The management of severe ulcerative colitis and Crohn's colitis remains a challenge, despite significant advances in medical and surgical therapy. Optimal management of the patient with severe colitis requires close collaboration between the gastroenterologist and surgeon. All patients with severe colitis should be hospitalized and treated with intravenous corticosteroids. If ...

Dementia is a progressive, degenerative disease of the brain that affects as many as 4 million Americans today. The risk of adverse events related to medical or surgical treatment is significant when even a mild cognitive impairment is not identified. An accurate diagnosis will facilitate a plan of care that ...

Surgical audit is imperative in modern practice, particularly in the developing world where resources are limited and efficient allocation important. The structure, process and outcome of surgical care can be determined for quality assurance or for research. Improved efficiency and reduction of morbidity and mortality are additional goals which may ...

One of the major disadvantages reported for the use of the S-ROM constrained total hip arthroplasty is the need for mandatory urgent revision surgery in cases of dislocation. In patients who are medically compromised and poor surgical candidates, this disadvantage presents a difficult management dilemma. To address this problem, we ...

The conceptual and computational structure of a performance assessment (PA) for the Waste Isolation Pilot Plant (WIPP) is described. Important parts of this structure are (1) maintenance of a separation between stochastic (i.e., aleatory) and subjective (i.e., epistemic) uncertainty, with stochastic uncertainty arising from the many possible disruptions that could ...

OBJECTIVE: We sought to determine the utility of routinely collected administrative data for risk adjustment for complications of hysterectomy. STUDY DESIGN: Using abstracted discharge data on 107, 648 women undergoing hysterectomy in North Carolina from 1988 through 1994, we constructed logistic regression models for the prediction of medical and surgical ...

A retrospective review was performed on 684 surgical procedures done aboard U.S. Atlantic Fleet ships during a 3-year period from 1994 to 1996. These procedures were compared with similar procedures performed at the Naval Medical Center in Portsmouth, Virginia. Morbidity and mortality rates were calculated and compared. A very low ...

Pneumomediastinum refers to the presence of free air in the mediastinum and is frequently associated with subcutaneous emphysema. It is known that a number of medical and surgical conditions may be complicated by pneumomediastinum. However, here we report the case of a young female in whom pneumomediastinum was the presenting ...

Over the past decade, management of Parkinson's disease has changed significantly due to the expansion of medical and surgical treatment modalities. Neurologists now have the ability (and the challenge) of choosing from multiple medications to devise an individual management strategy for each patient depending on his/her clinical symptoms and needs. ...

The doses of lidocaine used for lipoplasty often exceed what is commonly recommended for other surgical procedures. When using these high volumes of lidocaine and wetting solutions, a variety of safety issues must be considered. The author knows of no other plastic surgery operation in which the safety of the ...

Hazardous wastes, once generated, have to be stored, transported, treated, disposed off, recycled, depending upon the situation. With laws being tightened, all of the above operations have to be done safely without causing harm to people and environment. Before any operation is carried out, it is vital to know the ...

HYPOTHESIS: The aim of this study is to present the therapeutic methods and surgical techniques in diseases of the ear during Byzantine times (324-1453 A.D.). BACKGROUND/METHODS: The original Greek language texts of the Byzantine medical writers were studied to research early otologic knowledge of symptomatology, conservative treatments, and surgical confrontation ...

A randomized trial was conducted to evaluate the quality of four different brands of surgical gloves in terms of the perforation rate, ventilation, fitness, allergic reaction, elasticity, thickness, powder, and satisfaction. Gloves of four different manufactures which were used by various medical centres were distributed to participants according to a ...

A five-month-old English cocker spaniel with distichiasis had been treated four times surgically by a tarsomeibomian resection technique. As a result, three-quarters of the margins of its upper eyelids had been eliminated and the lower eyelids had become considerably thinner. The dog had developed upper entropion and upper eyelid trichiasis, ...

OBJECTIVE: To characterize clinical findings and compare effects of treatment and outcome for horses treated medically or surgically for impaction of the small colon. DESIGN: Retrospective study. ANIMALS: 84 horses with impaction of the small colon. PROCEDURE: Medical records were reviewed for history, physical examination findings, laboratory values, treatment, response ...

Dr. Archibald Edward Malloch was a surgeon whose life and work were greatly influenced by Joseph Lister and his revolutionary system of antiseptic surgery. This paper describes how a young Canadian medical man came to introduce Lister's system to North America in 1869 and studies his career in the light ...

PURPOSE: To review the current status and possible future of neuroleptanalgesia/anesthesia, techniques that may be nearly extinct. SOURCE: Articles from 1966 to present were obtained from the Current Science and Medline databases. Search terms include neurolepananalgesia/anesthesia, conscious sedation, droperidol, benzodiazepines, propofol, ketamine, and opioids. Information and abstracts obtained from meetings ...

