Abstract:
:Clinical features, findings of diagnostic studies, results of therapy, and prognostic factors were analyzed in 45 patients with brain abscesses. The number of patients diagnosed yearly has increased since CT scanning became available, but despite the enhanced sensitivity, the time from either onset of symptoms or hospital admission until initiation of therapy was not decreased and there was no dramatic effect upon morbidity or mortality in this series. Infections of paranasal sinuses, ears, lungs, and odontogenic foci were predisposing factors in approximately 70% of cases. Single abscesses, present in 75% of patients, were distributed equally in both hemispheres, with more than half in the frontal and parietal lobes. Common signs and symptoms included headache, fever, chills, seizures, nausea, vomiting, altered sensorium, nuchal rigidity, and localizing neurologic signs. Blood cultures were positive in 11%. Lumbar puncture rarely provided data from which a diagnosis could be established; CSF cultures were positive in only 7% of patients, and there was a 15% temporally associated incidence of brain herniation and death. Diagnostic information was most readily obtained using imaging techniques such as CT and 99mTc scanning, and arteriography was invasive and of no added value. CT scans are however, often initially negative in patients presenting with clinical signs of meningitis presumably following rupture of an abscess into the subarachnoid space, and the average time for changes to appear on CT scan is 9 days. It is, therefore, recommended that when the clinical assessment suggests the possibility of brain abscess the patient be treated empirically with antibiotics and that lumbar puncture be performed only after thoughtful assessment of the risk-to-benefit ratio for each patient. Causative organisms were isolated from more than 80% of abscesses despite prior antibiotic treatment; more than half grew a single pathogen, most commonly streptococci. Anaerobic and microaerophilic bacteria accounted for 62% of all isolates, and were the only organisms in 33% of patients. Computerized tomographic scans in 30 patients showed "ring-enhancing" lesions, nodular enhancement, or areas of low attenuation. Complete resolution of abscesses on CT scans rarely occurred during hospitalization and took as long as 5 months. Decrease in the size of abscesses on CT scan correlated well with clinical improvement and was seen within a week when abscesses were excised, but was often not obvious for 6 to 8 weeks if antibiotics were used alone.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Chun CH,Johnson JD,Hofstetter M,Raff MJsubject
Has Abstractpub_date
1986-11-01 00:00:00pages
415-31issue
6eissn
0025-7974issn
1536-5964journal_volume
65pub_type
杂志文章相关文献
MEDICINE文献大全abstract::Numerous studies have investigated the relationship between depression and temporomandibular disorders (TMD), but the conclusions remain vague. The aim of this study was to examine the causal effect between depression and TMD.The reporting of this study conforms to the STROBE statement. In this retrospective cohort st...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000004271
更新日期:2016-07-01 00:00:00
abstract::To characterize the current frequency of HIV-1 coreceptor usage in China and assess the candidacy of CCR5 antagonists for treatment of HIV infections. In addition, we aimed to evaluate the potential of X4/DM virus transmission in recently infected men who have sex with men (MSM) individuals.Viral tropism testing was p...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005017
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Urticaria is a common skin disease that has a high impact on a patient's daily life. Xiaofeng powder (XFP) is one of the most commonly used Chinese herbal formula in China for urticaria. However, due to the lack of systematic evaluations, its clinical efficacy remains controversial. This meta-analysis was pe...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000013039
更新日期:2018-11-01 00:00:00
abstract::The present study compared the efficacy of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and magnetic resonance elastography (MRE) in the estimation of hepatic fibrosis stages with histopathologic correlation.This retrospective study included 104 pa...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000008339
