gade
Dnr — A God-Like Decision, Dwain Gade
Henry Ford Hospital Medical Journal
No abstract provided.
Recovery Following Acute Pontine Hemorrhage, Janice M. T. Redmond, B. K. Ahmad
Recovery Following Acute Pontine Hemorrhage, Janice M. T. Redmond, B. K. Ahmad
Henry Ford Hospital Medical Journal
Massive pontine hemorrhage does not always carry a fatal prognosis. A case report is presented in which many of the features usually associated with a fatal outcome were seen: severe disturbance of consciousness with early onset of coma, decerebrate posturing, systolic BP ranging from 200 mm Hg to 250 mm Hg, and hypopnea. Intensive supportive therapy was instituted during the critical phase, and the patient recovered. Electrophysiological studies helped to define the neurological deficit.
The Phenomenon Of Multiple Stretch Reflexes, Robert D. Teasdall
The Phenomenon Of Multiple Stretch Reflexes, Robert D. Teasdall
Henry Ford Hospital Medical Journal
Multiple stretch reflexes occur in muscles adjacent to or remote from the tap. The response may be ipsilateral or bilateral. These reflexes are encountered not only in normal subjects with brisk stretch reflexes but particularly in patients with lesions of the upper motor neuron. The concussion obtained by the blow is conducted along bone to muscle. Muscle spindles are stimulated, and in this manner independent stretch reflexes are produced in these muscles. This mechanism is responsible for the phenomenon of multiple stretch reflexes. The thorax and pelvis play important roles in the contralateral responses by transmitting these mechanical events across …
Nutritional Support Of The Brain Injured Patient: Five Years Of Clinical Study In Perspective, Diana L. Twyman, Brack A. Bivins
Nutritional Support Of The Brain Injured Patient: Five Years Of Clinical Study In Perspective, Diana L. Twyman, Brack A. Bivins
Henry Ford Hospital Medical Journal
No abstract provided.
High-Frequency Ventilation: Current Status, John Popovich Jr.
High-Frequency Ventilation: Current Status, John Popovich Jr.
Henry Ford Hospital Medical Journal
No abstract provided.
Muscle Pathology In Total Knee Replacement For Severe Osteoarthritis: A Histochemical And Morphometric Study, Mark A. Glasberg, Janet R. Glasberg, Richard E. Jones
Muscle Pathology In Total Knee Replacement For Severe Osteoarthritis: A Histochemical And Morphometric Study, Mark A. Glasberg, Janet R. Glasberg, Richard E. Jones
Henry Ford Hospital Medical Journal
We evaluated a series of 12 biopsies from 11 patients with total knee replacements for severe osteoarthritis. All 12 biopsies showed denervation atrophy, while five cases had significant myopathic changes. Morphometric studies indicated a positive atrophy factor (greater than 150) in the type I myofibers in seven cases, the IIA myofibers in nine cases, and the IIB myofibers in all 12 cases. Type I predominance occurred in six cases, IIA paucity in two cases, and IIB paucity in two cases. The results indicate that patients with severe osteoarthritis of the knee have both significant neuropathic and myopathic changes in quadriceps …
Catamenial Hemoptysis: A Case Report, Paul S. Harkaway, Michael S. Eichenhorn
Catamenial Hemoptysis: A Case Report, Paul S. Harkaway, Michael S. Eichenhorn
Henry Ford Hospital Medical Journal
A young woman presented with recurrent hemoptysis temporally associated with menstruation. Catamenial hemoptysis, an extremely uncommon disorder, is usually caused by the presence of ectopic endometrial tissue within the lung. The use of progesterone suppressed menstruation and hemoptysis during four months of treatment. Chest x-ray was normal.