Radiation, chemical and surgical synovectomy are therapeutic options in the treatment of chronic synovitis, but the evidence for their efficacy is limited. The aim of this survey was to compare the frequency of, and the factors affecting the use of, the three types of synovectomy in the last 2 years ...

This study examines the surgical operations in the ninth century treatise Synopsis of the Medical Art authored by Leon Iatrosophistes, with particular attention to the instruments required. It is argued here on the basis of this and other relevant Byzantine texts that the surgeons of the Middle and Late Byzantine ...

An international task force made up of a panel of 16 experts was mandated to review and objectively evaluate all aspects of chronic venous disease of the leg. All available publications on chronic venous disease of the leg from 1983 to 1997 were identified through computerized search. Three different screenings ...

Myomas (also called fibroids) are the most common solid pelvic tumors. Treatment options for myomas include medical and surgical management. The goals of medical management are to shrink the myoma and reduce its blood supply. Surgical interventions include therapies for women who wish to preserve fertility or retain their uterus. ...

In the context of medicine cutting is one of the most important operations. Many surgical tasks start with an incision, allowing the surgeon to access the region of interest, using either conventional or minimal invasive surgery techniques. The work presented herein should be seen in the context of surgical training ...

This second paper on medieval descriptions and doctrines of stroke reviews concepts outlined by famous Muslim physicians of the Middle Ages such as Rhazes, Haly Abbas, Avicenna, and Averroes. Contrary to a popular belief, Islamic neurological texts represent not only a bridge between ancient and western medieval medical knowledge, but ...

Male erectile dysfunction is common although some patients are embarrassed and delay seeking medical advice. Recent improvements in the understanding of the anatomy, physiology and pharmacotherapy of penile erections, and the introduction of intracavernosal pharmacotherapy has resolved most of the controversies regarding the aetiology of erectile dysfunction. Impotence is equally ...

According to the MDD (Medical Devices Directive) 93/42/EEC of 13 June 1993, medical products including gowns and drapes must provide a high level of protection for patients, users and others. The European Commission CEN/TC 205/WG 14, under the leadership of its convenor, Professor Werner, is developing a mandatory European standard ...

A wide variety of medications is commonly used following thoracic surgical procedures. All of these medications have associated side effects that may adversely affect the recovery of patients. A complete understanding of the important adverse effects of all the medications used postoperatively can limit or eliminate unwanted medication effects and ...

Echocardiography is routinely performed for the evaluation of valvular regurgitation. Different applications of Doppler echocardiography have been successfully applied to detect and quantify valvular regurgitation. Recent advances in color Doppler made possible the study of the dynamic behavior of the regurgitant orifice and, along with continuous wave Doppler, can provide ...

Arthur Purdy Stout (1885-1967) started his medical career as a surgical intern and house surgeon at institutions that were to join the Columbia-Presbyterian Medical Center. With virtualy no formal training in pathology and little supervision, he was given the opportunity to work in a laboratory of surgical pathology. He focused ...

PURPOSE: Procedures of Japanese urologists of interventional therapy for benign prostatic hyperplasia (BPH) should be defined for resource economy and policy establishment. MATERIALS AND METHODS: A questionnaire was mailed to the urology departments of 80 medical schools in Japan for clarification of surgical procedures presently in use for treating bladder ...

Chronic hypertrophic rhinitis is sometimes refractory to local, as well as general, medical treatment. Before undertaking surgical reduction of the inferior turbinates, there is indisputably a place for cauterization or laser vaporization of the inferior turbinate mucosa. The authors present a study of 46 patients treated by the holmium:YAG laser ...

The surgical attenuation of an intrahepatic portosystemic shunt in 45 dogs is described. Twenty-nine (64 per cent) had left divisional shunts consistent with a patent ductus venosus (PDV), 15 (33 per cent) had central divisional shunts and one had a right divisional shunt. In the dogs with a PDV, the ...

Pars plana vitrectomy is employed to treat cases of aqueous misdirection that are refractory to medical and laser treatment. The authors describe a 65-year-old man without previous aqueous misdirection in whom this condition developed after a procedure that included pars plana vitrectomy. The aqueous misdirection recurred despite multiple interventions, including ...

Medical thoracoscopy is an efficient technique to evaluate the gravity of a spontaneous pneumothorax in order to choose the most appropriate treatment. Classification of lesions into four types (from endoscopically normal lungs to large bullae) guides the choice from local talc pleurodesis to surgical bullectomy and pleurectomy. Most patients with ...

Patients with a variety of medical conditions known to increase cardiovascular risk may require noncardiac surgery. After a preoperative assessment of risk, specific attention to medical therapy may be indicated in the perioperative period. The perioperative period begins before surgery when routine medical therapy may be interrupted, and continues through ...