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:To find out whether the intramedullary fixations are superior to the extramedullary fixations in treating unstable femoral intertrochanteric fractures (UFIFs). METHODS:The meta-analysis of randomized controlled trials (RCTs) was conducted by searching the PubMed, Cochrane Library, and Embase databases to evalu...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000017010
更新日期:2019-09-01 00:00:00
abstract::Factors associated with the physician workload are scarcely reported. The study aims to investigate the associated factors of on-call physician workload based on a published conceptual framework.The study was conducted in a general internal medicine unit of National Taiwan University Hospital. On-call physician worklo...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000004719
更新日期:2016-08-01 00:00:00
abstract:RATIONALE:Sporotrichosis is a subacute or chronic infection caused by sporothrix schenckii complex. The misdiagnosis rate of sporotrichosis is very high. Fungal microscopic examination and timely culture help us make an accurate diagnosis and treatment. We observed that combined treatments are more effective than monot...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000017155
更新日期:2019-09-01 00:00:00
abstract::There is an increased interest in extending surgical criteria for pancreatic cancer by performing pancreaticoduodenectomy (PD) combined with portal vein (PV) or superior mesenteric vein (SMV) resection and reconstruction for borderline resectable patients. However, whether this procedure suitable for elderly patients ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000007335
更新日期:2017-07-01 00:00:00
abstract:RATIONALE:Contrast-induced encephalopathy (CIE) is a rare complication caused by administration of intravascular contrast media and characterized by acute reversible neurological disturbance. Most of the CIE cases are reported after arterial administration of contrast media such as during cerebral or coronary angiograp...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000024035
更新日期:2021-01-15 00:00:00
abstract::Previous studies have reported that uterine leiomyoma (UL) may share pathogenic features with obesity and hypertension, which are components of metabolic syndrome (MetS). We examined the association between UL and MetS in premenopausal parous women.This 1:1 case-control study was conducted on 615 asymptomatic women wi...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005325
更新日期:2016-11-01 00:00:00
abstract:RATIONALE:The extent of protective effects of hemophilia against thrombotic events such as myocardial infarction (MI) and other acute coronary syndromes remains to be determined, as major risk factors for cardiovascular disease exist despite factor VIII (FVIII) deficiency. We present a case report of a 41-year-old male...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000009075
更新日期:2017-12-01 00:00:00
abstract:RATIONALE:Pulmonary sequestration (PS) presenting with elevated serum tumor markers is rare, and it might be misdiagnosed as malignancy. PATIENT CONCERNS:A 26-year-old asymptomatic male patient was admitted because the x-ray showed an intrathoracic lesion. Meanwhile, the serum neuron-specific enolase (NSE) was elevate...
journal_title:Medicine
pub_type: 杂志文章,评审
doi:10.1097/MD.0000000000022574
更新日期:2020-10-02 00:00:00
abstract:BACKGROUND:Bibliometric analysis is an approach to evaluate the circumstances and trends in specific research field over time and to provide inspiration in future research and policy. Researches have a tremendous increase focus on the role of the microbiota in the development of diabetes in recent years; however, there...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000007338
更新日期:2017-09-01 00:00:00
abstract::Idiopathic chronic eosinophilic pneumonia (CEP) is a rare disorder of unknown cause with nonspecific respiratory and systemic symptoms but rather characteristic peripheral alveolar infiltrates on imaging, developing mainly in women and in atopic subjects. The disorder is highly responsive to oral corticosteroid therap...
journal_title:Medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00005792-199809000-00001
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Benign prostatic hyperplasia (BPH) is a medical condition that affects the quality of life by causing lower urinary tract symptoms (LUTS) in 40% to 70% of men aged ≥60 years. Medication treatment is primarily recommended for patients with BPH if their symptom score based on the International Prostate Symptom...
journal_title:Medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/MD.0000000000019678
更新日期:2020-04-01 00:00:00
abstract::The objective of this study was to assess whether preoperative breast magnetic resonance imaging (MRI) combined with conventional breast imaging techniques decreases the rates of margin involvement and reexcision.Data on patients who underwent surgery for primary operable breast cancer were obtained from the Changhua ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000003810
更新日期:2016-05-01 00:00:00
abstract::The purpose of this study is to confirm and complement previous data regarding an association between gastroesophageal reflux disease and appendectomy.The Korean National Health Insurance Service-National Sample Cohort includes data from people ≥ 20 years old collected from 2002 to 2013. A total of 13,484 participants...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000013700
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Nutrients related to serum vitamin D level were previously shown to be significantly associated with the risk of many chronic diseases. This study aimed to assess potential relationships between serum vitamin D level and otitis media (OM) risk. METHODS:PubMed, EMBASE, and Cochrane Library databases were sea...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000004739
更新日期:2016-10-01 00:00:00
abstract:RATIONALE:A first seizure can range from a fleeting subjective experience or a twitch (myoclonic jerk) through to a tonic-clonic convulsion. A first seizure occurred in a parturient during cesarean section is very rare. We describe the case of a parturient who suffered seizure when the fetus was delivered. PATIENT CON...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000013785
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Optic atrophy (OPA) is a very tricky disorder. Presently, no effective management is available for this condition. Previous studies have reported that acupuncture may be effective for the treatment of OPA. However, its effectiveness is still inconclusive. Thus, this study will aim to assess the effectiveness...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000016879
更新日期:2019-08-01 00:00:00
abstract:RATIONALE:Hemoptysis or hematemesis is a common clinical symptom in adults, but is unusually to be observed in children. Hemoptysis can occur with circulatory diseases, injuries, several types of systemic diseases, or systemic factors including factitious disorder (FD), which is difficult to be diagnosed. Here, we repo...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000014152
更新日期:2019-02-01 00:00:00
abstract:RATIONALE:Tracheobronchial injury from acid ingestion is a less reported clinical presentation than injury of the gastrointestinal tract, but it can occur due to direct exposure from acid aspiration and cause fatal complications. PATIENT CONCERNS:A 43-year-old man presented to the emergency department after ingesting ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000023586
更新日期:2020-12-11 00:00:00
abstract:BACKGROUND:As the general population continues to age, there is an increase need for surgical management of elderly patients. Compared to open hepatectomy (OH), laparoscopic hepatectomy (LH) offers earlier mobilization, less blood loss, and shorter postoperative hospital stay. However, whether these advantages of LH ov...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000011703
更新日期:2018-07-01 00:00:00
abstract::This study aimed to investigate the correlation of long noncoding RNA zinc finger antisense 1 (lncRNA ZFAS1) expression with disease risk, disease severity and inflammatory cytokines levels in lumbar disc degeneration (LDD) patients.83 LDD patients underwent surgery and 28 traumatized, non-LDD patients underwent lumba...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000018465
更新日期:2019-12-01 00:00:00
abstract:RATIONALE:The improvement of microneurosurgery and neuroimaging, as well as neuronavigation and neurophysiological monitoring, enables neurosurgeons to safely and accurately resect lesions on the brainstem. PATIENT CONCERNS:A 54-year-old man, with 2-year history of hypertension, presented with sudden loss of conscious...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000018430
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Male fertility has gradually become a worldwide problem. Because of the limitation of treatment, many drugs have been used for improving sperm quality. Among them, alpha-lipoic acid (ALA), as a treatment of diabetic neuropathy, has been applied to improve the quality of sperm in clinical practice, with satis...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000018453
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Glypican-3 (GPC3) has been widely recognized in the progression of liver tumors for several years. The relationship between overexpression of GPC3 and the poorer prognosis of patients with hepatocellular carcinoma (HCC) was performed by 2 meta-analyses. However, there were also some latest literatures that i...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000011130
更新日期:2018-06-01 00:00:00
abstract::The goal of this study was to evaluate the potential relationship among polymorphisms of aromatic hydrocarbon receptor, aromatic hydrocarbon receptor repressor, and rheumatoid arthritis (RA) susceptibility as well as the association among the polymorphisms of aromatic hydrocarbon receptor, aromatic hydrocarbon recepto...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000006392
更新日期:2017-04-01 00:00:00
abstract::Acute motor axonal neuropathy (AMAN) is a variant of Guillain-Barre syndrome. It has been reported to have no sensory symptoms and is diagnosed by typical electrophysiological findings of low-amplitude or unobtainable compound muscle action potentials with normal sensory nerve action potentials. However, the authors e...
journal_title:Medicine
pub_type: 杂志文章,评审
doi:10.1097/MD.0000000000000392
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Asthma is a common chronic disease with heavy burden. The number of asthma patients may continue to grow in the next 10 years. Existing conventional treatments have problems in which a small number of patients do not respond, often accompanied by side effects, or are too expensive. Probiotics, prebiotics, an...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000017840
更新日期:2019-11-01 00:00:00