The viscosity of some routine hydrosoluble contrast media used in operational cholangiography (Bilignost and Verographin) was studied. The different viscosity of hepatic and vesical bile and of the contrast media was determined. This fact shows that the data of any direct cholangiography in accordance with the law of Hagen-Poiseuille is ...

The medical records of 39 horses treated for ulcerative keratomycosis over a 10 year period were reviewed. Records were evaluated to determine the medical and/or surgical treatment protocol, visual outcome, globe survival and whether the outcome was influenced by the fungal species isolated. Stromal abscesses and iris prolapses caused by ...

This article considers a number of key issues in the disposal of waste containing enhanced levels of naturally occurring radioactive material (NORM), including gaseous, liquid and solid media. A brief review is made of sources of natural radioactivity in the biosphere and of anthropogenic enhancement of the concentration of NORM ...

Considerable controversy has recently arisen regarding the patenting of medical and surgical processes in the United States. One such patent, viz. for a "chevron" incision used in ophthalmologic surgery, has especially occasioned heated response including a major, condemnatory ethics policy statement from the American Medical Association as well as federal ...

Patients who suffer from chronic rheumatologic diseases, such as rheumatoid arthritis, frequently require orthopedic surgical intervention during the course of their illness. This article provides the reader with an overview of approaches to postoperative risk stratification. Reviewed are the basic concepts that underlie perioperative medical management, including such issues as ...

STUDY OBJECTIVE: To assess the utilization of venous thromboembolism (VTE) prophylaxis in a medical-surgical ICU. DESIGN: Prospective cohort study. SETTING: A closed (mandatory critical care consult) medical-surgical ICU of a large community teaching hospital. INTERVENTIONS: The medical records of consecutive medical-surgical ICU admissions were evaluated by a single investigator during ...

Wood engraving as a medium of book illustration emerged at the end of the eighteenth century. In spite of its immediate technical and economic advantages to publishers of medical and surgical books, engraving on metal continued to dominate book illustration until the fourth decade of the nineteenth century. This study ...

PURPOSE: To determine if current telemedicine technology can support real-time telementoring to teach ophthalmologic surgical procedures in remote areas. METHOD: Using an integrated systems digital network (ISDN) line conveying information at a rate of 128 kbps, an endoscopic laser-assisted dacryocystorhinostomy (ELA-DCR) procedure was transmitted in real time from the Saint ...

A questionnaire concerning career progress was sent to 159 previous holders of temporary lecturer posts in anatomy (TLAs) at the University of Manchester (UK) between 1975 and 1992. Replies were received from 123 TLAs, of whom 90% were male and 71% had achieved Fellowship(s) of a Royal College of Surgeons. ...

Craniofacial dyskinesias encompass a variety of abnormal spontaneous craniofacial movements that often appear similar in morphology but are, in fact, of varied cause and nature. Although hemifacial spasm and blepharospasm are the two most common abnormal craniofacial movements, the clinician should be cognizant of other dyskinesias, particularly craniofacial dystonias, tremor, ...

Atrial fibrillation is the most common dysrhythmia encountered in clinical practice. A significant number of patients fail medical therapy because of inability to convert or control the rhythm pharmacologically, intolerance of the requisite medication, or persistent symptoms despite apparently satisfactory rate control. Based on experimental studies establishing the electrophysiologic basis ...

The treatment and favorable outcome of a bitch with uterine torsion and two retained fetuses are described. The condition was corrected surgically by ovariohysterectomy. Complications (i.e., septic shock, peritonitis, and hemostatic abnormalities) were managed with aggressive medical therapy. Torsion of the gravid uterus in dogs is a life-threatening condition which ...

Uncompensated vestibular disease is a serious, disabling disorder that substantially alters quality of life. Fortunately, most dizziness and vestibular disorders are managed conservatively or with medications and are self-limited. When medical management is unsuccessful, however, there is a wide array of surgical interventions that can significantly improve the symptoms. This ...

This article reviews selected medical and surgical advances that the authors view as important to improving the treatment of patients with epilepsy. This includes a review of six new antiepileptic drugs (fosphenytoin, felbamate, gabapentin, lamotrigine, toprimimate, and vigabatrin), recent studies of the surgical technique of Multiple Subpial Transections, and a ...

The case of a 57-yr-old man with a medical history of generalized atherosclerotic disease and newly diagnosed intestinal ischemia is presented. Because the patient was a poor surgical and anesthetic risk, medical treatment in the form of octreotide was administered with remarkable symptomatic relief. This is the first published report ...

Hippocrates, who is generally considered a focal point for the start of western medical tradition, left behind a corpus of medical writings that constituted the first recorded comprehensive health system. The pivotal point of the Hippocratic corpus was the Hippocratic Oath, which outlined the duties of healers of his school, ...